If Benjamin Franklin was right and nothing in this world is certain except death and taxes, he might also have added that a third certainty is that they will be unequal.
In this month’s Pulse, the report from the Office for National Statistics which looks at the relationship between how well off you are and how likely you are to die as the result of a preventable condition makes a simple point: The poorer you are the more likely you are to die before your time. This has always been so, but this inequality was improving between 2001 and 2010, but has got worse again between 2011 and 2017.
The NHS England Learning Disability Mortality Programme action from learning report looking at premature deaths by people with a learning disability further highlights the nature of inequality. Since 2015 eleven people with a learning disability died primarily as the result of constipation - a both highly preventable and treatable condition in the wider population.
There are no simple answers to the inequality of early deaths by any part of the population but it is true that the poorest and most vulnerable people have a far greater reliance on support from publicly funded services. Reducing spend which results in a reduction in provision rather than a greater efficiency means that this pattern of inequality is unlikely to change anytime soon.
It has been strange, almost surreal, to watch debates between experienced politicians vying to be the next Prime Minister where there appears to be collusion in the denial of the relationship between the levelling of tax and the amount of money available to fund public services.
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