Nothing is surprising about the latest figures showing that people in deprived areas are dying of coronavirus at double the rate of affluent areas. Shocking, perhaps, but the ONS findings follow a pattern that is familiar to those who research the impact of wealth on health.
So far they have been raising the alarm to deaf ears. The governments of the last decade have widened the health and wealth divide. The recent Tory era is defined by its most measurable outcome – the abrupt end to increasing life expectancy. For the first time in a century, women in poorer places are dying younger than those born before them. For the first time in anyone’s lifetime, infant mortality has risen. The country entered this crisis in social reverse.
All the indefatigable research on poverty has been ignored by Tories who have been in power most of my lifetime. And since 2010 they have taken a chainsaw to benefits and services for those with the least. Yet still they emerged the largest party in each of the last four elections. The hope must be that this pandemic changes people’s social sensitivities beyond recognition.
However, the fear remains that this will be another Grenfell Tower episode. That horror lifted gravestones on some stark figures: life expectancy is 22 years shorter in Kensington and Chelsea’s Grenfell ward than in the borough’s Harrods ward. Epic disadvantage in life chances was laid bare by the fire, with promises of lessons to be learned. But the news moves on.
This time the coronavirus epidemic touches everyone, as all can see who is harmed most. This time, double the death rate for the low-paid, their coffins soon piling up twice as fast in Blackpool or Middlesbrough as in the richest parts of the country, may deliver a shock on the political Richter scale rarely registered before.
Years of research show the social gradient of death is not a poverty cliff-edge but that it runs in a straight line from bottom to top: on the graph people get gradually healthier as they get richer. The grim reaper may wave a coronavirus scythe at the Prince of Wales, the prime minister or Tom Hanks, but death prefers the more fertile territory of Newham, Birmingham and Liverpool.
Professor Michael Marmot, director of University College London’s Institute of Health Equity, drew the seminal social graph of sickness and early death in 1978. He chose Whitehall, where employees are neatly socially graded 1-7, from messengers to top ranks, none destitute, all in secure work. He found a fourfold health difference from bottom to top – and it applied to all major causes of death. Social differences, such as smoking and weight gain, accounted for only a third of the death-rate difference.