‘Four reasons GPs are seeing patients become unhealthier earlier’

From childhood mental health to NHS access, Dr Katie Musgrave examines the trends that may be reducing healthy life expectancy

Statistics published by the Health Foundation suggest that Britain’s healthy life expectancy is falling. The number of years that we can expect to live in ‘good health’ has fallen by approximately two years between 2012-14 and 2022-20224 – to 60.7 years old for males and 60.9 for females. Of 21 high-income countries, the UK is one of only five that saw a fall in healthy life expectancy between 2011 and 2021. 

So why is the UK falling behind other nations? Why are we getting sicker, and living more years in poor health?

As GPs we are in a position to make observations on trends we see over time. So I am going to speculate on a few of the possible causes.

1. Rates of poor mental health amongst children and young people have sky-rocketed, and can lead to a lifetime of isolation and resultant poor health.

In days gone by, it might be unusual to receive a phone call about an anxious teenager or a self-harming child. But now it is an almost daily occurrence. The young people in question often go onto become adults with poor mental health and limited work prospects.

What has happened to our society that has left children feeling so hopeless and afraid of the world? How can we wrench their smartphones off them, and get them into the real world – interacting with people, getting active, building confidence? Too many children are being permanently damaged by isolation, and their health is undoubtedly suffering as a result.

2. Access to medical care is not what it should be. 

Try as we might, the NHS is not keeping up with patient demands. The public often cannot get timely GP appointments, and find themselves battling with online forms, or on hold for hours to get through to their GP surgery. People are afraid to attend A&E departments, for fear of being left waiting for hours to be seen (they often are).

Once seen, definitive treatments can be hugely delayed or unobtainable, due to a lack of capacity. Patients who should have knee or hip replacements are told to persist with physio and batted away. The delays in the UK in starting treatment for cancer, have long been documented. The NHS is simply not doing very well at being accessible to the population, or getting the basics done properly.

3. Lots of people who could work in the UK, don’t.

You all sign the same sick notes as I do. So you will know as well as I, that a lot of people who we are signing off as ‘unfit to work’ are tired, stressed, overwhelmed, and often miserable, but essentially if they needed to work to feed themselves, they could and would.

Yet for whatever reason, the UK is facilitating a growing proportion (especially of younger people) to be signed off as unfit to work. And sadly, many of those who are out of work will then become more isolated and more unhealthy, partly as a result of their not working. It is a vicious cycle.

4. The population is increasingly sedentary and isolated.

It feels as if there has been a shift over time towards inactivity and isolation. Young people don’t go to nightclubs anymore. People no longer go out on a Friday evening to the pub. Social clubs, youth clubs and leisure facilities are closing down. The hours spent ‘doomscrolling’ on a mobile device are replacing physical activity, and worsening our mental health to boot.

Rather than pay a subscription to a squash club, you are more likely to subscribe to Netflix; and rather than going out for a meal, people order a Deliveroo – people don’t even travel to pick up their takeaways. The rise of technology is isolating people, and contributing hugely to unhealthy lifestyles.

So those would be my top four adjustable factors. Of course there are countless others – broader socio-economic factors, inequality, limited transport options, health education, poor quality housing, bad dietary habits. I’m really interested to hear other GP opinions on why our patients’ healthy life expectancy is falling. Could we be involved in advocating for changes which might reverse some of these trends? 

Dr Katie Musgrave is a GP in Devon