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November 10, 2005




If you track back the mortality statistics to the 1850's you'll find that the impact of the NHS on longevity is pretty minimal.

By far the biggest factor in improving life expectancy was the massive programme of municipal public works in the late 19th & early 20th Century - improving the nation's health starts fundamentally with the basics of clean water, sewage treatment, slum clearances and the eradication of poverty-related diseases like cholera - not matters which are overly relevant in modern-day Britain but one's which remain of massive importance in international development.

Chris Brooke

Chris -- Bernard Crick, I think, suggested quite a few years ago that levelling life-expectancies upwards could plausibly be a central goal for socialists, and I've always thought there's something in that.

Unity -- I haven't seen figures on this kind of thing for ages, but I'd be surprised if crappy, overcrowded housing wasn't quite a significant factor behind inner-city life-expectancy being lower than elsewhere.

Phil Hunt

How much is this the fault of Glaswegians for their famously unhealthy diets?


Are these predictions for people born there recently or are they historical facts for people born there 70 or 80 years ago? If the latter, they are mere history and if the former, mere fantasy.


How much is this the fault of Glaswegians for their famously unhealthy diets?

Hey, it's not just the poor diet - it's our penchant for excessive drinking, smoking and class A drugs. There's definitely a few up here that could do with shooting - but that would just make the inequality figures worse, wouldn't it?


I don't think that most egalitarians expect to be able to eliminate all inequalities, just minimise them. In which case, is the gap between Ken/Chelseans and Glaswegians larger or smaller than it was 60 years ago?


On a serious note, there's two points: one is, as dearieme suggests, is that the death rates are taken from people born - not maybe as much as 70 years ago - but certainly 50.

The other is within Glasgow itself, the death rates can vary as much as 14 years.


plus there's the chibbings of young folks. Pulls the life expectancy down further.

James Hamilton

Even within K&C, you can actually see large health differentials between the poorer north of the borough and e.g. the area between Ken High Street and Earls Court.
The psychological effects of inequality - and concomitant physical effects - are there right enough, but bloody hard to explain. My personal suspicion is that this effect is worsening - that the psychological effects of inequality within a society that pays some lip service to equality may be greater than those within a society that accepts/approves of social division. Where people are supposedly more equal - but aren't - there's an additional dose of cognitive dissonance on top of the psychological effects of being low down on the tree, of being one of the "failures".
Having said that, politically I find the concept I've just referred to a pain - I can't see how you might go about making a difference (via equality of outcome, of course) without necessarily making things even worse (via increased unemployment and reduction in overall opportunities, personal freedoms, the erosion of psychologically-protective moral behaviour etc). Can't help feeling that this is one area where "you can't do both."

sean morris

Interesting, So Tory voters live longer, maybe thats why they are all old?

sean morris

Interesting, So Tory voters live longer, maybe thats why they are all old?

Owen Barder

This is embarrassing for egalitarians. ... We could equalize life expectancy between men in Glasgow and Chelsea by the simple expedient of shooting the latter.

But what if there were a policy option which would increase life expectancy in Glasgow and reduce it in K&C (eg by transferring some NHS resources from one to the other)? As a utilitarian with an egalitarian bias, I would do it - even knowing that this would result in shorter lives in K&C.

Furthermore, I would do it even if the gain in life expectancy in Glasgow would be somewhat smaller than the loss of life expectancy in K&C.

If pressed, my rationale would be diminishing marginal utility of life years: so transferring life years from those with more to those with fewer would increase aggregate utility.



Market solution: health isn't zero sum. Increase prosperity, and life expetecny for everyone rises. Tie behaviour to premiums and stop subsidising unhealthy lifestyles. We can all live longer, and not have to invoke policy intending to kill some people for the sake of extending the life expectancy of others.

That way, we can dismiss Owen's hideous suggestion for what it is: statist, static, class warfare.

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