Tag: life expectancy

How has Increased Life Expectancy Affected the Experience of Childhood…?

Life expectancy in England and Wales has risen dramatically over the last 100 years, increasing from around 55 in 1920 to 80 today for men and from 60 to 83 today for women. …

This means that children who grew up in the 1920s and 1930s would, on average, not have had the experience of being around many people over the age 60, whereas today, on average, children will experience the company of people aged 60-85 as ‘the norm’.

I am talking here of course just about ‘averages’ – experiences will vary from family to family.

For those parents who have children at a younger age, say in their 20s, their children stand much more chance of experiencing a four generation family, something which would have been almost unheard of in the 1920s.

However, three generation families would still have been common 100 years ago because people typically had babies much earlier, meaning children would still have experienced grandparents, but those grandparents would have been younger, in their 50s rather than in their 70s which would be the case in the typical three generation family today.

I think with the increase in family diversity, the increase in life expectancy would mean different experiences with grandparents for children depending on the type of family… for those parents who have children young then children are far more likely to experience grandparents in good health for their entire childhood and maybe only have to deal with their death as older teenagers, whereas experiencing the death of a grandparent during childhood would have been much more common 100 years ago.

HOWEVER, for those parents who have children later, in their 40s, probably dealing with the death of a grandparent would be more likely.

A possible negative affect of the ageing population on the experience of childhood is that parents who have to care for their ageing parents may not have as much time for their children, especially if end of life care is dragged out for several months or years as can be the case with degenerative diseases which are more common in old age.

The experience of childhood may also have been indirectly affected by wider social changes brought about by the ageing population – as society has refocussed its resources towards caring for the old (some might even say pandering to the old) there are relatively fewer resources left for children, so funding in education suffers as does Higher Education with students now having to pay for it themselves.

So as children get older they may start to feel like society is set up for the old and they get very little back in return – other than facing a life of working for 50 years as young adults in order to pay for the ever increasing ratio of old to young (the ‘dependency ratio’).

We kind of saw this with the Covid-19 pandemic – society was focused on protecting the very old while schools just closed – the children suffered for the sake of the old – the experience of childhood here was one of blocked opportunities and increased fear and uncertainty caused, effectively by the government’s choice to put the over 70s first – had the Pandemic happened in the 1920s when there were hardly any over 60s alive anyway society wouldn’t have had to shut down to protect them, because the risk of dying from covid for the under 60s was significantly lower.

Relevance to A-level sociology

This question cam up in the June 2022 families and households paper two exam.

This is a response I free wrote in around 15 minutes to give students some ideas about how they might have answered it. NB it’s not formatted like an answer to a 10 mark question should be, but there is enough information in here to top band I would have thought – there are certainly TWO ways fleshed out!

Life Expectancy in England is Stalling

Life expectancy has been steadily increasing since 1900, but this trend seems to be stalling, according to the recent Marmot Review of Health Equity.

You can clearly see the slow down in the increase in Life Expectancy for males and females in England in the two graphs below.

For both males and females the graph above shows a clear increasing trend from 2001 to around 2011, and then a much flatter trend from 2011 to 2017.

The above two graphs also highlight the clear correlation between deprivation and life expectancy, with the least deprived (or wealthiest) quintile of males and females enjoying around 6-8 more years of life than the most deprived (or poorest) quintile.

You can’t see it from the above graphs, but the poorest decile (the poorest tenth) of women actually experienced a slight decline in life expectancy in recent years. That is to say the very poorest women now die younger.

Declining healthy life expectancy

The report also highlights a small decline in healthy life expectancy, which I personally think is important to consider, given that it’s much more desirable to live a longer life in good health, compared to a longer life in poor health!

How do we explain the stalling of life expectancy?

The Marmot report says that an increase in deaths from winter illnesses such as flu in recent years can only explain about 20% of the decline in life expectancy.

The report also highlights funding cuts to health and social services as something which has ‘undermined the ability of local authorities to improve the social determinants of health’.

NB – note that the wording of the above is very careful, the report doesn’t say that funding cuts have caused a decrease in the rate of improvement of life expectancy, probably because the report doesn’t have sufficient data to infer a significant enough correlation between funding cuts and life expectancy trends.

So while the trends may be objective, we need to be careful about jumping to conclusions about why life expectancy is stalling!

One thing we can say is that inequality clearly hasn’t improved in the last 20 years, if we use differences as life expectancy as an indicator of this!

Relevance to A-level sociology

This is useful as an update to explaining trends in the death rate!

Why are Americans Dying Younger?

Life Expectancy in the U.S. has fallen for the last three years in a row, which is yet further supporting evidence that the United States might actually be a less developed country.

The decline is driven by the increasing death rates in young Americans, aged between 25 to 64, which the main causes of death being ‘deaths of despair’ – alcohol and drug related deaths, suicides, obesity and drugs linked to chronic stress.

Interestingly the high death rates cut across class, gender and ethnic lines, and all regions of the United States.

Why does America have such a high mid-life mortality rate?

America has one of the highest mid-life mortality rates of high income countries, despite spending more on heath care than most other countries.

The statistics tell a depressing tale – mortality from drug overdoses has increased by around 400% since the late 1990s and Obesity rates have increased dramatically too – men now way on average 30 pounds more than they did 50 years ago.

In short, the causes of high mid life mortality are that people are just making destructive life choices and choosing not to take care of themselves, with increasing numbers of people self-medicating with alcohol, drugs (both illegal and legal) and junk-food.

There are number of possible deeper economic and social explanations as to the increasing mid-life death rate in America – we could apply Strain Theory – it could be that the people making the above choices are experiencing a sense of ‘anomie’ – these are people just working to survive with no obvious chance of ‘succeeding’.

It could also be that America is one of the most unequal countries on earth – and while many struggle to survive, they see daily success stories on the media, which enhances the sense of relative deprivation and their own failure.

Or these people self-medicating may be successful in some ways – have successful careers, but they’ve sacrificed their families because of it, so these could be deaths due to to loneliness or social isolation.

Whatever the causes, I’m just glad I don’t live in the US!

Find out more:

If you want to find out more, read this November 2019 article from The Washington Post.

Finally, don’t forget the useful application of this material to the demography section of the families and household module!

What’s the most valid representation of trends in Life Expectancy?

Here’s a dual line chart showing trends in life expectancy for males and females in the UK from 1948 to 2016….

The above chart is only one way of visualizing this data, starting at zero. It gives the impression of a steadily increasing life expectancy for both sexes, with little difference between them.

 

Visualizing starting at age 64

However, if you cut off the bottom 60 odd years, you get the impression of a much faster increase in life expectancy and you also get the impression of a more rapidly closing gap between male and female life expectancy:

 

Same data, two different impressions…. the first ‘calm and steady’, the second ‘rapid and intense’ – it just goes to show how easy it is to ‘distort’ even ‘hard’ data in the visualisation/ representation phase!

 

Exploring Inequality in Life Expectancy in the United Kingdom

What are the causes and consequences of low life expectancy in the UK?

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.

The Human Development Index

The United Nations uses The Human Development Index (HDI) as a summary measure for assessing long-term progress in three basic dimensions of human development: a long and healthy life, access to knowledge and a decent standard of living. It provides a useful ‘snap-shot’ of a country’s economic and social development.

HDI Scores in 2020

Dark Green is high ranging through to dark red which is low….

Source

The Human Development Index

The Human Development Index measures Human Development using four indicators

  • To measure health – Life expectancy at birth
  • To measure education – the average (mean) number years of adult education adults over 25 have received and the number of expected years of education children attending school can expect
  • To measure standard of living – Gross National Income per capita (PPP)

Each country is then given a rank from between 0 and 1 based on how well it scores in relation to ‘constructed minimum’ and ‘observed maximum scores for each of these criteria. The minimum and maximum scores for each criteria are as below

 Minimum scores*Perceived maximums
Life expectancy at birth2083.2
Mean years of adult education adults over 25 have received013.2
number of years of education children attending school can expect020.6
Gross National Income per capita (PPP)163108, 211

(*This is the level below which the UN believes there is no prospect for human development!)

How does the HDI work out a country’s score? – it’s quite easy – if a country has a life expectancy of 83.2, and all the other maximums, it would score one, if it had a life expectancy of 20, and all the other minimums it would score zero. If it was half way between the minimum and maximum – it would score 0.5 – NB by the UK’s standards, this would be a pretty low level of human development!

The Human Development Index – Best and Worst Performers

Top

1 Norway0.954
2  Switzerland0.946
3 Ireland0.942
4 Germany0.939
4 Hong Kong0.939
6 Australia0.938
6 Iceland0.938
8 Sweden0.937
9 Singapore0.935
10 Netherlands0.933

Towards the Bottom 

179 Congo, Democratic Republic e0.459
180 Mozambique0.446
181 Sierra Leone0.438
182 Burkina Faso0.434
182 Eritrea0.434
184 Mali0.427
185 Burundi0.423
186 South Sudan0.413
187 Chad0.401
188 Central African Republic0.381
189 Niger0.377

What do the scores above mean?

  • If a country scores 1-0.788 it is classified as a ‘developed country’ with ‘high human development’ – as are 42 countries – most European countries come into this category. These are typically the countries with GNIs of $40K per capita or more, 13 full years of education and 80+ life expectancies.
  • If a country scores 0.48 or lower it is classified as having Low human development – e.g. Sierra Leonne – here you will see a GNI per capita of below $1000, 10 years or less of school and life expectancies in the 60s.

Advantages of the Human Development Index

  • It provides us with a much fuller picture of how well developed a country is, allowing for fuller comparisons to be made.
  • It shows us that while there is a general correlation between economic and social development, two countries with the same level of economic development may have different levels of social development. See below for examples.
  • Some argue that this is a more human centred approach, concerned more with actual human welfare than just mere economics. It gets more to ‘the point’ of economic development.

Two Limitations of the Human Development Index

  • Relying on the HDI score alone may disguise a lack of social development in a country – for example a very high GNI can compensate for poor life-expectancy, as is the case in the United States.
  • It is still only provides a fairly limited indication of social development – only health and education are covered – there are many other ways of measuring health and education.

Explaining the long term decrease in the death rate

economic growth, improved living standards, technological advances and improved public health all help explain the declining death rate.

The death rate is the number of deaths in relation to the number of people in a population. It is normally measured per hundred thousand or per thousand people.

The death rate is also known as the mortality rate.

The crude mortality (or death) rate in England and Wales was approximately 10/1000 in 2021. This has decreased significantly since 1840 when the death rate was approximately 23/1000.

What is the long term trend in the death rate?

graph showing decline in death rate England and Wales 1840 to 2020.
The long term decrease in the death rate, England and Wales, 1840 to 2020.
  • The death rate has halved in the last century, declining from 23/1000 in 1840 to 10/1000 today.
  • The death rate decreased most rapidly between 1840 and 1830.
  • Since 1930 the death rate has declined overall, but at a slower rate.
  • There were spikes in the death rate during WW1 and WW2 (not shown on the graph below). See the data source (1) for details.
  • The death rate has increased since 2010, when the Tory government came to power.

NB the Census cites the death rate per 100 000 of the population. To get the death rate per 1000 you simply divide the above figures by 100!

How did Coronavirus affect the death rate?

There were more deaths in England and Wales due to the Coronavirus Pandemic especially in 2020 and 2021 (2)

graph showing decrease in death rates for males and females, England and Wales.
  • The age standardised death rate for males increased from 1079 per thousand in 2019 to 1236 per thousand in 2020
  • The age standardised death rate for females increased from 798 per thousand in 2019 to 894 per thousand in 2020.

The death rates now seem to be coming back down to what they were before the Pandemic. The overall long term trend is towards a declining death rate, and this is what this post will focus on.

Why has the death rate declined?

There are three major reasons for the long term decline in the death rate:

  1. Economic growth and improved living standards resulting in declining infant mortality and increased life expectancy.
  2. Medical advances such as improved immunisation and better survival rates from ‘diseases of affluence’ such as heart disease.
  3. Social policies and improved public health. Such as the establishment of the NHS and pollution laws.

In the first part of the century, most of this decrease was due to fewer children dying of infectious diseases, later on in the century, the continued decline is due to people living longer into old age.

The major causes of death have changed: from mainly being due to preventable, infectious diseases in the early part of the century to ‘diseases of affluence’ such as heart disease and cancers today.

There are considerable variations in life expectancy by gender and social class – people in the poorest parts of Glasgow die before 60, in the wealthiest parts of the UK (e.g. Kensington) life expectancy is nearer 90.

Economic growth and improving living standards

There are number of ways in which this had led to a decline in the death rate:

  • better food and nutrition (which in turn is related to better transport networks and refrigeration) which has meant that children are better able to resist infectious diseases, reducing the infant and child mortality rates. This is estimated to account for 50% of the decline in the death rate.
  • Better quality housing – Better heating and less damp, means less illness.
    Smaller family sizes – as people get richer they have fewer children, which reduces the chances of disease transmission.
  • More income = more taxation which = more money for public health services.
  • Evaluation – It’s worth noting that not all people have benefited equally from the above advances. The wealthy today have longer life expectancy than the poor, who still suffer health problems related to poverty.
  • Evaluation – In terms of food and nutrition, obesity is now becoming a serious problem – more food doesn’t necessarily mean better nutrition.

Medical Advances

  • Mass immunisation programmes limited the spread of infectious diseases such as measles.
  • Important in improving survival rates from ‘diseases of affluence’ such as heart disease and cancers.
  • Only really significant since the 1950s.
  • Evaluation – It’s easy to fall into the trap into thinking that modern medicine is the most important factor in improving life expectancy, it isn’t – economic growth, rising living standards and improvements in public health are more important.

Social Policies

  • The setting up of the NHS.
  • Health and safety laws – which legislate so that we have clean drinking water, food hygiene standards and safe sewage and waste disposal.
  • The clean air act and other policies designed to reduce pollution.
  • Health and Safety laws at work.
  • Evaluation – These are largely taken for granted, but they are important!

Other factors

  • There is greater knowledge and concern about health today
  • The decline of manual work means work is less physical and exhausting and less dangerous.

Analysis points

Two important related trends are the declining in infant mortality and the increase in life expectancy.

Declining Infant Mortality

The decline in infant mortality has broadly mirrored the declining death rate:

graph showing decline in infant mortality rates England and Wales 1850 to 2020.

Increasing life Expectancy

Much of the decrease in the death rate has been due to increasing life expectancy.

graph showing increased life expectancy.

Life expectancy isn’t increasing as fast today as it did between 1840 and 1850. This partly explains why the death rate has remained at around 10/1000 for the last several decades. People simply aren’t living that much longer!

Conclusions

  • 3/4s of the decline between the 1850s and 1970 was due to the reduction of infectious (fairly easily preventable) diseases such as Cholera, and improved nutrition accounts for half of this reduction. In these early years
  • More recently, the decrease in the death rate has been due to improving survival rates from heart disease and cancers.
  • The declining death rate is not necessarily all good – in the last decades we have witnessed a declining death rate and a declining birth rate – and so we now have an ageing population, which requires society to adapt in order to meet the different demands of differently structured population.
Mind map showing why the death rate has declined.
Related Posts

This topic is part of the demography aspect of the families and household module within A-level sociology.

A closely related topic with some overlapping themes is Explaining changes to the Birth Rate

To return to the homepage – revisesociology.com

Sources

(1) Office for National Statistics (2021) Annual deaths and mortality rates, 1838 to 2020 (provisional).

(2) Office for National Statistics (2021) Deaths registered in England and Wales: 2021 (refreshed populations)