Money can’t buy you love – but it can buy you life.
Have you ever wondered why the British royals last so long?
It’s not about genetics. Not “breeding”. It’s about a healthy, controlled lifestyle – and the most rigorous, attentive and stupendously expensive health care anywhere.
Most of us can’t afford the best healthcare or even the best food, so we don’t last as long. Poverty and death go together.
Although we all pop off eventually, poorer people do it much more quickly. In any one year (in this case, 2018) the poorest 20% of Australians account for 24% of deaths for women and 26% for men.
At the other end of the scale, the death rate in richest fifth is 17% and 15% respectively. Compared with the poorest quintile, that’s 41% less for women and 73% less for men.
When you look at the three main risk factors for early death, you can see at once how money and social position buys health and, consequently, a longer life. People with lower incomes tend to smoke more and are more likely to be overweight or obese. And, although this country claims to have universal healthcare, it doesn’t. The rich have a healthier lifestyle and access to good healthcare. The poor don’t.
It’s not all bad news. Although inequalities remain, we’re all much better off than people in earlier generations. A boy born in 1880 could expect to live, on average, only until the age of 47. Girls could expect to die by 51.
The change is immense. A baby girl born today can expect to live 68% longer than one born in 1880. For a boy, it’s 72%.
Much of the improvement has been in the dramatic decline in infant mortality. In 1907, 2,412 children in every 100,000 died before their fifth birthdays. Today, that’s down to 71.
Again, advances in both lifestyle and healthcare were critically important. The flu epidemic of 1917-20 hit hardest among the very young and the very old: we would handle things differently today. Since then, the improvements in living conditions, and the introduction of antibiotics and vaccines, were largely responsible for the continuing decline in the deaths of children.
Even so, death rates vary substantially around the country. The difference between states with older and poorer populations (Tasmania, South Australia) and the others is stark. The good news is that the Covid lockdowns lengthened the lives of people in every state.
None of us can put off dying forever, so what’s most likely to snuff us? These are the top 15 killers for Tasmania, but they’re not much different in other states.
The big one is coronary heart disease. Heart attacks. Together with stroke, the two main cardiovascular diseases account for around 23% of all deaths.
Dementia takes about 9%. Alzheimer’s is the main form, but vascular dementia – a series of mini-strokes often caused by high blood pressure – is also highly significant.
And we can see how those three main risk factors – smoking, blood pressure and obesity – are implicated in a high proportion of these top 15 killer diseases in 2018.
These are the most recent figures available but if Covid deaths for the past year were included, the pandemic would come in last on the list, with 68 deaths.
So what’s it like where you are? Here are the death rates for each local government area in Tasmania, on a five-year average. There are some surprises but broadly the rule holds: the less money you have, and the further you are from a major city, the earlier you’re likely to die.
It all looks a bit grim, but compared with the rest of the world, we do remarkably well. This table shows how life expectancy in Australia differs from the eight OECD countries with which we most often compare ourselves.
There’s another important but little-understood aspect to life expectancy: the longer you live, the longer you live. Let me explain.
Because these figures deal in averages, life expectancy at birth includes all those who will die in youth and middle age. By the time you reach 60, your average improves substantially. And it goes on improving.
I find that oddly comforting.
Oh, and the royals. Buckingham Palace has its own GP, specially to treat the servants. That’s on the NHS. The royals don’t go there. They go private.