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  • Nearly 25% more working-age adults will have diagnosed major illness by 2040 – up from 3 million to 3.7 million
  • 80% of this increase will be in more deprived areas, with significant implications for labour markets and entrenching stark health inequalities  
  • Health Foundation warns of major health and economic consequences without action across government, public services and employers

Action from government, public services and employers is needed to address rising levels of ill-health in England, a new report published today by the Health Foundation, an independent charity says.

The report focuses on inequalities in major illness in England, notably among working-age people. It reveals that growing ill-health will continue to significantly impact people's lives and the economy. On current trends, 3.7 million working-age adults will be living with major illness by 2040—up from 3 million in 2019.  

The report warns that 80% (540,000) of this increase will be in the more deprived 50% of areas, further entrenching health inequalities and having considerable implications for local and regional economies. 

Employers already face significant challenges caused by rising economic inactivity. The report shows that this challenge isn’t going away and could lead to more people leaving the workforce, thereby reducing labour supply and undermining efforts to increase economic growth. 

Jo Bibby, Director of Health at the Health Foundation, said,

“Good health is our most precious asset, and a healthy workforce is the backbone of any thriving economy. We are already seeing the impact of poor health on the economy, with record numbers of people out of the workforce. Without action, the number of working-age people living with major illness is set to increase, particularly in the most deprived areas of the country.”

This is the first analysis of its kind into current and future inequalities in diagnosed illness and the second report from a major research programme led by the Health Foundation’s Real Centre in partnership with the University of Liverpool. The first report projected that the total number of people living with major illness would increase to 9.3 million in 2040, an increase of 2.6 million people from 2019.  

The new report finds that, without action, stark health inequalities are projected to persist up to 2040, with people in the most deprived areas of England likely to develop major illness ten years earlier than those in the least deprived areas. They are also three times more likely to die by the age of 70.

The analysis finds that a handful of conditions contribute to most of the health inequality such as chronic pain, type 2 diabetes and anxiety and depression, which are projected to grow at a faster rate in the most deprived areas. These conditions have a significant impact on quality of life and may limit people’s ability to work for long periods of time. They are also typically managed by GPs or in the community, underlining the importance of investing in primary care and focusing on prevention and early intervention. 

On current trends, the government’s target to improve healthy life expectancy by five years by 2035 and narrow the gap between the areas with the best and worst health will be missed by a significant margin. With Labour also proposing measures to improve healthy life expectancy and reduce health inequalities in their health mission, the report underlines the need for the parties to set out the action they will take to improve working-age health ahead of the forthcoming General Election.  

Ann Raymond, Economist at the Health Foundation’s REAL Centre, added:

“The findings from this report clearly demonstrate how people living in more deprived areas develop major illness earlier, live for longer in poor health and die younger than their counterparts in less deprived areas. These inequalities will remain stubbornly persistent over the next two decades if current trends continue.

This report should be a wake-up call for politicians ahead of the General Election about the need for action to address rising ill health – our future health and prosperity as a nation depends on it.”

The report concludes that action beyond the NHS is needed to address poor health. Policies focused on the risk factors of ill health – smoking, poor diet, physical inactivity and harmful alcohol consumption – are essential but insufficient to tackle health inequalities. The report also calls for:

  • a long-term, cross-government approach to address the underlying causes of ill health, such as poor housing, inadequate incomes and poor-quality jobs
  • investment in the NHS, local authorities and the voluntary sector to manage higher demand for services, especially in the most deprived areas
  • employers to be doing more to improve working conditions and support the wellbeing of their staff.

Notes to editors

Health inequalities in 2040: current and projected patterns of illness by deprivation in England is a Health Foundation publication authored by Ann Raymond, Toby Watt, Hannah Rose Douglas, Anna Head, Chris Kypridemos, Laurie Rachet-Jacquet. 

The report is the second of the REAL Centre’s research programme with the University of Liverpool to develop projections of illness, health inequalities and health care demand.

The Health Foundation’s REAL Centre (research and economic analysis for the long term) provides independent analysis and research to support better long-term decision making in health and social care.

Methods in brief:

Patient records provide a detailed picture of diagnosed health by individual characteristics such as age and type of illness across the life course. They also include information on the level of deprivation of their area of residence. We combined these data with the Cambridge Multimorbidity Score (CMS) to compare the average level of illness in different population groups by level of deprivation. This enabled us to gather new insights into health inequalities across England.

Our key measure is major illness, which corresponds to a person having a condition, or multiple conditions, that result in a CMS greater than 1.5. The score is designed around a patient’s use of primary care, their likelihood of an emergency admission and the mortality risk associated with each condition (for instance, cancer on its own has a score of 1.53). We use “major illness” as an indicator of combinations of conditions that involve high health care needs or substantial risk of mortality.

A more detailed explanation of the methods is available on request.

Media Contact
Billie Morgan
020 7257 8000
0790 8637 666

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