Health inequalities in England worsening says Audit Office

The life expectancies of the richest and poorest people in England are getting further and further apart according to the National Audit Office (NAO).

Average life expectancy is now 77.9 years for men and 82 years for women but in poorer areas it falls to 75.8 and 80.4 years. Between 1995-97 and 2006-08, the life expectancy gap grew by 7% for men and 14% for women. The NAO concludes that 'the Department of Health has made a serious attempt to tackle health inequalities across England' but that a government target to reduce the difference in life expectancy by 10% between 2000 and 2010 is unlikely to be met.

Michael Marmot, whose recent report for the government Fair Society, Healthy Lives covered similar ground said he was not surprised by the findings since the persistent inequalities highlighted in his report remain. The MHF has since called for Marmot's report to be implemented.

The NAO report says the Department of Health’s strategy for reducing health inequalities, published in 2003, 'lacked effective mechanisms to achieve the target because the evidence base was still being developed. It was not until 2006-07 that the strategy was matched by focused action to tackle health inequalities, leaving little time for these actions to have an impact before the 2010 target date.'

Three key interventions

The report says that three 'key, cost-effective interventions to reduce the gap in life expectancy' were identified by the Department’s 2007 Health Inequalities Intervention Tool:

• to increase the prescribing of drugs to control blood pressure and drugs to reduce cholesterol by 40%; and
• to double the capacity of smoking cessation services.

But, says the report, 'these interventions have not yet been used on the scale required to close the gap and progress in improving the take-up of these interventions is not monitored.'

NAO chief Amyas Morse recommended: 'The Department should target its efforts on the most deprived areas of the country and develop costed proposals to maintain or increase investment in preventative interventions to tackle the conditions which lead to health inequalities.'