Healthy life expectancy in the UK: a turning point for health and inequality
The Health Foundation’s latest analysis, Healthy life expectancy trends in the UK: a watershed moment, sets out a concerning picture of how long people in the UK can expect to live in good health. Rather than simply focusing on how long people live, the report looks at how many of those years are spent in good health - free from long-term illness, disability, or conditions that limit day-to-day life.
This distinction matters. While life expectancy has generally increased over time, the report shows that improvements in healthy life expectancy have stalled and, in some cases, gone into reverse. In other words, people may be living longer, but they are not necessarily living better.
What the report tells us
A slowdown in progress and signs of decline
One of the most striking findings is that the long-term improvement in healthy life expectancy has largely stayed the same in recent years. For some groups and areas, particularly those facing higher levels of deprivation, it has actually declined.
This represents a significant shift from earlier decades, when steady improvements were being seen across the population. The report describes this as a “watershed moment” because it signals a break from the long-standing expectation that each generation would live healthier lives than the last.
Growing inequality between communities
The report highlights deep and persistent inequalities in health outcomes across the UK.
Where someone lives has a major impact on how many years they can expect to live in good health. People in more deprived areas not only live shorter lives overall, but also spend a larger proportion of those lives in poor health.
This gap is not small, it is substantial and, in many cases, widening. It reflects wider social and economic inequalities, including income, employment, housing quality, education, and access to services.
More years lived with ill health
Another key trend is the rising number of people living with long-term health conditions. These include physical conditions such as cardiovascular disease, respiratory illness, diabetes, and musculoskeletal problems, as well as mental health conditions.
The result is that more people are living longer, but with complex and ongoing health needs that affect independence, daily functioning, and quality of life.
This places increasing demand on both health services and social care, as more people require support over longer periods of time.
The role of wider determinants of health
A central message of the report is that these trends cannot be explained by healthcare alone.
Healthy life expectancy is shaped by a wide range of factors, often described as the “wider determinants of health,” including:
- Income and poverty
- Employment and job security
- Housing quality and overcrowding
- Education and early life experiences
- Local environment, including access to green space and transport
- Access to timely and appropriate health and care services
The report suggests that stagnation in healthy life expectancy reflects cumulative pressures across these areas over time, rather than a single cause.
COVID-19 and its lasting impact
The pandemic had a significant impact on population health, both directly and indirectly. While COVID-19 affected mortality and health outcomes in the short term, the report emphasises that the slowdown in healthy life expectancy began before the pandemic.
However, COVID-19 has likely intensified existing inequalities and added further pressure on already stretched health and social care systems.
Why this matters for health and social care
The implications of these trends are far-reaching. If people are spending more years in poor health, demand for services such as social care, community support, rehabilitation, and long-term condition management will continue to grow.
At the same time, services are being asked to support people with increasingly complex needs, often alongside wider challenges such as isolation, housing insecurity, and financial hardship.
This raises important questions about how services are designed, funded, and delivered and whether they are equipped to meet changing patterns of need.
What needs to change
The report points towards the need for a broader, prevention-focused approach. Improving healthy life expectancy is unlikely to be achieved through healthcare alone. Instead, it requires coordinated action across multiple areas, including:
- Reducing poverty and improving living standards
- Investing in prevention and early intervention
- Strengthening public health and community support
- Improving housing, education, and employment opportunities
- Tackling regional and local inequalities in outcomes
- Ensuring equitable access to health and social care services
What this means locally
For organisations like Healthwatch Cambridgeshire and Peterborough, these findings reinforce the importance of listening to lived experience.
Behind the national statistics are real people navigating everyday barriers to staying healthy and accessing support. Understanding those experiences, what helps, what doesn’t, and where gaps exist, is essential to improving services locally.
As the report makes clear, improving healthy life expectancy is not just a health system challenge. It is a societal one and one that requires people’s voices to be at the centre of change.
