Longevity is a privilege of the wealthy. In the debate on ageing, it’s time to talk about class
In a leafy, affluent corner of Hampstead, tucked away in high-up north London, I meet Eliza, aged 88. A retired journalist who also worked as a teacher and film producer, she regales a broad social network with stories of global travel, music, and theatre. This week, with her tenth decade on the horizon, Eliza is performing her first ever comedy gig.
Seven miles away, across the river Thames in Peckham, it’s a different story. Ray suffers from COPD, the result of years of exposure to pollution, cigarette smoke in local pubs, and the industry that paid for his labour. Ray toiled then, and he toils now. His coughing pierces the peace of his local council estate; his wheezing the soundtrack to a long and painful day. Ray’s life is punctuated less by social appointments than by hospital appointments. With underlying respiratory conditions, he will be more vulnerable if infected by Coronavirus. Ray has just turned 65. Even before the spread of the virus, he didn’t expect to see 70.
This inequality of longevity is not new, nor is it wholly universal. The pictures of extremes — true though both are — may come down to genetics and hard luck as well as life experience. But, as the news from the latest Marmot report showed again, to pin these common stories merely on fate or fortitude, pandemic or personal choice, would be to overlook the realities of structural inequality, and how our social frameworks condition our life chances from birth.
The Marmot report demonstrates how life expectancy is stalling, and in some cases falling, among the poorest. It underscores findings from a recent study of adults in England and the United States, featured in the New York Times earlier this year, which shows that the gap between rich and poor, dead and alive, is indeed getting bigger on both sides of the pond: wealthy men and women live on average eight to nine years longer than their less affluent peers.
The findings also echo research published last year, that showed that a boy born in one of the UK’s wealthiest areas will outlive one from one of the poorest by eight years and five months — a year longer than in 2001. That’s a full year of extra life reserved for those with wealth compared with those without — and a cleft heaved in less than a single generation.
Some of the reasons may seem obvious. People’s education, housing and work conditions, and socially conditioned diets and lifestyles, all contribute to our physical and mental wellbeing, and ultimately to the number of good years we live. But few of these factors are individual choices. Rather, it’s cultural segregation, the economic opportunity gap and the uneven distribution of loneliness — in other words, our class — that shape our realities and longevities so unequally.
Labelling health crises as the result of “lifestyle” choices erases the fact that systemic forces — and political choices — have engineered this inequality. Margaret Thatcher’s Right to Buy and industrial and trade union policies promoted individualism over togetherness, and since the 2008 financial crash, gentrification and inequity have accelerated. This deprives lower income people of the bastions of health once common in working class neighbourhoods: solidarity, belonging, connection and community.
Today, those associations are frayed. And so — just as financial wealth goes to financial capital in our rigged economies — social wealth is going to existing social capital, further exacerbating the trends.
Some of the organisations best placed to deal with this issue are in fact perpetuating it. Big corporations with higher wages, generous pensions, and innovations to support workers in moments of transition and hardship continue to recruit from a narrow social pool. The public sector is not much better: private education continues to be a feeder system for judges, senior civil servants and diplomats, locking many people out of the chance to extend life through better pay, better security, and better conditions at work.
Meanwhile, many traditional charities extend cultural stereotypes that lead to systemic inequity — for example by fundraising with tired images of wrinkly hands, or ghettoising the ageing process as a quirk of the over 50s, over 65s, or over 80s, rather than focusing on a natural lifelong process made unnatural by inequality.
So all of us — in charity, business and government — need to rethink and reframe our attitudes to ageing. We need to see our ‘social care crisis’ as a social change opportunity. We can start by celebrating that there are now 584,020 people in the UK over the age of 90. That increased longevity over the past two centuries is one of our great human achievements.
But we should also recognise that this ultimate privilege of more days on the earth is not yet for everyone. On the contrary: longevity is increasingly an opportunity limited to the rich. That will become starker in the age of Coronavirus.
The challenge of our time — now — is to help people live not just longer lives, but happier, healthier, better connected lives with more intergenerational relationships, more cohesive communities, more empathy in our national discourse and more focus on community health. And we need to get real about the intersections between ageing and class, particularly in a time of unevenly spread epidemics. Only then will we extend that greatest of gifts — life — to Ray as well as Eliza.
Alex Smith is the Founder and Chief Executive of The Cares Family which reduces loneliness, isolation and disconnection amongst older and younger people. He is an inaugural Obama Fellow and Encore Public Voices Fellow.