The COVID-19 pandemic has highlighted stark inequalities in healthy life expectancy, according to a report into ageing published on Friday 15 January.
The report into healthy ageing has been published by the House of Lords Science and Technology Committee, following an in-depth inquiry for which CMAR’s director Professor Janet Lord was Special Adviser.
The report finds that the “understanding of the biology of ageing is advancing rapidly”, with new medications and drug repurposing bringing the potential to delay the onset of age-related diseases.
The Committee recommends that the Government ensure the UK remains a global leader in drug research and development and that UK Research and Innovation commit to funding further research into the biological processes underlying ageing. Research to identify accurate biomarkers of ageing in humans should also be prioritised.
AI, emerging robotics and data driven technologies have the potential to significantly support healthier and independent living in old age. The report recommends that the Government make strategic investments in research in these areas to develop national expertise.
The report finds that the Government’s “Ageing Society Grand Challenge” target of ensuring people have five extra healthy years of life by 2035 will not be met. The Committee recommends that the Government produce a roadmap on how to achieve the target and report annually to Parliament on progress.
Inequality is a major cause of ill health, resulting in a growing period of poor health towards the end of life. The report finds shocking differences in healthy life expectancy amongst ethnic groups and in the most deprived groups, who spend almost 20 years longer in poor health than the least deprived.
For women, the Committee finds that “healthy life expectancy at birth has decreased in the past decade”, whilst for men improvements in healthy ageing have slowed. The Committee asks Government to set out a clear plan for reducing health inequalities over the next Parliament.
Furthermore, the report finds that healthy living messages are not having sufficient impact and urges more targeted public health advice, including making interventions early and throughout life.
Health inequalities
The report finds that COVID-19 has tragically further highlighted health inequalities, showing how poor health makes people more vulnerable to further health risks. Even before COVID-19, the “fragmentation of care contributes in many cases to even poorer health in older age”.
The report finds that the rate of multi-morbidity is increasing and that the current health system was not designed to treat people with multiple conditions. Care pathways are not well coordinated or integrated for older people, particularly those with multi-morbidity.
The report recommends assigning each older person a designated clinician who will have oversight of the patient’s care as a whole and who can coordinate across multi-disciplinary teams. The report also recommends that the MHRA ensure older people are more frequently included in clinical trials and show greater willingness to approve trials which target multiple conditions.
Professor Lord, Director of the University of Birmingham’s Institute of Inflammation and Ageing, and Specialist Adviser to the House of Lords Science and Technology Committee’s Inquiry, said: “The government has set a target of the UK achieving five more years of good health and reducing current stark health inequalities by 2035.
“This inquiry by the House of Lords Science and Technology Committee revealed that the target is unlikely to be met until there is a clear roadmap to achieve the target.
“Life expectancy is increasing but the time spent in good health in old age is not keeping pace – we are living longer but not healthier.
“Worryingly there are significant disparities in the time spent in ill health, with adults in the bottom decile of income spending almost 20 years more in ill health than those in the top decile.
“There have been major advances in our understanding of why we age and clinical trials are even now beginning with drugs that inhibit ageing processes in order to prevent age-related disease.
“This could deliver the step change required to achieve a longer and healthier life.”
Commenting on the report, Lord Patel, Science and Technology Committee Chair said: “The Committee found that the Government needs to urgently address the key issues of reducing health inequalities, implementing health system reforms and promoting lifestyle changes.
“The Government must therefore act now to increase support for the exciting new scientific research that targets the underlying processes of ageing.
“Treatments are being developed that could improve health without the need to treat multiple separate illnesses. Furthermore, technologies can be better utilised to help people live independently for longer.”