Widening health poverty gap could heap more pressure on elderly care in future

Poor people in Britain have worse health than people born a century ago, research suggests.

The health gap between the least and most well-off in society is widening and may heap increased pressure on care for vulnerable older people in the future, a University College London (UCL) study found.

The author wanted to find out if “baby boomers” born after 1945 rated their health as better or worse than those born in the early 1920s, according to household income.

More than 200,000 working-age people in England, Wales and Scotland were asked if they had a limiting long-term illness and to rate their overall health as part of the General Household Survey for 1979-2011.

The study analysed their responses to create nationally representative 3-year “health” snapshots of the generations born between 1920-22 and 1968-70.

Overall, self-reported health outcomes remained constant between the two cohorts, with the exception of limiting long-term illness in men, which showed a statistically significant downward trend.

But the gaps between the richest and poorest households widened over time, with inequalities in the prevalence of long-term conditions doubling among women and by 1.5 times among men, the study showed.

Around a quarter (26%) of men born in 1920-22, with the lowest household incomes, said they had a limiting illness compared to one in six (16%) in the richest households.

For those born in 1968-70, more than a third (35%) of the men in the poorest households reported a limiting illness, compared to just 11% of those living in the richest households.

Around one in seven women (15%) born in 1920-22 and living in the poorest households said their health was “not good”, compared with 8% in the richest households.

This had risen to around a fifth of women (20%) born in 1968-70 and living in the poorest households, while the proportion claiming their health was “not good” in the richest households remained similar at 9%.

The research suggests that the gap in early deaths will further widen due to the links between poor self-rated health and long-term conditions, sickness and death.

The author, Dr Stephen Jivraj (pictured), of UCL’s Research Department of Epidemiology and Public Health, said: “The results presented here show a widening in health inequalities by income in later-born British birth cohorts, 1920-70.

“They point to a greater future demand in healthcare from people in society who will be least capable of managing their health as they enter ages when (ill health) becomes more common.

“The poorest among these later-born cohorts are likely to require more healthcare sooner in life.

“In the absence of policy interventions, there is likely to be a growing inequality by income in premature mortality.”

The gaps could be due to increased income inequality, leading to increased marginalisation of the poorest in society, Dr Jivraj wrote.

Another possible explanation could be that people born later during the period have greater expectations of their own health, and may be more likely to self-define as having poorer health because they know treatment is accessible.

The paper is published in the Journal of Epidemiology and Community Health.

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