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Gap in life expectancy in Wales increased before Covid-19

THE gap in life expectancy between the most and least deprived parts of Wales increased in the years leading up to the Covid-19 pandemic, according to new research.

A study by Cardiff University and Public Health Wales examined routine data on deaths in relation to age, gender and the Welsh deprivation index to explore trends between 2002 and 2018.

It found women in the most deprived parts of Wales had an overall life expectancy of 79 years, while this was 85 years for those in the least deprived areas – a gap of six years.

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For men, those in the most deprived areas had an overall life expectancy of 74 years. This figure was 81 years for those in the least deprived parts, a gap of seven years.

There was a “concerning” decrease in life expectancy for both men and women in the most disadvantaged areas in the years following austerity policies introduced in 2010, the study published in the journal Public Health found.

Dr Jonny Currie, a primary care and public health doctor who led the analysis, said: “The Covid-19 pandemic in Wales has highlighted significant historical inequalities in health between social groups – our study shows that even in the decade before Covid-19, the gap in life expectancy between the most and least deprived in our society was widening.

“Our analysis highlights crucial areas for action to consider as Wales recovers from the pandemic – both to build a fairer society for our population and one that is resilient to any future pandemics.”

The study found female life expectancy at birth in the most deprived areas rose by 1.2 years between 2002 to 2004, and 2016 to 2018.

However, in the least deprived areas the increase was 2.53 years.

Life expectancy for men in the most deprived areas rose 1.97 years, but increased by 3.02 years in the least deprived areas.

By 2018, women in the most disadvantaged areas lived on average 6.02 years less than in the least disadvantaged areas while men lived on average 7.42 years less.

For women, the gap in life expectancy was driven by deaths from respiratory disease, lung cancer, circulatory conditions, drug and alcohol-related deaths and other cancers.

In men, this was driven by deaths from respiratory conditions, digestive disease, drug and alcohol-related conditions, suicides and accidents, and circulatory conditions.

Despite the gap between different parts of Wales, overall life expectancy across the country rose between 2002 and 2018.

Dr Ciaran Humphreys, consultant in public health for the wider determinants of health at Public Health Wales, said: “Many conditions contribute to the gap in life expectancy between the least and most disadvantaged communities.

“This shows that we must look beyond simple medical explanations to the root causes and to the wider conditions in which people live.

“If we are to build back to a healthier, fairer Wales we need to rethink how we can improve health.

“A healthy future means addressing wider determinants of health such as income, education, housing and good work, particularly for those communities facing disadvantage, many of whom have been affected disproportionately by the Covid-19 pandemic.”

The analysis identified key areas where action could be taken, such as tackling smoking, more accessible drug and alcohol services, promoting healthy diet and physical activity, and improving access to health services.

It also suggests improvements to living conditions and air quality, as well as policies to prevent drug and alcohol misuse.

Dr Currie added: “Any post-Covid recovery must recognise the significant levels of inequality in Wales, including the risks from the virus itself, economic factors and other challenges like Brexit.

“As we recover from this unique period in our history there is a clear need to consider – and ultimately take action on – the underlying causes of health inequalities in Wales so we can work towards narrowing this gap.”

The researchers are now examining the role of frontline health services in addressing inequalities, and the contribution of factors such as smoking, alcohol, physical activity and obesity.

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