By Greg Fell
Health and wealth is a two way relationship. Here is why…
The economy is everything, everything is connected.
The economy is not just about the activities of private sector business. Investments in the public sector, voluntary sector and the actions of individuals all contribute to outcomes we individually and collectively value and thus what we consider “the economy”. Sometimes measurement and valuation is difficult, but that doesn’t make it less important. Everything is connected.
Healthy Life Expectancy is an economic issue.
Healthy life expectancy is the age to which a person can expect to live in good health. In the UK healthy life expectancy is 63.1 years for men and 63.6 years for women. With the retirement age rising to 67 by 2028 this means on average we will be working for 3-4 years in less than good health. So how healthy we are (or not) has critical implications on how actuaries advise the government about the retirement age.
There is deep inequality in the distribution of illness. This is an economic productivity issue, as well as intrinsically bad. There is a 25 year gap in healthy life expectancy so a baby born in the most deprived areas can expect to live to just 45 years old in good health whilst a baby born in the most affluent will reach 70.
Inequalities in health are intrinsically linked to inequalities in economic outcomes.
Many people and organizations have commented that the way in which the economy has developed has left people behind and often exacerbated poverty. There is a strong research base on this, and this has led to the establishment of terms like “inclusive economy”, which describes an effort to ensure the economy works for everyone. Given that health inequality is essentially driven by wealth inequality this underscores the importance of our efforts around creating an inclusive economy as important for reducing inequalities in health and wellbeing.
Multi-morbidity (having more than one condition) is more common than having a single illness. It is more common in working age adults than old adults, and (you guessed it) is very unequally spread across our population. As more than half of over 60s have two or more long-term conditions this makes preventing, and delaying and treating, those conditions a quality of life and an economic issue. And as more deprived areas have more people out of work due to long-term health conditions for more of their working lives, economic growth in these areas is that much more difficult.
The Sheffield Example
Illness costs the Sheffield economy an estimated £1bn (as a comparator, the NHS spend in Sheffield is £1.1bn) every year! 100,000 working days are lost a year to mental illness, and a similar number for musculoskeletal conditions… to name just a couple of examples.
So what does this all mean and what can we do about it?
Simply, a healthier population is likely to be more economically productive (and to need less spending on healthcare and health-related benefits). This is a two way link as a more prosperous society is likely to be healthier. Just as HS2 is seen as an investment in the economy, so is investment in a healthy population.
We should consider health as a balance sheet asset, not a cost.
What we measure and value is important. This is one of the things that underpins calls to widen the measure of economic growth from solely gross value added to a wider measure that includes social benefit. It would be easy, in narrative terms at least, to also include resilience and cohesion into the things we value in our economy.
Health and wellbeing should be a central component of economic strategy. The above issues are not issues that will be (only) solved by more, or better health care services. That is necessary but not sufficient. Poor health has a direct and indirect impact on the economy at an individual and societal level. So the central “health” challenges – stalling healthy life expectancy, and inequalities of that – aren’t just a problem for the NHS, they are a problem for the whole economy. Keeping people well is a major national infrastructure project. A bit like HS2. With those kind of timeframes. How seriously are we really taking this?
Once we start to treat health as a linchpin to community and economic development, we can begin to insist on different investment decisions and improve our programmatic approaches to power boost results.
See here for some references to support the above.