160308 Marmot Curve
  • The Marmot Review… We normally produce our own graphs here on To The Point. But the one above is too complicated for our spreadsheets and our patience, so we’ve simply copied and pasted it from the Internet. It is the Marmot Curve that I mentioned in my post on life expectancy last week. It’s called that because it arose from a review, Fair Society, Healthy Lives, that was conducted by Michael Marmot between 2008 and 2010. Forget the knighthood he received a few years earlier, Marmot has joined Art Laffer and Ernst Engel and a select few others in having a line named after him.
  • …and its findings. But what does the Marmot Curve actually show? Much of it should be clear from the image itself: the review team charted the deprivation of various English neighbourhoods against both their average life expectancies and – an often overlooked detail – their expectancies of a life lived free from disability (aka disability-free life expectancy, aka DFLE). They found that those living in the poorest neighbourhoods will, on average, die 6.9 years earlier than those living in the richest. More shocking, the DFLE gap between these two groups is a full 17 years.
  • 160308 Marmot Curve 2Updating the figures. The Marmot Review’s data was for the years 1999 to 2003, which is obviously rather a long time ago now. The King’s Fund used more recent life expectancy figures, for the years 2006 to 2010, in last year’s Inequalities in Life Expectancy report. I’ve pasted their curve to the right; you can click it for a larger version. It suggests that things have, or at least had, improved since 2003. The life expectancy gap between the poorest and the richest neighbourhoods was reduced to 4.4 years.
  • The implications. These curves obviously have implications for health policy – many of which were considered by the Coalition in its Healthy Lives, Healthy People document – but they have other implications too. The original Marmot Curve made a point by marking out what would happen if the pension age were increased to 68, all other things remaining equal. As they put it, “With the levels of disability shown, more than three-quarters of the population do not have disability-free life expectancy as long as 68. If society wishes to have a healthy population, working until 68 years, it is essential to take action to both raise the general level of health and flatten the social gradient.”
  • Flattening the curve. This is a good example of why legislators need to look beyond the median. Raising the state pension age might – and does – make sense when the average life expectancy is rising. But for those at the poorer end of society, who can expect to fall ill sooner and to die sooner, it’s also form of discrimination. For their sake, politicians should be striving towards a Marmot Plateau.