The Health Foundation recently published an article discussing the significant challenges facing the health and care sector in England. This article explores nine significant challenges facing the health and care sector in England. In this post, I will focus on one of these challenges, specifically the fact that people are living longer lives but with major health conditions.
Several factors contribute to the growing number of individuals experiencing poor health. These factors encompass shifts in the occurrence of key risk factors for ill health, socio-economic conditions, population size, demographics, and many more.
The Health Foundation points out that in the decade preceding the pandemic, England witnessed a 25% increase in the number of individuals coping with significant illnesses, such as cancer, dementia, or a combination of various health conditions. This period also marked a substantial rise in the amount of people living with multiple health conditions.
The impact of illness is not uniformly distributed across society. Individuals residing in more deprived areas face a higher likelihood of experiencing multiple health conditions, and they tend to develop these conditions at a younger age. For instance, The Health Foundation notes that an average 60-year-old woman in one of England’s most deprived regions has a burden of diagnosed illnesses, such as chronic pain, diabetes, cardiovascular disease, or depression, equivalent to that of a 76-year-old woman in one of the wealthiest areas.
The article highlights recent analyses that suggest these trends are expected to continue. By 2040, almost one in five adults in England, up from one in six in 2019, will be living with major illnesses. This translates to an additional 2.5 million individuals, representing a 37% increase since 2019. Consequently, by 2040, approximately 9.1 million people in England will be living with significant health conditions. In contrast, the number of healthy working-age individuals is projected to increase by just 4% during the same period, creating challenges for the labour market and the economy as demand for NHS funding from a relatively smaller tax revenue grows.
Although life expectancy is expected to increase by an average of 1.4 years between 2019 and 2040, the age at which individuals are projected to encounter major illnesses is anticipated to remain constant at 70 years. Moreover, the prevalence of multimorbidity is expected to rise across all age groups, with people having an average of three long-term conditions at the age of 70 and five or more by the age of 85. Significant increases are anticipated by 2040 in conditions such as diabetes (49% increase), chronic pain (32% increase), anxiety or depression (16% increase), dementia (45% increase), heart failure (92% increase), and cancer (31% increase), with obesity serving as a key factor driving this upswing.
The escalating prevalence of major illnesses will significantly impact both the NHS and wider public services, adding pressure to various aspects of the NHS. Many of the conditions expected to see substantial growth, like diabetes and chronic pain, are typically managed in primary and community healthcare settings. Paradoxically, The Health Foundation report that over the past two decades, NHS resources and spending have shifted away from primary and community care towards acute hospitals.
It is important to emphasise that these are projections and not certainties. They represent a worst-case scenario, but serve as a vital warning for the future, nonetheless.
Our online RSPH level 2 Award in Understanding Health Improvement covers these issues (and many more). For more details see here >>
Further information:
Ageing and health – World Health Organization (WHO)
Major conditions strategy: case for change and our strategic framework
Health in 2040: projected patterns of illness in England
Health in 2040: interactive chart projections
2.5 million more people in England projected to be living with major
Health in 2040: projected patterns of illness in England | Health
Multi-morbidity predicted to increase in the UK over the next 20 years
Health Profile for England: 2021 – GOV.UK
