Things Fall Apart: the British Health Crisis 2010–2020
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.
One hundred years ago, Yeats wrote that ‘Things fall apart’ in his poem ‘The Second Coming’. Written in response to turmoil across Europe, including in his native Ireland, it has often been invoked in writings about societal decline. In 2016, it seemed particularly apt in the UK when, by a small majority, the British population opted for a future outside the EU, beginning a process that, so far, has created almost 4 years of political gridlock in which a barely functioning parliament has been unable to tackle mounting and increasingly severe social, economic, housing and health problems. An analysis published a few months after the referendum found that Yeats’ poem had been quoted more often in the first part of that year than in any of the previous thirty years.
There is no doubt that the UK has faced many problems in recent years, including political crises and relative economic decline. But are things really falling apart? In this paper, we argue that there is considerable evidence that they are, with profound consequences for the future of the UK. Our assessment is based on an examination of what is happening to the health of the British population. Since the middle of the 18th century, the health of the British people has been improving.Yet in recent years infant mortality has risen overall (most markedly in England and Wales), life expectancy fell everywhere in 2015 and appears now to have stalled, health inequalities have widened and access to healthcare has worsened. History tells us that this should be a matter of great concern. One of the first indicators that a state is failing has been stagnating or worsening health. In the early 1980s, few observers of the USSR believed that it was in decline, but those who studied health data challenged this consensus when they found an unexpected rise in infant mortality. In the 21st century, worsening health in the USA has been associated with a loss of faith in traditional institutions.
In the remainder of this paper we review the evidence that causes us so much concern.
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