The amount of time we can expect to live in good health has fallen rapidly. Journalist Kaye McIntosh explores the reasons why and the importance of strong foundations.
Healthy life expectancy (HLE) has dropped dramatically in the UK, The Health Foundation has revealed (Mooney, Alarilla and Cavallaro, 2026). From 2012-14 to 2022-25, the amount of time we can expect to live before we start to battle serious health conditions fell by two years, to just more than 60 years for women and men – well below the retirement age of 66.
The findings are stark. Researchers at The Health Foundation found the UK had the second steepest decline among 21 wealthy countries. Only the United States now has a lower rating.
Deprivation and poverty reduced HLE by up to 20 years. The report called it ‘a watershed moment’.
Joint author Francesca Cavallaro says: ‘To see that the UK had the second largest decrease in HLE, and we’re now 20th out of 21 countries, should be a wake-up call for policymakers.’
The findings align with other evidence that highlights a decline in workingage health, says the report, including worsening mortality rates among 25- to 49-year-olds compared with other countries, and a rise in the number of 16- to 24-year-olds not in education, employment or training (NEETs) because of work-limiting conditions.
Many argue this is driven by young people’s mental health, but Francesca says: ‘The decline in people reporting to be in good health is not just among young people; it’s throughout the working age.
‘It’s not just mental health. Previous work showed that there’s been a rise in chronic physical conditions, including diabetes, chronic pain and heart conditions.’
‘PEOPLE LIVING IN MORE DEPRIVED AREAS ARE MORE LIKELY TO DEVELOP SERIOUS ILLNESS… AND EXPERIENCE FEWER HEALTHY YEARS’
POVERTY LIMITS LIVES
HLE is strongly associated with deprivation, the report found. In England, HLE is highest in Richmond upon Thames, one of the least deprived areas in the country, at nearly 70 for males and just over for females in 2022–24. It is lowest in Blackpool for men (51) and Hartlepool for women (51), both among the most deprived. In these places, people on average experience the onset of ill health almost 15 years before state pension age (Mooney et al, 2026).
Dr Chris Packham, population health special adviser for the Royal College of Physicians (RCP) says: ‘The finding reflects what RCP members have told us based on their own experience. Last year, 72% of UK physicians responding to our snapshot survey reported seeing more patients in the previous three months with illnesses caused or worsened by wider social determinants of health [RCP, 2025].’
Greg Fell, president of the Association of Directors of Public Health, agrees: ‘We know that health outcomes are shaped by much more than our individual choices. Instead, the environments where we live, grow, work and play, alongside the commercial influences we face every day, are continually shaping our decisions and health outcomes.’
Dr Packham adds: ‘People living in more deprived areas are more likely to develop serious illness, receive poorer care and, as a result, experience earlier decline, greater disability and fewer healthy years.’
Women are more severely affected than men, the report found. Female HLE fell more rapidly than for men, raising concerns about the worsening trend of women’s health (see The HLE report at a glance, below).
Healthy life expectancy – a good measure?
There has been some recent criticism of the HLE measure, because it combines hard data – mortality – with self-reported health status.
But Andrew Mooney, one of the report authors and principal data analyst at the Health Foundation, says: ‘While the latter may be shaped by expectations and lived experience, it [HLE] remains a reliable public health measure and is broadly linked to both morbidity and mortality.’
The report describes HLE as ‘a key measure of the population’s health, providing a more comprehensive picture of the UK’s health than life expectancy alone’.
EARLY FOCUS IS KEY
Dr Packham highlights: ‘Children and adolescents are particularly vulnerable to the causes of long-term ill health because of the development of key protective systems [such as the immune system].
‘Children are significantly affected by the health inequality caused by social determinants of health more broadly. Children from deprived groups in England are more than twice as likely to be living with obesity than their more affluent counterparts, and rates of childhood obesity are increasing significantly faster in communities with high deprivation compared with low deprivation.’
So why has the UK been so hard hit? The experts point towards health inequalities. The gap in life expectancy between the most and least deprived areas is wider than in most comparable European countries, such as the Netherlands (Cavallaro et al, 2024). Health inequalities have widened. People living in more deprived areas are more likely to wait longer for treatment, for instance.
Underinvestment in public services has played a key part. Francesca adds: ‘We know that the budgets for local authorities have been cut. We know that health visitors and children’s centres play a big role in not only influencing health outcomes but also in reducing inequalities. If you want to tackle poor health and inequalities, early childhood is a really important place to start.’
Reductions in local government funding led to cuts to frontline services, including preventative services funded through public health budgets, she adds.
‘ONLY BY MAKING SURE WE CREATE THE CONDITIONS WE NEED TO LIVE IN GOOD HEALTH, THROUGHOUT
EACH STAGE OF OUR LIVES, CAN WE HOPE TO
IMPROVE THE STATISTICS’
The HLE report at a glance
- Over the decade 2012–14 to 2022–24, healthy life expectancy (HLE) in the UK fell by about 2 years, to 60.7 years for men and 60.9 years for women
- Of 21 high-income countries, the UK is 1 of only 5 that saw HLE fall between 2011 and 2021, and had the 2nd steepest decline
- Most local areas in Great Britain saw a decline in HLE. It has fallen below the state pension age of 66 years in more than 90% of areas. In more than 1 in 10 local areas, HLE is below 55 years
- Deep inequalities in healthy life expectancy between affluent and deprived areas have widened. The gap between the most and least deprived deciles in England is now 19 years for men and 20 for women
- In Wales, female HLE fell by 3.7 years over the decade, leaving Welsh women with lower HLE than men and the lowest HLE in the UK. For men, Scotland saw the largest decline (down 2.5 years) and now has the lowest male HLE, just below Wales.
Mooney, Alarilla and Cavallaro, 2026
THE CP ROLE
There’s a mountain to climb to turn this trend around, but community practitioners havean important part to play. CPHVA Executive chair Janet Taylor says: ‘HVs and school nurses can help people to make healthy choices and be considerate of their budget. There are community programmes where people can go.
‘Signposting to the right places or showing what resources are available within the community, such as healthy eating programmes or cookery classes’ is important, she adds.
‘It starts with breastfeeding, which can lay down good pathways for brain development.’ In the long term, these babies are less likely to be overweight, too, Janet says.
‘There are various programmes across health visiting services where we can refer our clients to have some education and support, because sometimes, if you manage your budget accordingly, you can buy better choices. If you get in early, you can get good patterns in place.’
‘HVs AND SCHOOL NURSES CAN HELP PEOPLE TO MAKE HEALTHY CHOICES’
TACKLING ILL HEALTH
Turning this around ‘requires a new approach that looks beyond the NHS to focus on the drivers of poor health’, states the Health Foundation report (Mooney et al, 2026). It continues: ‘Successive governments – including Labour and its much vaunted, but largely abandoned, “health mission” – have understood the importance of targeting improvements in healthy life expectancy, but have failed to take the necessary action.
‘These findings should mark a watershed moment that sparks a new drive to rebuild the nation’s health, putting improving health on a par with delivering economic growth as a core objective of government policy.’
A spokesperson for the Department of Health and Social Care described the figures over the past decade as ‘a disgrace’ and added: ‘We know there is much more to do, but by building an NHS fit for the future, we will help people live well for longer, whatever their background.’
Francesca says: ‘There’s no silver bullet or single intervention that will help reverse this worsening trend in healthy life expectancy. What’s going to be needed is concerted cross-government action.’
She’s calling for ‘broad investment across the building blocks of health from early childhood’ to enable people to live healthier lives for longer.
Greg adds: ‘Directors of public health are working hard with partners across the system to make sure that everyone – regardless of their background or income, or where they live – has access to safer homes, green spaces, stronger social connections, affordable, nutritious food, and opportunities to keep engaged and active in work and the wider community, from the very beginning of their lives.
‘Only by making sure that we create the conditions we need to live in good health, throughout each stage of our lives, can we hope to improve the statistics, while making sure our health and care services are there when people need them most.’
RESOURCES
- The Health Foundation report (2026) on healthy life expectancy (Mooney et al)
- Young people with mental health conditions are more likely to be NEET, says The Health Foundation
- The Royal College of Physicians clinical audit report on deprivation and respiratory health
Image | ISTOCK
REFERENCES
Mooney A, Allarilla A, Cavallaro F. (2026) Healthy life expectancy trends in the UK: a watershed moment. See: health.org.uk/reports-and-analysis/analysis/healthy-life-expectancy-trends-in-the-uk-a-watershed-moment (accessed 7 July 2026).
Cavallaro F, Stafford M, Major A, Finch D, Bibby J, Tallack C. (2024) Inequalities in life expectancy: how the UK compares. See: health.org.uk/reports-and-analysis/analysis/inequalities-in-life-expectancy-how-the-uk-compares (accessed 7 July 2026).
Royal College of Physicians. (2025) A snapshot of UK doctors: experiences of health inequalities. See: rcp.ac.uk/policy-and-campaigns/policy-documents/a-snapshot-of-uk-doctors-experiences-of-health-inequalities (accessed 7 July 2026).
