Balancing HLE

Towards the end of April, the BBC reported on 2 somewhat contradictory reports within 5 days of each other. The second article (published on 27^th April) reported on the latest analysis by the Health Foundation that over the past decade, the healthy life expectancy (HLE) for both men and women has dropped by around 2 years.

The key takeaways are; the average HLE for both men and women is now 61 years, the UK is only 1 of 5 of the world’s wealthiest 21 countries to have seen such a fall and the UK’s fall was the second deepest out of these 5.

Unsurprisingly, poverty, poor housing and lifestyle were given as the reasons why, along with the covid pandemic. The Health Foundation (with some justification) has called this a watershed moment and has highlighted the economic impact (both in terms of GDP and NHS funding). Whilst the Health Foundation should be praised for the work undertaken, there is one aspect of the report which should come as no surprise; that people in the south of the UK have a higher HLE than people in the North.

I do not want to appear flippant, but anybody with even an inkling of medical, historical or geographical knowledge would know that this has always been the case, dating back to the birth of the Industrial Revolution. This is not to say that we should accept this or not look to change HLE in the more disadvantaged areas. To suggest this would be absurd. Rather, it is to highlight that such a finding really should not come as a surprise to anyone.

Both the thinktank’s analysis and the BBC’s reporting should be taken seriously and can lead to a stark improvement in the nation’s health.

Unfortunately, this is a minor contradiction of the first BBC report (published on 25^th April) which highlighted the potential benefits drinking beer can bring. According to a study conducted by the Journal of Agricultural and Food Chemistry in Germany, a beer “serving” might provide up to 15% of an adult’s required daily B6 vitamin intake, a vitamin which brings benefit to the brain, blood and the immune system.

No doubt the cynics amongst you would argue that this is only a minor contradiction and I am perhaps grasping at straws so I can fill another thinktank’s blog. However, consider something.

As important as the obvious physical aspects to a long HLE as reported by the Health Foundation are absolutely vital, it is important that we remember the mental aspect to HLE.

The majority of people who will enjoy a beer “serving” are not alcoholics, nor are they binge drinkers who are putting their future wellbeing in jeopardy by enjoying some alcoholic drinks with friends or unwinding at the weekend. However, it is easy to fall into the trap that any drinker of alcohol is adding to the lifestyle issues which are driving down the UK’s HLE.

As the isolation policies adopted during the covid pandemic demonstrated, daily social interaction helps contribute towards an individual’s psychological wellbeing, which in turn helps to mitigate neurological and mental ill health. I am sure that many of us know of at least one example amongst our friends and family of someone who has suffered from an earlier onset of dementia as result of having to remain isolated for months during covid.

What we should be looking for in a healthier HLE should also be more nuanced. The emerging emphasis on longevity within the private sector contains many principles which are more than transferable to the NHS. Prevent disease by encouraging the population to think about diet, sleep and stress reduction. Adopt some of the German principles of Achtsamkeit, i.e. mindfulness. For example, take an hour out and go for a walk when stressed. Take your problems with you and work out solutions. By the time you return to work, the problems are solved, productivity will have increased and you would have benefitted from an hour’s exercise.

This will require a change of mindset, and an hour’s walk is not a possibility for many workers. However, that is not to say that other principles cannot be easily adopted (such as departmentalising causes of stress and encouraging switch-off after work).

As I have argued before, private sector healthcare should not be seen as a threat to the NHS or purely exclusive for those who can afford. Innovation is born through private endeavour, not state-sponsored initiatives. How private healthcare is helping to improve HLE across the world should become an inspiration for policymakers in the UK. Why is poverty a cause of lower HLE? Is it purely down to financial considerations such as diet, lifestyle or access to the same standards of living as those not in poverty enjoy?

Indeed, as one recent report has demonstrated, the level of subsidy in the UK for those in poverty (or at least on benefits) is now so high for many aspects of life that it is now increasing the costs for everyone else, and is actually pricing these individuals out and therefore negatively impacting their wellbeing.

We could even be braver and dispel with such lazy phraseology as “poverty” as these are used more as an excuse and therefore a barrier to better wellbeing and rather concentrate on education and a more holistic approach to HLE in the 21^st century.