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Key points

  • The rate of infant mortality in London was below 3.6 per 1,000 live births in 2013. A decade earlier it was 5.4.
  • The rate of underage pregnancies in London was 4.8 per 1,000 in 2011 to 2013, better than the England average of 5.5. In the last ten years the rate has fallen in London and was previously worse than that for England (when it was 9.9 and 8.0 per 1,000 respectively in 2001 to 2003).
  • The one health indicator that stands out for its deterioration is childhood obesity. Obesity rates among Year 6 pupils (age 11) in most London boroughs are higher than the England average. It is rising almost everywhere.
  • The incidence of long-term health problems or disability among working-age adults that limits day-to-day activities show a clear east/west pattern with all ten boroughs with the highest rates being in the Inner or Outer East.
  • Life expectancy has increased in London more than the rest of England and Wales over the past two decades. Life expectancy in London (at 80.0 for men and 84.1 for women) is now almost a year more than the rest of England and Wales.
  • While in absolute terms health outcomes have improved, substantial inequalities remain, both within and between areas of London. Kensington & Chelsea and Westminster men in the most deprived quarter of areas can expect to live 8 years less than a man in the least deprived quarter.

The relationship between poverty and health

There are strong and enduring links between health and poverty. Ill health is an additional burden that is more likely to affect those on lower incomes.

Sir Michael Marmot's wide ranging 2010 review of health inequalities across the country (Fair Society, Healthy Lives: The Marmot Review) demonstrated the gaps in life expectancy, disability and poor mental health between the top and bottom of British society.

At the national level, health problems are somewhat more likely to affect those with low incomes (or from manual social classes) than those with average or above-average incomes (or from non-manual social classes). Across England as a whole:

  • Infant deaths (deaths before the age of 12 months) are 50% more common in families from manual social backgrounds as families from non-manual social backgrounds.
  • People in the poorest fifth of incomes are far more likely to be at risk of a mental health problem than those in the richest fifth (22% – 7% for men, 24% – 12% for women).
  • Two-fifths of adults aged 45 to 64 with below-average incomes have a limiting long-term illness, more than twice the rate for adults of the same age with above-average incomes.
  • Death rates for cancer and heart disease, the two biggest causes of death for under 65s, are about twice as high for people from manual rather than non-manual backgrounds.

On average, then, ill health is an additional burden on people already coping with low incomes.