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Cuts to local government funding in recent years cost lives, study finds

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A new study from researchers at the University of Liverpool shows that decreasing local government funding over recent years probably contributed to declines in life expectancy in some areas of England, which was stalling even prior to the COVID-19 pandemic.

Local government funding and life expectancy in England, a longitudinal ecological study published in The Lancet Public Health, linked annual local government funding data from the Ministry of Housing, Communities, and Local Government with life expectancy and mortality data from Public Health England between 2013 and 2017.

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Corresponding author Dr Alexandros Alexiou said: “Since 2010, large reductions in funding for local government services have been introduced in England, which led to reduced provision of health-promoting public services. We wanted to investigate whether areas that showed a greater decline in funding also had more adverse trends in life expectancy and premature mortality.

“Prior to the COVID-19 pandemic, stalling life expectancy in England was a major public health concern, and the causes were unclear.

“Our research shows that cuts to local government over recent years have probably cost lives. We found that, during a period of large reductions in funding for local government in England, areas that experienced the greatest cuts also experienced slower improvements or a decline in life expectancy. As funding for the most deprived areas decreased to a greater extent, they experienced the most adverse impact – widening health inequalities.

“This has important implications for current policy and for recovery from the COVID-19 pandemic.”

On average between 2013 and 2017 central funding to local governments decreased by 33% or £168 per person in total. Each £100 reduction in funding per person was associated with an decrease in 1.3 months in male life expectancy and 1.2 months in female life expectancy.

As funding reductions were greater in more deprived areas, these places were more severely affected, increasing the gap in life expectancy between those places and more affluent areas. Researchers estimated that cuts in funding increased the gap in life expectancy between the most and least deprived areas by 3% for men and 4% for women. Overall reductions in funding during this period were associated with an additional 9600 deaths in people younger than 75 years old.

Dr Alexiou added: “Our study suggests that reduced funding for local services that disproportionally affected deprived areas have had a significant impact on health. The UK government has declared that austerity is over and has committed to investing more to ‘level up’ those places that have previously been ‘left behind’. Fair and equitable investment in local government services can redress these inequalities, enabling the country to ‘build back better’.”

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This work was funded by the NIHR and MRC.

The full paper is available in the Lancet Public Health, here: http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00110-9/fulltext

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