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Massey Magazine Issue 13 November 2002

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Professor Neil Pearce: problem beyond the reach of Health Minister.

Growing gap in life expectancy

The gap in life expectancy between rich and poor is continuing to increase, according to new research from the Centre for Public Health Research.

Centre director Professor Neil Pearce has already studied social class differences and death rates over two periods in the mid-70s mid-80s. Working with Professor Peter Davis and Andrew Sporle at the University of Otago’s Christchurch School of Medicine, he’s now updated these figures with a similar analysis for the mid-90s.

Classification of the mortality data was based on the current, or most recent occupation. The findings have just been published in The Australian and New Zealand Journal of Public Health.

Professor Pearce says death rates have generally dropped and life expectancy has improved during the past century. This has mainly been due to better living conditions such as better housing, improved nutrition and recent decreases in smoking. Some of these declines have been quite marked – there was a 21 percent drop between 1985 and 1995. But set against that, the difference in death rates between the wealthiest and the least advantaged socio-economic groups has not diminished, and may have even increased.

Professor Pearce says in any given year, if a group of unskilled manual workers is compared to a group of professionals, twice as many manual workers will die. “That was the case in the 70s and 80s, and now we find it’s also true for the 90s. If anything the gap has widened. The risk of dying was 1.8 times higher in unskilled manual workers in the 70s. Today it is 2.3 times.”

He says although some of the deaths are due to the nature of work – to manual workers having more accidents on the job – most can be traced to general living conditions.

“If everybody was as healthy and lived as long as those in the professional and managerial group, then the death rate overall would be about one-third lower than it is now. That’s a huge figure – roughly equivalent to eliminating cancer and all smoking-related diseases.”

Professor Pearce says the social class differences in life expectancy are spread along a continuum, from poor to wealthy. Some health problems, such as heart disease, have traditionally been associated with stressed-out executives. The reality today is that they actually have less stressful jobs, can work out at the gym, have check-ups and find it easier to adopt a healthy lifestyle.

“Now, the highest risk of death by heart attack is within the unemployed and the unskilled manual workers. These workers have the more stressful jobs, and they don’t have the same healthy lifestyle options.”

Professor Pearce says if you’re poor, if you’re struggling to survive and smoking helps get you through the week, then it’s quite difficult to completely turn your life around. Many reports have already identified these problems – the issue now is to do something about it.

“Changing one component won’t do it, these things come in a package. We know that political changes since Rogernomics have resulted in the biggest growth of inequality in any OECD country, also increasing the gap in life expectancy.

“So when it comes to political solutions, Cabinet ministers covering health, education, finance, housing, social welfare and employment must all address these issues. It can’t be done by the Minister of Health alone. Right now, we don’t seem to be ‘closing the gaps’; instead they are growing wider.”

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