Inequalities in life expectancy

What are health inequalities?

Health inequalities are avoidable differences in health between different groups. One example is that life expectancy varies substantially between different parts of the UK.

What is healthy life expectancy?

Healthy life expectancy (HLE) is the average number of years that somebody can expect to live in good self-reported health.

HLE was 61.9 years for women in England and 61.5 years for men. In Wales HLE for men was 60.3 years and 59.6 for women.

The difference in HLE between the most and least deprived areas in England has grown by 22% between 2011 to 2013 and 2021 to 2023 for men (17.9 years) and by 17.1% for women (18.2 years).

Source: ONS, Life expectancy for local areas of Great Britain, 4 December 2024

Risk factors for healthy life expectancy

The biggest risk factor for avoidable mortality (deaths that are either preventable or treatable for those aged under 75 years) is tobacco, followed by high body mass index (BMI), high cholesterol and high blood pressure.

Like HLE, the prevalence of these risk factors is highly variable across areas in England. These risk factors are also strongly associated with socioeconomic determinants of health, such as income deprivation and education.

For a detailed discussion of risk factors and possible interventions, see the POSTbrief on Geographical differences in healthy life expectancy.

Reports and government commitments

Fair Society, Healthy Lives

In 2010, Professor Marmot’s report ‘Fair Society, Healthy Lives’ highlighted the scale of health inequalities in England, linking deprivation with reduced life expectancy. Recommendations included early years investment, improving housing, and a stronger focus on prevention. A 2020 follow-up found these inequalities had widened, with life expectancy falling for women in the most deprived areas. It proposed six areas for action, including early intervention and fair employment.

Independent Investigation of the NHS in England

In 2024, Lord Darzi’s Independent Investigation of the NHS in England highlighted unequal access to and quality of care. It found that poverty, ethnicity, and homelessness were significant determinants of poorer health outcomes.

Government commitments

The government has committed to halving the healthy life expectancy (HLE) gap and improving HLE by five years by 2035. In 2025, ministers outlined funding reforms and programmes to address structural inequalities in access to healthcare and workforce participation.

International comparisons

Life expectancy in the UK placed 27th out of 185 countries in 2021. Similarly, HLE placed 28th, just ahead of Greece and just behind Germany. Globally, the WHO reports that HLE increased by 7% between 2000 and 2021.