Average healthy life expectancy — the number of years you can expect to live in good health — has fallen by two years to just under 61 in the UK, according to a report from the Health Foundation. And, as someone who has always believed that it is not how long you survive but how well you have lived that matters, this bothers me. A lot.
I have spent most of my career looking after people struggling with health issues that have had a profound effect on their quality of life. Many — but not all — of them because of modifiable risk factors such as poor diet and lifestyle that have rendered them vulnerable to chronic conditions including heart disease and type 2 diabetes.
Most will be fine until they enter “sniper’s alley”, between the ages of 50 and 70, when they start to get picked off. Some will die from conditions such as cancer or an early heart attack or stroke, but most will survive with “injuries” that will affect them for the rest of their lives.
To put the risks in perspective, based on cardiovascular disease alone, a healthy, slim 55-year-old man living in Gloucestershire has about a 1 in 20 chance of having a stroke or a heart attack before his 65th birthday, according to the QRISK3 calculator favoured by the NHS. However, if he is overweight, has high blood pressure, smokes and has type 2 diabetes, the odds increase to about 1 in 4. For a similar woman the risk increases from 1 in 40 to 1 in 7.
Some people become evangelical about their health after they have run into trouble and, while too late is way better than never, much of the damage will have been done. If only they had had their Damascene conversion earlier. And in this regard health is a bit like wealth.
Too few of us give our pensions due consideration until we get closer to drawing them, when we start checking funds on a daily basis and wish we had listened more carefully when setting them up. And, important though financial security is, if forced to choose I would opt for good health over a decent pension.
Ideally you want a comfortable and healthy retirement but that requires forethought and investment. And, as with pensions, there can be no guarantees that such investment will pay off. My father was a fit, clean-living chap who breezed through sniper’s alley only to step on a landmine (pancreatic cancer) just as he was emerging on the other side. However, it has paid off for my mother, who is circumnavigating the world at 84. And she is more typical than my father.
One of the striking features of the Health Foundation report (see below) is how healthy life expectancy varies depending on where you live. There is a near two-decade difference between men in affluent Richmond upon Thames (average 69) and the more deprived areas of Blackpool (51). The gulf is caused by myriad factors but diet, lifestyle and access to good (and preventive) medical care are high on the list.
Not everyone agrees. Last week I wrote about the hazards of heavy drinking, prompting a reader in the online comments section to quote the notorious bon viveur Kingsley Amis: “No pleasure is worth giving up for the sake of two more years in a geriatric home.” Seemingly a good point well made, but was it? Amis died at the age of 73, spending his last month in hospital with fractured vertebrae after falling. A month in a hospital bed that I suspect must have felt like two or more years to him. It is certainly not how or where I would like to die.
So I invest in my health in the hope that I will stay healthier and happier for longer. Regular readers will know that I am no saint — I enjoy an occasional long boozy lunch as much as Amis did — but I try to balance the risks by looking after myself. And so far so good. At 63 I am still slim (ish), relatively clean living, fit and very active.
Despite four decades in medicine I still lack some motivation so I am well aware that looking after yourself isn’t easy. To quote another bon viveur, Oscar Wilde, who died at 46, I can resist everything except temptation. However, with help from my wife, Ros, and my son-in-law Karl, who is a personal trainer, I keep mostly on the straight and narrow. As I would urge you to.
Will it pay off? Who knows? And if it doesn’t, and I end up spending too long in my dotage overly dependent on the care of others, or in a nursing home, I may just change tack and live on carrot cake, claret and the odd cigar. After all, what’s the worst that could happen?
A healthy later life
- To calculate the chances of someone like you having a stroke or a heart attack over the next decade, visit qrisk.org
- If you don’t have all the required data to hand, such as recent blood pressure or cholesterol readings, the calculator will fill in the blanks with an average reading
- You can read the Health Foundation report “Healthy life expectancy trends in the UK: A watershed moment” at health.org.uk/reports-and-analysis/analysis
