One third of premature deaths linked to social inequality

Nearly 900,000 deaths in England could have been avoided in a more equal society, according to a UCL study of 2.5 million premature deaths over the last 16 years.

The study, published today in The Lancet Public Health, found that one in three deaths before the age of 75 are attributable to socio-economic and regional health inequalities.

Heart disease, lung cancer and lung diseases such as chronic bronchitis were the biggest problems, causing almost 400,000 excess deaths between them.

Lead author, Research Fellow, Dan Lewer (UCL Epidemiology & Health Care) said, "We have known for a long time that poverty and inequality have a major effect on people’s health and life expectancy. Our study shows how this translates into actual numbers of deaths. If everyone in England had the same mortality rate as people living in the best-off areas, there would have been 877,000 fewer premature deaths between 2003 and 2018. That’s one death every 10 minutes.

"When we look at the figures across the life-course, we show that there could have been 22,000 fewer deaths in children aged under 10 if everyone had the same life chances as the best-off. We hope our study brings home the reality of differences in life expectancy in this country."

The study also found that although inequality was greater among men, peaking in early childhood and between the ages of 40 and 49, the proportion of deaths attributable to inequality increased for women in particular.

Lewer added, "Although premature mortality reduced during the study period, the social inequalities persisted. Mortality rates for some diseases, including lung disease, actually increased among the most deprived women."

The researchers used data from the UK Office for National Statistics on all deaths between the ages of zero and 74 in England between 2003 and 2018. Mortality rates were calculated for 33,000 neighbourhoods, which were also graded in terms of levels of deprivation.

Northern towns and cities had the highest number of premature deaths associated with social inequality. In Manchester, Blackpool and Liverpool, there was more than double the number of premature deaths than in the best-off parts of the country. Cambridgeshire, Dorset and Hampshire had the lowest number of premature deaths.

The researchers say that the study can help inform allocation of public health resources as it breaks down the data by disease category and geographical area.

Lewer added, "These results show that social inequalities are linked to more than 50,000 early deaths in England each year. To address this, we will need policies that will reduce inequalities in income and wealth that underlie differences in life expectancy. It doesn’t help that 900 million has been cut from public health services that help smokers quit, treat alcohol and drug dependence and tackle obesity. The cuts have fallen disproportionately in areas where we found the most excess deaths."