How are you feeling? If you are reading this in the UK, that question is definitely worth pausing on.
New analysis this week reveals that more than five million of us are living with diabetes for the first time. That is just the latest in a line of frightening figures pointing to a sickening society.
Since the statistical fog of the pandemic started to clear, the official jobs numbers have stubbornly registered a huge growth in the group—currently an additional 400,000-plus people—who are “inactive” and not even searching for work because they are “long-term sick.”
The latest available data is suggestive of a drop in “healthy life expectancy” for men, and more especially in the expectation for “healthy disability-free” longevity for men and women alike.
Last month, the government actuary confirmed that the retirees of 2020 are now expected to die two years earlier than had been forecast just six years earlier. Looking further ahead, he relayed that the retirement millennials can look forward to in a few decades’ time is in parallel projected to be three years shorter.
Soothing notes?
Can any soothing notes be heard through this statistical funeral dirge? Well, some of the figures, such as on healthy life expectancy, may still be coloured by Covid. Strip out of the deaths directly attributable to it, and we might hope to see stagnating rather than declining longevity. But even in our heavily vaccinated present, over the year to date, total deaths in England and Wales are running 8 per cent up on the five-year average.
Britain might draw comfort of a sort in the fact that progress on life expectancy has also slowed somewhat in most other big countries in western Europe. Or indeed from the undoubted reality that the American big picture, recently brilliantly illuminated by John Burn-Murdoch of the Financial Times, is far worse. I turn my pen to singular epidemic of middle-aged deaths stalking the US in the next print edition of Prospect.
Over here, we don’t have a comparable epidemic of prescription opiates and don’t leave untold millions without any healthcare. But we do have quite a lot of the inequality that underlies the American catastrophe. Well before Covid hit, the lifespans of women specifically in England’s poorest communities was already recorded to be falling outright. Then the virus arrived, killing twice as many in the most-deprived as the least-deprived neighbourhoods, with most of the victims being men. Hence the latest official verdict we have is that “females and males living in the most deprived areas of England decrease in life expectancy between 2015 to 2017 and 2018 to 2020.”
Umbilical connection
To make sense of this sprawling but umbilical connections between deprivation, disease and death I can’t recommend anything better than the reportage of Dani Garavelli, who spent serious times in the Glasgow postcodes where people die earlier than anywhere else in Britain for Broke, the new collection I have edited for the Joseph Rowntree Foundation. After speaking to doctors, patients and the so-called “links workers”, who try to fill the many gaps between medicine and messy lives, she reflects:
“A life of poverty is a life spent firefighting. If you are well off, you are more likely to invest in your own wellbeing. You are more likely to eat good food, get fresh air and go to the gym. You will probably remember to make an appointment for cervical smears and breast screenings; and then you’ll remember to attend those appointments. But everyone’s financial and emotional resources are finite. If you’re always living on the edge, it can take so much energy to navigate your way from one crisis to the next, you have nothing left for self-care.”
To drill into how the same connection works in one particular context of rising importance, namely obesity, I spoke to the government’s sometime food guru, Henry Dimbleby. He has just co-written (with journalist Jemima Lewis) Ravenous, a hit book on the deadly consequences of the food system and rapidly widening waistlines.
He describes that new number of five million diabetics as both “the most shocking and the least surprising thing in the news”—shocking because of the pending price to be paid in terms of heart disease, amputations, and pressure on the health system, but unsurprising because of the way eating habits have been allowed to drift.
While much of the discussion around the new book has picked up on the sinister “nudges” that an amoral food industry subjects all of us to, Dimbleby tells me that every aspect of the problem is “weighted very strongly towards the poor.”
Why exactly? First, for psychological reasons: “Stress—eating sugary fatty foods is simply a relief” when material conditions make life a grind. Second, through much more practical channels: while “in theory it may be possible to cook well cheaply, it isn’t going to happen” when you can’t maintain a working car to get you to a decent supermarket, or when you can’t risk having to provide your kid with a second dinner after they refuse to eat something healthier but less familiar than a microwave meal.
So what needs to change? While regulatory tweaks and subsidised meals in the school holidays might “make a difference round the edges,” I am surprised by the extent to which Dimbleby the food specialist lands at exactly the same conclusion as Garavelli the all-purpose social affairs reporter: “Fundamentally, what needs to be fixed is society and inequality: not just the food system.”
The scale of what needs to be done is vast, and so too will be the price tag—at least until the public health benefits come through. It feels as unthinkable as it is unarguable under the current administration.
But what about under Labour? What worries me most about the ludicrous smear adverts on Rishi Sunak for being soft on paedophiles is not that it represents a step down the road towards the politics of QAnon, though that is obviously a worry. It is rather that the macho posturing on law and order will make extra prison places the top priority for social spending, at the very the same time as Keir Starmer’s “sound money” economic stance intensifies the effects of Britain’s (genuinely) battered public finances.
Society is sick. A politics defined by a clash of rival fears won’t nurse it back to health.
