ABSTRACT
The health of a country depends on the behaviour of its citizens, and British Governments have been expecting the latter to be responsible for, and look after, their own health. Health varies with social position and health behaviour, and ‘to a greater extent than in some other European countries, health in Britain follows the contours of social disadvantage’ (Graham, 1990; Townsend, 1979). Among the seven countries which form the G7, the UK is in second from last position (sixth) regarding healthcare spending as a proportion of GDP (9.9% of GDP in 2014). France and Germany spent more per person on healthcare, while Italy spent the least (9.1% of GDP) (ONS, 2016b). Average life expectancy in the UK is 81.2, namely 79.4 for men and 83 for women; in Italy, 82.7 and in France, 82.4 (Kontis et al., 2017). In England, ‘people living in the poorest neighbourhoods, will, on average, die seven years earlier than people living in the richest neighbourhoods … Even more disturbing, the average difference in disability-free life expectancy is 17 years … So people in poorer areas not only die sooner, but they will also spend more of their shorter lives with a disability’ (The Marmot Review, 2010, 16). Health is a complex interaction between environment, lifestyle, work, genetics, education, background and housing in particular, and also the interest that individuals take in their own health. The most important factor associated with self-reported health is an individual’s well-being, then their employment status, followed by the nature of their relationships, which has an important impact on people’s well-being. Single people rate their happiness on a lesser score than do married couples or those in civil partnerships (ONS, 2013a): ‘Living alone is negatively related to our personal well-being, regardless of relationship status’ (Ibid, 2).
‘In the 30 years since the publication of The Black Report, it has become apparent that people’s behaviours are often anchored not just in their culture but in their social and economic circumstances: eating healthily is not cheap and smoking can afford temporary relief in the face of the monotony of everyday lives devoid of tangible hope’ (Scambler et al., 2013, 134). Research surmises that ‘material poverty predisposes, however circuitously, to poverty of health and life expectancy’ (Ibid, 131).
