Lifestyle choice does not explain a 17-year life expectancy gap

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By Dr Kayleigh Garthwaite, Birmingham Fellow
Department of Social Policy, Sociology and Criminology, University of Birmingham

When a researcher at BBC’s Panorama got in touch with me to say they were making a programme about health inequalities in Stockton, I had mixed feelings.

Just three years before, the second series of the popular ‘poverty porn’ television show Benefits Street was filmed on the Tilery estate, around less than a mile away from the town centre. The show depicted frequent criminal activity and a lack of education of residents amidst litter, empty beer cans, and horses freely roaming the streets. It left many local residents angry.

At the time, I was a researcher on a large five-year project, interested in examining why Stockton had the largest difference in life expectancy for men between the most and least deprived areas – just a 2 mile drive and a man in the Town Centre would live on average 17 years less than a man in nearby Hartburn – the largest gap in any single local authority in England. For women, the gap is over 11 years.

I spent 4 years carrying out ethnographic research in the Town Centre and Hartburn. That meant me spending time in both communities, getting to know the residents and asking them about their lives, their health, the neighbourhood, and possible explanations for the huge gap in life expectancy. I volunteered at the Trussell Trust foodbank, Citizen’s Advice Bureau, children and family centres, went to gardening clubs, yoga classes, and coffee mornings, alongside engagement with charities, events and services in the area.

Our research found that people across both the most and least deprived areas recognised how poverty can impact upon peoples’ health and bodies, both physically and mentally. The gap cannot be attributed to lifestyle choice.

Because of this, I decided to speak to the researcher from Panorama, despite my reservations. For an hour and a half, we spoke about the multiple and complex issues that factor in to make the gap so huge. We talked about how lifestyle ‘choices’ such as smoking, obesity and addiction are blamed as being the key reason behind the life expectancy gap, but the reality is much more complicated than that.

I was keen to stress to the researcher that in focusing on apparent choices such as smoking and drug taking, we miss the wider picture of structural inequality and its effects – for example, the poor housing conditions, insecure, precarious work, problems accessing (and indeed surviving on) the social security system, budget cuts to services such as Sure Start under austerity.

The researchers on Panorama also spent a lot of time with many different organisations in Stockton, such as Thrive, an anti-poverty charity who work with marginalised members of the community to affect change, improve livelihoods and give people a voice. And even filmed at the foodbank where I had volunteered.

Sitting down to watch the show, I was disappointed to see that none of this made the final cut. Instead, the BBC focused mainly on the shock factor with stories such as Amy’s, a 31 year old mother who had recently given her baby up for adoption due to her inability to care for her due to drug addiction.

Much of the social media reaction to the show focused on choice – why did she choose drugs over her kids? Why did Rob Hill, 46, who was dying of emphysema, choose to smoke and let his children eat pizza and chips for tea even though he was obese? Politicians and the wider public then get stuck on this viewpoint and the conversation never goes any further than “this person shouldn’t choose drugs” or “they shouldn’t eat a kebab”.

The life expectancy gap in Stockton can’t be explained away by lifestyle choice. Scapegoating people as ‘undeserving’ or as making so-called ‘poor choices’ doesn’t help. The bottom line is that people living in the most deprived areas don’t have enough money coming in to protect their health.

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