The Health Foundation has published a report on healthy life expectancy in the UK that deserves far more attention than it is likely to receive. That is unfortunate, because it says something profoundly important about the state of this country and the consequences of the economic choices that have been made within it.

Healthy life expectancy is a much better measure of national well-being than life expectancy alone. It does not simply ask how long we live. It asks how long we can expect to live in good health, and that distinction matters a great deal.

The report shows that over the period from 2012–14 to 2022–24, healthy life expectancy in the UK fell by a little over two years. It now stands at 60.7 years for men and 60.9 years for women.

That needs to be put into context. The state pension age is now 66, but is increasing over the next two years to 67, meaning that in most parts of the UK, people can now expect to spend some years in poor health before they even qualify for the pension they have been told to wait for their whole lives. And as the report makes clear, this is not a marginal issue. In more than 90 per cent of local authority areas, healthy life expectancy is now below state pension age. In more than one in ten areas, it is below 55.

The geographic inequality within these figures is striking. In the wealthy London suburb of Richmond upon Thames, healthy life expectancy is more than 69 years for men and more than 70 years for women. In northern coastal towns, Blackpool and Hartlepool, it is barely above 50.

That gap of around twenty years between the healthiest and least healthy places in England cannot be explained by individual choices. It is the consequence of structural inequality, and as the report makes clear, we should stop pretending otherwise.

Nor should anyone suggest that this is part of a wider global trend, as the report addresses that claim. Of twenty-one high-income countries reviewed, the UK was one of only five where healthy life expectancy fell between 2011 and 2021. Worse, it had the second-steepest decline of all.

As a result, the UK has fallen from 14th to 20th place in that league table of twenty-one states. Only the United States now performs worse, and that matters because it addresses the excuse that this decline was inevitable. It was not. Other countries faced the same pandemic pressures as the UK did, the same inflationary pressures in its aftermath, and many of the same demographic challenges that we do, yet most have managed to protect public health more effectively than the UK.

The question to ask then is, why is that the case? The answer is clear. People become ill earlier when they live in poor housing, face insecure employment, struggle with inadequate incomes, experience chronic stress, and lose access to public services that once sustained their communities. None of those factors has emerged by chance in the UK. They are the product of political decisions.

That is why this report is not really about the NHS, although many politicians will no doubt pretend otherwise. The report makes clear that overall life expectancy has remained broadly stable. People are not necessarily dying younger; they are instead becoming unwell earlier and living with poor health for longer, which to me is a critical issue. It matters because this tells us where the problem lies. That is in the conditions in which people live and work precisely because these issues now usually arise during those lives, and those conditions have steadily deteriorated over the past decade.

We have lived through austerity, stagnant wages, rising housing insecurity, weakened local government, cuts to public health budgets, and a deliberate assault on the social security system. There has been systematic destruction of the social safety net in the UK, and this is its consequence. At the same time, policymakers have repeatedly insisted that economic growth will solve our problems, and this data provides the evidence that this is not the case: if growth were the answer, this report would not exist.

What we have instead is an economy that too often extracts value from people whilst failing to provide the conditions in which they can live well. We measure success by GDP growth, whilst ignoring whether that measure checks whether people are healthy enough to enjoy their lives.

The consequences are not only personal, although those are severe enough. There are economic consequences as well. UK governments regularly complain about falling workforce participation and weak productivity in this country. Doing so, they appear strangely reluctant to acknowledge that millions of people cannot work because they are too ill. That fact has serious consequences: their personal and financial well-being is reduced before they ever have a chance to enjoy old age.

They also ignore the fact that poor health reduces tax revenues, increases demand for social security, raises pressure on the NHS and social care systems, and undermines economic resilience. In other words, neglecting public health is expensive.

This report also poses serious questions about pension policy. Governments continue to push people towards later retirement whilst ignoring the reality that many will not reach that point in good health. That approach looks increasingly detached from the realities of everyday life, assuming as it does that the physical and emotional resilience that many people no longer possess is not theirs to enjoy because the economy has steadily worn them down.

The real lesson in this report is clear. It is that health policy and economic policy cannot be separated. If we want a healthier population, we need better housing, greater income security, improved working conditions, stronger public services and reduced inequality. In other words, we need an economy designed to support human wellbeing. If people are becoming ill earlier in one of the wealthiest countries in the world, whilst most of our peers are avoiding this decline, then our current economic model is very clearly not working.

That is the issue this report exposes. The question is whether anyone in government is willing to admit that what we need is politics for people and of care. We are a long way from there at present.

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