United Kingdom: 20-year gap in healthy life expectancy between the richest and the poorest

A recent study highlights a marked decline in healthy life expectancy in the United Kingdom, with a loss of approximately two years over the last decade. Between 2012-2014 and 2022-2024, it fell from 62.9 to 60.7 years for men and from 63.7 to 60.9 years for women. This decline is accompanied by particularly pronounced social inequalities, which can exceed 20 years between the most advantaged and the most disadvantaged populations. While most comparable countries are making progress, the United Kingdom appears to be lagging behind, revealing the significant influence of social and economic determinants of health as well as a lack of structural public policy.[1].

Healthy life expectancy corresponds to the average number of years a person can expect to live without chronic disease, disability or limitation in daily activities, in other words, in good functional health.

A structural deterioration in the health of the British population

Analyses by the Health Foundation confirm a significant decline in the UK's performance compared to other high-income countries. Between 2011 and 2021, healthy life expectancy increased or remained stable in 16 of the 20 comparable countries, with an average increase of 0.4 years. Conversely, the UK is among the few countries where this indicator has fallen, along with the Netherlands, Canada, Germany, and the United States, with the second-largest decline among these countries. The UK has thus fallen from 14th to 20th place out of 21 countries, now ahead of only the United States.

The data published by the Office for National Statistics These findings confirm that healthy life expectancy is declining, now settling at around 60.7 years for men and 60.9 years for women, a loss of approximately two years in a decade. At the same time, the proportion of life lived without disability—that is, the share of life spent without activity limitations due to a health problem—is decreasing: it has fallen from approximately 79 to 77 for men and from 77 to 73 for women. Meanwhile, overall life expectancy has stagnated at around 79 years for men and 83 years for women, reflecting a growing disconnect between longevity and quality of life.

This trend, which began in the mid-2010s, is not a temporary phenomenon. It is part of a long-term dynamic marked by the increase in chronic diseases, particularly cardiovascular, respiratory, and metabolic diseases, as well as mental health disorders. These conditions now represent the vast majority of the disease burden. Among the risk factors, obesity is a key determinant. Approximately 64% of British adults are overweight or obese, including nearly 30% who are obese—levels among the highest in Western Europe.[2]. This situation directly fuels the progression of pathologies such as type 2 diabetes, cardiovascular diseases and certain cancers, and contributes significantly to the deterioration of overall health.

Alcohol consumption is also an aggravating factor. The United Kingdom is characterized by high levels of consumption, with a significant prevalence of binge drinking, contributing to chronic diseases, mental health disorders, and premature deaths.

Tobacco-related illnesses remain highly prevalent in the United Kingdom

Smoking also remains a major determinant of morbidity in the United Kingdom, despite a gradual decline in its prevalence. In 2024, approximately 9.1% of adults reported smoking, representing nearly 5.3 million people – a historically low but still significant level, according to the Office for National Statistics. The health consequences remain considerable: tobacco is implicated in a wide range of chronic diseases, including cardiovascular diseases, cancers (especially lung cancer), respiratory diseases such as chronic obstructive pulmonary disease (COPD), and also diabetes.

Beyond mortality, tobacco is a determining factor in years lived with disability. It is responsible for a significant proportion of long-term illnesses, leading to shortness of breath, functional limitations, chronic pain, and loss of independence, according to the British Heart Foundation.[3], Approximately 40 deaths per day are linked to cardiovascular diseases attributable to smoking. These conditions are often accompanied by a progressive decline in quality of life, with repeated hospitalizations and long-term medical care.

These findings illustrate the persistent burden of tobacco not only in terms of mortality but also morbidity, directly contributing to the increase in years lived in poor health. They confirm its central role among the commercial determinants of health, particularly in the most vulnerable populations where smoking prevalence remains higher.

Massive social and territorial inequalities

The data shows that the gap in healthy life expectancy between the most advantaged and most disadvantaged populations now reaches 19.3 years for men and 20.1 years for women.

In the most disadvantaged areas, healthy life expectancy falls below 50 years: it stands at around 49.8 years for men and 48.2 years for women, compared to nearly 70 years and 68.5 years respectively in the most advantaged areas. This situation results in an accumulation of years lived with disability, with direct effects on employment, income, and quality of life.

These differences are not limited to a general state of "good health", but also concern overall longevity. Life expectancy at birth varies by more than 10 years for men (83.6 years in the most advantaged areas versus 73.2 years in the most disadvantaged) and by more than 8 years for women (86.4 years versus 78.3 years).

A warning sign for public health policies

The decline in healthy life expectancy in the United Kingdom is a major warning sign for public policy. It highlights the limitations of a model still too focused on treatment, even though a significant proportion of chronic diseases are preventable. The increasing number of working-age people living with a disability is placing growing pressure on health and social care systems, as well as on the labor market.

This observation underscores the need to address the structural determinants of health upstream, particularly those influenced by commerce. The accessibility, promotion, and normalization of harmful products—tobacco, nicotine products, alcohol, and ultra-processed foods—continue to create environments detrimental to health, directly contributing to the burden of disease and observed inequalities.

In this context, the adoption of the Tobacco and Vapes Bill marks a significant and consistent step forward, aligned with the identified challenges. By establishing a generational ban on tobacco sales starting in 2027, strengthening the regulatory framework for nicotine products, and providing additional tools (notably the possibility of banning cigarette filters), this legislation is part of a sustainable transformation of consumption environments. This type of policy, which aims to reduce initiation and limit the exposure of younger generations to tobacco and nicotine products, is recognized as one of the most effective levers in public health. By directly impacting the supply, accessibility, and appeal of products, it allows for changes in consumption patterns in the short and long term and significantly reduces the burden of preventable diseases.

Beyond its anticipated impact on smoking, this reform illustrates a paradigm shift: a health policy that no longer merely addresses the consequences, but structurally tackles their root causes. Beyond the British case, this observation resonates across Europe and internationally. It underscores the urgent need to strengthen prevention policies, more strictly regulate the commercial determinants of health, and guarantee supportive environments in order to reverse trends that, if they continue, threaten healthcare systems and could permanently jeopardize the health gains of recent decades.

©Generation Without Tobacco

AE

[1] Analysis, Healthy life expectancy trends in the UK: a watershed moment, The Health Foundation, published April 26, 2026, accessed April 28, 2026

[2] Denis Campbell, UK's obesity and overweight epidemic costs £126bn a year, study suggests, The Guardian, published on July 2, 2025, accessed on April 28, 2026

[3] Emily Hickey-Mason, 40 lives are lost daily to smoking-related cardiovascular disease, British Heart Foundation, published on September 23, 2025, accessed on April 26, 2026