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The contribution of changes to tax and social security to stalled life expectancy trends in Scotland: a modelling study
  1. Elizabeth Richardson1,
  2. Martin Taulbut1,
  3. Mark Robinson2,
  4. Andrew Pulford1,
  5. Gerry McCartney1
  1. 1 Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
  2. 2 The University of Queensland, Saint Lucia, Australia
  1. Correspondence to Gerry McCartney, Place and Wellbeing Directorate, Public Health Scotland, Glasgow G2 6QE, UK;gmccartney{at}nhs.net

Abstract

Background Life expectancy (LE) improvements have stalled, and UK tax and welfare ‘reforms’ have been proposed as a cause. We estimated the effects of tax and welfare reforms from 2010/2011 to 2021/2022 on LE and inequalities in LE in Scotland.

Methods We applied a published estimate of the cumulative income impact of the reforms to the households within Scottish Index of Multiple Deprivation (SIMD) quintiles. We estimated the impact on LE by applying a rate ratio for the impact of income on mortality rates (by age group, sex and SIMD quintile) and calculating the difference between inflation-only changes in benefits and the reforms.

Results We estimated that changes to household income resulting from the reforms would result in an additional 1041 (+3.7%) female deaths and 1013 (+3.8%) male deaths. These deaths represent an estimated reduction of female LE from 81.6 years to 81.2 years (−20 weeks), and male LE from 77.6 years to 77.2 years (−23 weeks). Cuts to benefits and tax credits were modelled to have the most detrimental impact on LE, and these were estimated to be most severe in the most deprived areas. The modelled impact on inequalities in LE was widening of the gap between the most and least deprived 20% of areas by a further 21 weeks for females and 23 weeks for males.

Interpretation This study provides further evidence that austerity, in the form of cuts to social security benefits, is likely to be an important cause of stalled LE across the UK.

  • Health inequalities
  • Poverty
  • Public health policy
  • Social epidemiology
  • Socio-economic
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Footnotes

  • Twitter Gerry McCartney @gerrymccartney1.

  • Contributors MT conceived the idea for the study. ER conducted the analyses. GM, MT and ER wrote the paper. All authors contributed to drafting the paper, provided substantive comments on the paper and approved the final version.

  • Funding All authors were employees of the NHS when the study was completed. No specific funding was sought or received for this work.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval We did not require ethics approval for this study as this used only secondary anonymised data.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

  • Supplemental material This content has been supplied by the authors. It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the authors and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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