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15 April 2021

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Veena Raleigh

This article was updated on 15 April

2021. It was previously updated in June
2020 and originally published in August
2018.

There have been two turning points in trends in

life expectancy in England in the past decade.
From 2011 increases in life expectancy slowed
after decades of steady improvement,
prompting much debate about the causes. Then
in 2020, the Covid-19 pandemic was a more
significant turning point, causing a sharp fall in
life expectancy the magnitude of which has not
been seen since World War II.

This article examines trends in life expectancy

at birth up to 2020 and the impact of Covid-19
in 2020, gender differences, geographical
inequalities, causes of the changing trends
since 2011, and how the UK’s life expectancy
compares with other countries.

Note: This article presents findings for

England, except where the published data
relates to England and Wales or the UK.
The article refers throughout to life
expectancy at birth.

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Mortality has declined since the 19th

century, leading to a long-term rise in life
expectancy for both males and females
(see Figure 1). Males born in 1841 could expect
to live to only 40.2 years and females to 42.3
years, mainly because of high mortality rates in
infancy and childhood. Improvements in
nutrition, hygiene, housing, sanitation, control of
infectious diseases and other public health
measures have reduced mortality rates,
increasing life expectancy to 56 years for males
and 59 years for females by 1920.

Figure 1 Life expectancy at birth

England and Wales, 1841 - 2000

85
World War I

World War II

80 Females

75 Males

70

65

60
Years

55

50

45

40

35

30
18 1
50
60
70
80
90
00
10
20
30
40
50
60
70
80
90
00
4
18

18
18
18
18
19
19
19
19
19
19
19
19
19
19
20

Source: ONS • World War I 1914-1918. World War II 1939-

1945.

A Flourish chart

The 20th century saw further dramatic

improvements in life expectancy resulting from
public health measures such as childhood
immunisations, the introduction of universal
health care, medical advances in treating adult
diseases such as heart disease and cancer, and
lifestyle changes including a decline in smoking.
A century later, by 2019, life expectancy at birth
in England had increased to 80 years for males
and 83.7 years for females (see Figure 2).
However, the Covid-19 pandemic caused life
expectancy in 2020 to fall for males to 78.7
years and for females to 82.7 years, the level of
a decade ago.

Figure 2 Life expectancy at birth

England, 2000–20

85

84

83
Females
82

81
Years

80

79
Males
78

77

76

75
00

02

04

06

08

10

12

14

16

18

20
20

20

20

20

20

20

20

20

20

20

20

Source: ONS (2000-2019), PHE (2020)

A Flourish chart

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Women have always lived longer than men, but

the gender gap in 1841 (2 years) was relatively
small because of the high prevalence in the 19th
century of diseases that killed men and women
indiscriminately. In the late 19th and early 20th
centuries the gender gap in life expectancy
started to widen, peaking at 6.3 years by 1971
(see Figure 1). Reasons for the widening gender
gap included poor working conditions and
smoking among men in contrast to improved life
chances for women, for example, lower risk of
dying in labour and from tuberculosis, which
affected women more than men.

The gender gap narrowed from the 1970s, to

3.7 years in 2019, with mortality falling faster in
males than females because of decreases in
smoking and mortality from cardiovascular
diseases among men. However, the gender gap
widened in 2020 to 4 years because mortality
rates from Covid-19 were higher in males than
females.

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The data in this section predates the

Covid-19 pandemic.

a
Healthy life expectancy also increased over
time, but not as much as life expectancy,
so more years are spent in poor
health. Although an English male could expect
to live 79.8 years in 2017–19, his
average healthy life expectancy was only 63.2
years – ie, he would have spent 16.6 of those
years (21 per cent) in ‘not good’ health.

In 2017–19 an English female could expect to

live 83.4 years, of which 19.9 years (24 per cent)
would have been spent in ‘not good’ health. And
although females live an average of 3.6 years
longer than males, most of that time (3.3 years)
is spent in poor health.

Similarly, disability-free life expectancy is almost

two decades shorter than life expectancy, and is
higher among males (62.7 years) than females
(61.2 years).

a. Healthy life expectancy is an estimate of the number of

years lived in ‘very good’ or ’good’ general health, based on
how individuals perceive their general health. Disability-
free life expectancy is an estimate of the number of years
lived without a self-reported long-lasting physical or
mental health condition that limits daily activities.

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The data in this section predates the

Covid-19 pandemic.

People living in more affluent areas live

significantly longer than people living in
deprived areas. In 2017–19, males in the least
deprived 10 per cent of areas in England could
expect to live to 83.5 years, almost a decade
longer than males in the 10 per cent most
deprived areas (74.1 years). Females in the least
deprived 10 per cent of areas in England could
expect to live to 86.4 years, compared with 78.7
years for females in the most deprived areas, a
difference of almost 8 years. Much of this
inequality is caused by higher mortality from
heart and respiratory disease, and lung cancer in
more deprived areas. The male–female
difference in life expectancy is greater in more
deprived areas: for example, females in the most
deprived areas live 4.6 years longer than males,
compared with a difference of 2.9 years in the
least deprived areas.

The rich–poor gap in healthy life expectancy is

even greater – almost two decades – than the
gap in life expectancy. Those living in the most
deprived areas spend nearly a third of their lives
in poor health, compared with only about a sixth
for those in the least deprived areas. Males in
the most and least deprived areas spent 21.8
and 12.8 years respectively in poor health; for
females, the corresponding figures were 27.3
and 15.3 years. Hence, not only do people living
in the most deprived areas have the shortest life
spans, they also live more years in poor health.

Socio-economic inequalities in life expectancy

are widening as a result of greater gains in life
expectancy in the least deprived populations.
Males and females living in the least deprived
areas of England saw a significant increase in life
expectancy between 2014–16 and 2017–19; in
the most deprived areas no significant changes
were observed.

While mortality has declined everywhere, there

is a persistent north–south divide in life
expectancy and healthy life expectancy, with
people in southern regions on average living
longer and with more years in good health than
those living further north. For example, in
2017–19, life expectancy for males was about
eight years lower and for females about seven
years lower in Blackpool, Middlesbrough,
Manchester and Liverpool than in Kensington
and Chelsea, Camden, and Westminster. The
gap in years lived in good health across local
authorities in England was even greater, about
17 years.

Some population groups have significantly

shorter life expectancy than the general
population. For example, homeless males and
females live 31 years and 38 years fewer years
respectively than males and females on
average. People with learning disabilities also
have shorter lives than the average, by 23 years
among males and 27 years among females.

About 14 per cent of the population of England

is non-white. Life expectancy data is not yet
available by ethnic group because ethnicity is
not currently recorded at death registration but,
following the disproportionate impact of Covid-
19 on ethnic minority communities, the
government has said it will be introduced in
England (Scotland introduced it in 2012).

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Mortality from Covid-19 has had an unequal

impact on different population sub-groups and
exacerbated inequalities. Between 2019 and
2020 life expectancy in males fell by almost 2
years in the poorest decile of areas (from 74.3
to 72.4 years) compared with 1 year in the
richest decile (from 83.6 to 82.6); for females in
the poorest areas it fell by 1.6 years (from 78.9
to 77.3) compared with 1 year in the richest
(86.8 to 85.8). As a result, the gap in life
expectancy between the richest and the
poorest areas widened in 2020 to 10.2 years for
males and 8.5 years for females, compared with
9.3 and 7.9 years respectively in 2019.

Although 2020 life expectancy data isn’t yet

available for all population sub-groups, mortality
data for other groups also shows inequalities
which in turn will impact on life expectancy. For
example:

learning disabilities: mortality from Covid-

19 is about 1.5 times higher among people
with a learning disability or self-reported
disability compared with those without a
disability

ethnicity: although most ethnic minority

groups had lower overall mortality than
the white population before the pandemic,
that differential was reversed in 2020 in
some groups because of their higher risk
of infection and mortality from Covid-19.

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2011 marked a turning point in long-term

mortality trends, with improvements tailing off
after decades of steady decline. In the 100 years
to 2010–12, life expectancy increased by nearly
3 years every decade, but between 2011 and
2019 it increased by only 0.8 years for males
and 0.6 years for females, having virtually flat-
lined between 2014–18. However, in 2019 life
expectancy increased by 0.3 years in males and
0.4 years in females and in January–March
2020, before the Covid-19 pandemic took
effect, mortality was again at the lower level
seen in 2019. The life expectancy gains in
2019 and the fall in mortality in early 2020 were
associated with mild influenza (flu) seasons and
troughs in winter mortality.

One year deserves special mention – 2015,

when life expectancy fell across virtually all of
Europe. In England there were an estimated
28,000 deaths associated with flu and life
expectancy fell by 0.2 years in both males and
females – unprecedented for decades until the
Covid-19 pandemic in 2020. As in Europe, most
‘excess’ deaths in 2015 occurred among older
people, with deaths from respiratory disease
(including flu and pneumonia) being a key
contributor to the largest annual rise in deaths
since the 1960s.

A review of mortality trends in England to 2017

found that improvements in life expectancy
since 2010 had slowed in most areas of England
and among all socio-economic groups, but the
slowdown was greater among the most
deprived groups and inequalities had widened.
Slowing mortality improvements among people
aged 50 years and over played a significant role.

The reasons for the post-2011 slowdown in life

expectancy improvements are unclear and have
been hotly debated.

Several studies attributed both the 2015 fall in

life expectancy and the slowdown in mortality
improvements after 2011 to the consequences
of austerity-driven constraints on health, social
care and other public spending and their impact
on services.1-6 Others acknowledge that
austerity could have had negative consequences
on the quality of care, resulting in some excess
deaths, but they suggest that statistical
associations don't prove causality and there
could be other explanations. For example, the
growing complexity of medical conditions in an
ageing population, and the contribution of
decelerating improvements in cardiovascular
disease (CVD) mortality and periodic bad flu
seasons to the decelerating mortality
improvements seen in many high-income
countries.7-10 Moreover, some European
countries that didn’t adopt austerity policies
also experienced slowdowns in life
expectancy improvements (eg, Germany and
Sweden), while life expectancy increased in
others that introduced severe austerity
measures (eg, Spain, Ireland, Greece).11

Public Health England’s review identified some

of the factors contributing to slowing
improvements in life expectancy to 2017:
increasing numbers of older people vulnerable
to flu and other winter risks, slowing
improvements in mortality from heart disease
and stroke, widening inequalities and rising
death rates from accidental poisoning among
younger adults (mainly due to drug misuse). It
noted that the slowdown occurred across much
of the population, at a time when health and
social care services faced increasing demand
and unprecedented financial pressures.

A slowdown in improvements in life expectancy

since 2010 was seen also in many European
countries, but it was greatest in the UK. It’s
likely that there were several reasons for these
trends, some specific to the UK (such as
widening inequalities) and some common to the
UK and other European countries (such as the
swings in flu-related mortality and slowdown in
CVD mortality improvements in some
countries).11-13 The later uptake of smoking in
women compared with men is cited as one
explanation for the long-term, relatively small
increases in female life expectancy in the UK in
recent years, and why it compares poorly with
Europe.14

The slowdown in life expectancy improvements

between 2011 and 2019 was nothing compared
with what was to follow. The Covid-19
pandemic caused 72,000 excess deaths in
England in 2020 compared with the 2015–19
average, resulting in the largest annual fall in life
expectancy since World War II: a fall of 1.2
years in males and 0.9 years in females.
Moreover, there have been more than 28,000
excess deaths between 1 January and 2 April
2021, 20 per cent more than the 2015–19
average for the same period, so life expectancy
in 2021 could remain below levels seen in the
pre-2020 decade.

Further details about mortality from Covid-19

are available in our explainer, ‘Deaths from
Covid-19 (coronavirus): how are they counted
and what do they show?’.

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b
Life expectancy data for European countries is
available only to 2019, hence it doesn’t reflect
the impact of the Covid-19 pandemic.

In 2019, life expectancy at birth varied by 10.6

years for males and 7.9 years for females across
the 28 European Union (EU) countries (the UK
did not leave the EU until 2020) (see Figures 3
and 4). Generally, western, northern and
southern European countries had higher life
expectancies than central and eastern European
countries. Women outlive men in all EU
countries.

In 2019, male life expectancy in the UK was

below that of several western European
countries, while female life expectancy was
below that of all western European countries
and also the EU average. For males in the UK,
life expectancy was almost 2 years less than the
highest seen in the EU (Sweden) and for females
it was more than 3 years shorter than the
highest (Spain).

Figure 3 Life expectancy at birth in the EU,

males
2019

90
80
70
60
50
Years

40
30
20
10
0
Sl ola ry
Huma ia

Sl rtu 27

F e y
nmand
A Uk
Beust K
xe Fr um

en
Gr ana
ngnia

la s
Sp nd
Li ulgtvia

Ireands

M ain
Rohua ria

Po EU ep

Sw Itata
ed ly
Esvak d
Cz Croonia

Lu lgi ria
De inl ece
ec at a
h ia

th Cypurg
Geovegal

Ne bo ce
er ru
ar
rm ni
t i
o n
n
P a

al
m an
R
t a
B La

Source: Eurostat, ONS (UK only) • Note that EU and UK data

are from di!erent sources and therefore not strictly
comparable; however historical life expectancy data show
any di!erences between Eurostat and ONS calculations are
likely to be very small (less than 0.3 years)

A Flourish chart

Figure 4 Life expectancy at birth in the EU,

females
2019

90
80
70
60
50
Years

40
30
20
10
0
Li La ary

Crvakia

Ne Ge m UK
th rm ark
la y

Aueec7

Sl yp m

m dd
bo en
Ire alta
ngnia

EUnds

F tu d
Sl ua via

e s

n
Huma ria

to p

Po la a

a y
Cz Po atia
Es Red

C iu a
Be st e
De nia
ec lana

Fr Italg
Lu S inlagal

Spnce
ov ru
er an

Gr 2

M ni
o i

lg ri

ur
xe we n

ai
r n
o n
Roulga

th t

n
B

Source: Eurostat, ONS (UK only) • Note that EU and UK data

are from di!erent sources and therefore not strictly
comparable; however historical life expectancy data show
any di!erences between Eurostat and ONS calculations are
likely to be very small (less than 0.3 years)

A Flourish chart

Figures 5 and 6 show that, whereas male life

expectancy in the UK in the preceding decade
was about average compared to most western
European countries, female life expectancy in
the UK was consistently the lowest among
peers. As in the UK, improvements in life
expectancy slowed in many European countries
in the decade to 2019. However, the slowdown
was greater in the UK than in most other EU
countries.

The periodic spikes in excess deaths in some

recent winters, especially among older people,
show similar patterns across the UK and several
European countries, and, according to official
agencies are associated with flu and cold spells.
In particular, as in the UK, European agencies
reported increased mortality in 2015 that
disproportionately affected older people, and
women in particular. Compared with 2014, in
2015 life expectancy fell in 23 of the 28 EU
countries for females and in 16 EU countries for
males (see Figures 5 and 6). European
monitoring agencies report that this
widespread fall in life expectancy resulted from
excess winter mortality associated with flu.

Figure 5 Life expectancy at birth for

selected EU countries, males
2005–19

82
Sweden
Italy
81 Spain
Ireland
80 France
UK
Greece
79
Germany
Years

EU 27
78

77

76

75
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

Source: Eurostat, ONS (for UK 2019) • EU27 as of 2020, a"er

Brexit and the accession of Croatia

A Flourish chart

Figure 6 Life expectancy at birth for

selected EU countries, females
2005–19

87
Spain

86 France
Italy

85 Sweden
Ireland
84 Greece
EU 27
Years

Germany
83 UK

82

81

80
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20

Source: Eurostat, ONS (for UK 2019) • EU27 as of 2020, a"er

Brexit and the accession of Croatia

A Flourish chart

When 2020 life data becomes available, it is

likely (as in the UK) to show a fall in life
expectancy in several European countries, as
most of them also experienced excess mortality
due to the pandemic compared with preceding
years. The ONS analysis showed that the UK
had the highest excess mortality rate in Europe
in the first Covid-19 wave to June 2020, but not
in the later months of the year. Excess mortality
in the UK in 2020 overall ranked 7th out of 22
c
European countries, with only Spain, Belgium
and some eastern European countries having
even higher rates. Some countries, including
Denmark, Norway, Finland, Estonia, experienced
no excess mortality in 2020

b. Eurostat data on life expectancy in the EU countries from

2005 to 2019 is used in this section. Although the UK did
not leave the EU until 2020, UK life expectancy data for
2019 is not available from Eurostat, so ONS data is used
instead. Methodological differences in calculating life
expectancy between Eurostat and ONS could affect the
results, therefore UK life expectancy for 2019 is not
strictly comparable with that of other EU countries.
However, a comparison of ONS and Eurostat data on life
expectancy in the UK for the pre-2019 decade shows the
difference is likely to be small (about 0.1 to 0.3). Because
the Eurostat data for 2019 doesn’t include UK data, the EU
average is shown as EU27 not EU28. UK data is available
in the Eurostat database for years preceding 2019.

c. Data for some European countries (eg, Republic of Ireland,

Germany, Italy) was not available, hence they were not
included in the ONS analysis.

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The scale of excess mortality associated with

Covid-19 thus far in 2020 and 2021, and
evidence that many lives have been cut short, is
unprecedented in recent decades. The
pandemic isn’t over and the magnitude of its
continuing impact on life expectancy in England
will depend on associated mortality (caused
directly by Covid-19 and indirectly by fewer
people seeking or receiving care for other
conditions) in the months ahead. These, and the
wider socio-economic effects of the Covid-19
pandemic on population health and mortality,
could last well beyond 2020 and widen health
inequalities further.

Before the Covid-19 pandemic, life expectancy

in the UK trailed many western European
countries, especially for females, and the UK