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Exploring Inequality in Life Expectancy in the United Kingdom

Get rich or Die Young (BBC, Panorama 2018) explores the causes and consequences of low life expectancy in Teeside, in the North East of the United Kingdom. It focuses on the experiences of three people who are living through three of the main causes of low life expectancy: smoking and poor diet, drug addiction and mental ill health.

The documentary is hosted by the ever-reliable Richard Bilton, who seems to be the BBC’s go-to guy for these social injustice documentaries.

Teeside has the largest life expectancy gap in the country. Those in poorest boroughs of the region have a life expectancy of just 67, the same as Ethiopia. Those living just a couple of miles away in the wealthiest boroughs live until 85, 4 years above the national average.

This means that the life expectancy gap between the poorest and richest boroughs in Teeside is 18 years.

The inequalities are literally written on the gravestones, where in some graveyards, 60 years seems like a ‘good innings’

low life expectancy UK.png

Richard Bilton points out early on that most babies in the U.K are born healthy, but a baby’s health is shaped by what comes next, and a crucial variable which influences health and life expectancy is wealth, or lack of it.

He also suggests more than once that leading an unhealthy life is not simply a matter of individuals making poor choices. Rather, being socialised into poverty restricts the kinds of choices people can make, and in extreme cases results in stress which seems to literally take 10 years off an individual’s life.

The first of the three emotionally charged case studies focuses on a 46-year-old male whose life is nearly over. He has fluid on the lungs, sciatica, and type 2 Diabetes, among other things, and is dependent on breathing apparatus.

get rich die young.png

There’s quite a lot of footage of his 4/5 kids musing about how he hasn’t got much time left…. And I guess that’s the ultimate negative consequence of his dying in his late 40s: a partner left to bring up 4 distraught kids on her own

His Illnesses are down to smoking and poor diet: people are four times more likely to smoke than those from wealthy areas.

The second case study focuses on a gran mother who is bringing up her daughters two children because she seems to be a hopeless crack addict. We see an interview with the drug-addict daughter who just appears to have given up the will to look after her kids. (Possibly because she knows her mother will do it?).

Drug deaths in Stockton have doubled in a decade and nationally they are substantially higher in the more deprived areas.

The grandmother attends a support group for grandparents who look after their grandkids because their children are drug addicts…. And we can see clearly how the stress she’s under is reducing her own life expectancy.

Finally, the documentary visits a middle-aged woman suffering from depression and anxiety who has made multiple (unsuccessful) suicide attempts. Suicides are twice as common in the poorest areas.

One of the problems here is that mental health services have been cut. There’s nowhere for her to go. If it were not for a voluntary support group, she’d probably be another early death statistic.

So how do we tackle low life expectancy? 

This is a very short section towards the end of the documentary which visits a school in a deprived area. The headmistress of the Carmel Education Trust thinks she can turn things around. She doesn’t believe the poor-health life path of those in poverty is fixed.

She believes that therapies help kids to better at school, and if they do better at school, they get better jobs, and that seems to be the key to a healthier life…

NB the documentary doesn’t actually go into any depth about what these ‘therapies’ are. This section is very much tagged on the end of the gawp-fest.

Final critical appraisal of the documentary

What I like about the documentary is that it’s rooted in what you might call micro-statistics. It ‘digs down’ into the sub-regional variations in life expectancy in Teeside. It even distinguishes between life expectancy and health life expectancy.

If You rely on the Office for National Statistics own accessible data on life expectancy, you don’t even see these variations!

However, the documentary spends too much time ‘gawping’ at the poor sick poor people rather than analysing the deeper structural causes of poverty related health problems.

There’s no real mention of the longer term historical downturn in the North East of the U.K. which highlights the high levels of unemployment, for example.

I’m also not entirely convinced by the (too brief) look at the solutions on offer. Therapeutic interventions in schools was offered up as the solution. Relying on the education sector yet again to sort out this social mess of extreme in equality in life expectancy just isn’t practical.

Having said that, if the mission of the documentary was to alter us to the extent of the problem and shock us, I think it did a reasonable job overall.

Possibly most shocking of all is that men in the poorest boroughs have a life expectancy of just 64: the average man doesn’t even make it to retirement age. And this isn’t the only region in the UK where this happens. In the very poorest regions, men work hard, pay their National Insurance, and get nothing back for it. There’s something not quite right about that!

Ultimately, I agree with the message the documentary puts out, even if it gets somewhat lost in the emotionalism of the three case studies: the reasons people die young are complex, but the most common reason is poverty – low income limits your choices. There is also no reason why anyone should be getting a chronic illness and dying in their 40s. All of the likely soon-to-be deaths in the documentary are entirely preventable!

Relevance to A-level sociology

This documentary offers some us some qualitative insights into the causes, but mainly the consequences of low life expectancy in the poorest regions of the United Kingdom and so should be relevant to the ‘ life expectancy and death rates‘ aspect of the families and households module.

It’s also quite a useful reminder of how we need qualitative data to give us the human story behind the statistics.

If you want to find out more about variations in life expectancy in the UK, you might like this interactive map as a starting point.

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Outline two consequences of the ageing population for British society

Consequence 1 – The ageing population may put a strain on public services

Increasing numbers of pensioners puts a strain on the NHS because pensioners use health services more than younger people

Furthermore, with increasing numbers of pensioners ‘sucking money’ out of the welfare state’ there is less left for everything else – services for the young are being cut to compensate

This is because healthy life expectancy is not keeping pace with life-expectancy, and there are increasing numbers of people in their 80s who spend several years with chronic physical conditions such as arthritis, and also dementia both of which require intensive social care.

While the ageing population presents problems, there are solutions – such as improving education about how to stay healthy in later life, changing ideas about working so that people are able to work for longer could be part of the solution.

Consequence 2 – The ageing population puts more of a burden on the younger generation

An ageing population means the dependency ratio has increased – there are fewer working aged people around to support pensioners. The next two generations are bearing a disproportionate cost of the current ageing population.

People in their 50s have become a ‘sandwich generation’ – they are now caught between having to provide care for their elderly parents, while still having their 20 something children living at home.

However, things are even worse for today’s teenagers – the retirement aged has now been pushed back to 68 – young people today are going to have to retire much later than their current grandparents.

While the ageing population presents problems, there are solutions – such as improving education about how to stay healthy in later life, changing ideas about working so that people are able to work for longer could be part of the solution.

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Demography – Families and Households Topic Overview

Topic 7: Demography

Demography refers to the study of the causes and consequences of changes to the size and structure of a society’s population. There are generally three things which can change the size and structure of a population – birth rates, death rates and migration, and these three things make up the three major sub-topics.

As with marriage and divorce, we break this down into discussing the reasons for the changes and then consider the consequences. A final additional topic here is migration patterns, which we deal with separately.

Subtopics

7.1: Reasons for changes to the Birth Rate

7.2: Reasons for changes to the Death Rate

7.3: The consequences of an Ageing Population

7.4: The reasons for and consequences of changes to patterns of Migration

Key concepts, research studies and case studies you should be able to apply

  • Birth rate

  • Death rate

  • Dependency Ratio

  • Total fertility rate

  • Infant Mortality Rate

  • Child Mortality Rate

  • Life Expectancy

  • Healthy Life Expectancy

  • Demographic Transition

  • Immigration

  • Emigration

  • Net Migration

  • Push Factors

  • Pull Factors

Possible exam style short answer questions

  • Suggest two reasons for the long term decline in birth rate (4)

  • Suggest changes in the role of women that may explain why they have fewer children (4)

  • Suggest three consequences of the decline in the birth rate (6)

  • Suggest three reasons for the long term decrease in the death rate (6)

  • Suggest three problems society may face as a result of an ageing population (6)

  • Suggest three ways in which the elderly might be represented in stereotypical ways (6)

  • Suggest three ways in which society might respond to the challenges of an ageing population (6)

  • Suggest three pull factors which might attract people to immigrate into a particular country (6)

  • Suggest two push factors which might explain patterns of migration (4)

  • Identify two changes in the patterns of child-bearing over the last thirty years (4)

Possible Essay Questions – You should plan these

  • Examine the reasons for, and the effects of, changes in family size over the past 100 years or so (24) (January 2012)

  • Using material from item B and elsewhere assess the view that an ageing Population creates problems for society (24) (June 2014)