A major cause of the fall in healthy life expectancy (People in UK spend fewer years in good health than a decade ago, study finds, 27 April) is austerity and the continued cuts to social and health spending. In our report Still Digging Deeper: The Impact of Austerity on Inequalities and Deprivation in the Coalfield Areas, which covers Scotland, England and Wales for the period 1984-2024, we highlight how public expenditure cuts since 1984 have disproportionately impacted coalfield areas of the UK.

Since 2010, austerity has been stepped up, and we have calculated that welfare reforms and benefit cuts amounted to £32.6bn over the period of 2010-21. Furthermore, in 2025-26 coalfield local authorities had a combined funding gap of £447m. These are areas where a significant proportion of the working-age population is affected by long-term sickness and experiences poverty.

The rates of “avoidable mortality” – deaths from causes considered treatable or preventable given timely and effective healthcare or public health interventions – along with those on NHS waiting lists are higher in these areas.

We agree with the Health Foundation that a new, more radical approach is required, but we also call for an end to austerity policies and an economic and social model that focuses on poverty reduction, raising people’s incomes and sustainably funded public services.
David Etherington
Emeritus professor, University of Staffordshire
Prof Mia Gray
University of Cambridge
Prof Lisa Buckner
University of Leeds

The sharp decline in healthy life expectancy in the UK in the decade from 2012-14 to 2022-24 revealed in analysis by the Health Foundation is a shocking indictment of the state of health of the UK population. Neither the authors of the Health Foundation analysis nor the Guardian article mention the role of the decade of austerity initiated by the coalition government in 2010 that is known to have been linked to thousands of excess deaths and is plausibly implicated in the decline in healthy life expectancy. Policy initiatives aimed at lifestyle and health behaviour change are unlikely to reverse this decline in the absence of measures to reverse the ravages of austerity.
Professor Emeritus Nick Spencer
Leamington Spa, Warwickshire

Given that we have had austerity since 2010, is it surprising that healthy life expectancy has fallen? But as a teacher I do wonder why more efforts have not been made to boost food technology or cooking in schools, and spend more time on physical education. Is prevention not more effective in increasing healthy life expectancy?
Kartar Uppal
Streetly, West Midlands

I’m surprised that no connection is ever made between the reduction in smoking and the increase in obesity. Is it possible that people have turned to overeating junk food in place of smoking for a quick hit of much-needed pleasure or self-medication, and that this turns out to be even worse in health terms?
Tessa Hall
Woodstock, Oxfordshire

Your story highlighting recent research from the Health Foundation saying that Britain is “going backwards” on healthy life expectancy compared with most other rich countries is a sad and damning indictment of the sick society we live in, and the craven behaviour of politicians of all stripes who have been in thrall to the activities of big business, especially big food and big alcohol, for years. Of course, the unaccountable multi-million pound lobbying industry is part of the problem too.

More than a decade ago, I used to work for a health inequalities campaign organisation in the north-west of England, Our Life, which was set up by the NHS in the region and supported by many local authorities. Many of the findings in this Health Foundation study come as no surprise to me, given the work that we were undertaking back then, which included campaigns to introduce a minimum price for alcohol and sustained efforts to address “food deserts” by improving access to fresh, healthy and affordable food in local communities. This latest analysis of healthy life expectancy in 21 countries by the Health Foundation would seem to indicate that nothing has changed in this area for more than a decade. Actually, this is not strictly true. Things have got worse. Politicians should hang their heads in shame.
Andy Walker
Langley Park, County Durham