From Owen Jones:

No excuses for the Tories, no place to hide: that poverty and economic insecurity kill is an incontrovertible fact. Some may flinch when they hear that the government’s failure to address a worsening cost of living crisis will tip many of its citizens into premature graves, but the macabre nature of a fact does not make it less true.

New research published by the Office for National Statistics is merely the latest addition to what has been understood by anyone with a sufficient interest in matters of life and death for centuries. The ONS figures show that avoidable deaths account for four in 10 male deaths in England’s poorest communities: in the least deprived, that figure is less than half, at 17.8%. For women, the figures are lower, but the gap barely less acute: 26.7% and 11.9% respectively.

Does deprivation kill? Most certainly it does, yes. Deprive someone of water and they die very soon. Deprive them of food and it takes a little longer. And so on. But what Jones is describing here is not deprivation - it’s inequality. This is some having less than others. Inequality does not, in fact, work in the same way as deprivation.

The actual ONS figures:

Alcohol and drug-related disorders; the only category of causes where the age-standardised mortality rate (ASMR) has shown statistically significant increases since 2001 for males and females in the most deprived areas and males in the least deprived areas.

Neoplasms (cancers); the largest cause of avoidable mortality for females in the most and least deprived areas and for males in the least deprived areas in 2020.

Those are the two big issues.

Booze and drugs runs up against that long standing criticism we’ve had about the Sir Michael Marmot numbers. Marmot insists that it is the poverty - inequality, sorry - which drives the health inequality. As we keep saying, this could be possible but it’s vital to also note that health inequality will drive, to some extent, the economic inequality. Those drinking themselves to death - or injecting etc - are rather likely to have made themselves poorer in the process and thus be living in cheaper areas.

Until and unless this is unpicked then the numbers are valueless. Certainly, we cannot say that inequality leads to cirrhotic livers if it’s the exploding livers which lead to the inequality.

The other part, the cancers. Well, yes, this is a measure of “mortality amenable to health care” as ONS says. As is also true in all of the international surveys of health care systems among rich nations the NHS does worst in “mortality amenable to health care”. In those studies from the likes of the Commonwealth Fund the NHS is great at equality of access, equity of funding and so on. And, of rich world systems, worst at actually treating people - that mortality amenable to health care.

Both ONS and Jones have just noted that people making themselves poorer through addictions tend to live in cheaper areas. Plus, the NHS as a health care system isn’t very good at actual health care. But important, even vital, points to make. But not the point that Jones chooses to make which is a pity. For reducing inequality isn’t going to solve either of those issues yet inequality reduction is Jones’ preferred policy.

Ah well, it is only a Guardian column after all.