There is now a 20-year gap in healthy life expectancy between the most and least advantaged groups in the UK, according to Professor Jennie Popay of Lancaster University. In a letter responding to recent coverage of the Oxford Longevity Project's study, she challenges the notion that personal responsibility is the primary driver of poor health in old age.
The Myth of Personal Responsibility
Popay, who has spent decades researching health equity, expressed irritation at what she calls a "well-worn, misleading trope" that individuals bear at least 80% responsibility for their health in later life. She argues that the Oxford Longevity Project's study gave the impression that the causes of poor health and its unequal distribution are still an open question, which is not the case.
Evidence Points to Material Conditions
The weight of evidence accumulated over decades is clear: the primary causes of health inequalities are the material conditions in which people are born, live, work, and grow old. It is growing inequalities in access to material resources, power, and privilege—not irresponsible behaviours—that have created the stark 20-year gap in healthy life expectancy between the most and least advantaged groups in the UK.
Sponsorship Concerns
Popay also raises concerns about the study's main sponsor, Oxford Healthspan, a company that sells "whole-food spermidine" supplements. While good-quality research suggests these supplements show promise in laboratory and observational studies, the benefits shown in clinical human trials are mixed. She suggests that readers should have been informed about this potential conflict of interest.
In conclusion, Popay emphasises that health inequalities are not simply a matter of personal choice but are deeply rooted in social and economic structures. Addressing these requires tackling the material conditions that shape people's lives from birth to old age.
