Life expectancy, obesity and mental health in the UK: health trends over 25 years

The Conversation's health series, by Michael Murphy of the London School of Economics, surveys how the UK’s health landscape has changed over the past quarter century, highlighting life expectancy trends, mortality shocks, obesity, mental health, and shifts in food and drug use. It draws on demographic insights to discuss policy implications and the future burden of chronic disease.

• Life expectancy gains in the UK have broadly tracked comparator countries, but improvements slowed from around 2011 and suffered a historically large fall in 2020 during the COVID-19 pandemic.
• Major causes of death remain cardiovascular disease and cancer, with declines in cardiovascular deaths slowing since 2019 and rising obesity signaling future health burdens.
• Food purchasing and advertising have shifted toward out-of-home and online consumption, contributing to unhealthy intake patterns despite regulatory progress.
• Mental health issues have risen among working-age adults, with parity of esteem shaping NHS policy but with ongoing workforce and funding pressures.

Life expectancy and illness

Life expectancy is a useful lens on national health, explaining how long a person born today would live if current death rates persisted. The UK exhibits two major turning points in its period life-expectancy over the past 25 years: a pronounced slowdown in improvements from the early 2010s and a sharp drop in 2020 during the COVID-19 pandemic. The 2020 shock was unusually large, with COVID-19 deaths contributing to the spike, but mortality rates subsequently fell each year, returning toward pre-pandemic levels by 2024, a pattern mirrored across western Europe. Across major high-income countries, UK gains were similar on average to peers, though the UK’s improvements were somewhat more persistent in the longer run. The most striking disruption occurred in the pandemic years, after which mortality rates settled back to near-2019 levels.

The long-running causes of death in England have been dominated by cardiovascular disease (about a quarter of deaths), cancer (roughly a quarter), respiratory diseases, and dementia, together accounting for about three-quarters of deaths. Earlier in the 2000s, cardiovascular mortality declined rapidly due to better treatment and prevention and a sustained decline in smoking; since 2019, however, progress has slowed, reflecting weaker breakthroughs in chronic disease management and mounting strains on health and social care systems. Obesity has risen markedly, from around a fifth of adults in 2001 to roughly 30% in 2024, foreshadowing higher future burdens from cardiovascular disease, diabetes and certain cancers. Non-fatal but disabling conditions are increasing; back pain is now a leading cause of years lived with disability, and rising mental health conditions, particularly among younger adults, are a growing concern. Overall health is deteriorating modestly, with fewer years lived in good health than one might expect given increases in life expectancy. The future health of the UK will hinge on addressing chronic disease, reducing obesity, and improving resilience to shocks.

Author: Michael Murphy, Emeritus Professor of Demography, London School of Economics.

Eating and drinking habits

Britain’s relationship with food has changed markedly since 2001. The retail landscape has been reshaped by the rise of discounters and the continuing dominance of supermarkets, which nonetheless influence public health through pricing, availability and promotion. Food purchased outside the home has increased substantially, with takeaway and delivery services expanding rapidly in tandem with online grocery shopping. Online ordering, apps, and loyalty schemes have made takeaway consumption easier and more frequent, often translating to higher caloric intake per eating occasion. Outdoor and indoor food advertising has grown in scale and complexity, including digital avenues, complicating the public health effort to shift diets toward healthier options.

Regulatory measures have evolved from voluntary to more interventionist policies. In 2025, the government announced a policy requiring large food businesses to report the healthiness of their sales and to meet mandatory improvement targets. Although these developments improve the regulatory framework, further action is expected to shift the nation toward healthier eating patterns.

Author: David Dearlove, Jurin Katayama, Lydia Leon (Nesta Healthy Life Mission).

Alcohol and drug use

Drug use has shifted with changing fashion, market dynamics, and global supply chains. Since the millennium there has been a notable increase in cocaine use, supported by wider availability and distribution channels, with cocaine-related deaths rising in England and Wales. Synthetic drugs, including synthetic opiates and novel psychoactive substances, have also grown, contributing to rising mortality. The internet has facilitated access to drugs via platforms like WhatsApp and Telegram, complicating enforcement of existing policy. Despite these shifts, policy remains anchored to a decades-old framework that may not align with contemporary patterns of use, suggesting a health-oriented rather than purely punitive approach could be more effective. There is little appetite for broad policy change, despite the need to disrupt supply in criminal networks.

Author: Ian Hamilton (University of York).

Sexual behaviour

Natsal data provide a window into Britain’s changing sex lives. By the early 2000s, shifts included later childbearing, more liberal attitudes toward sexuality, and increased diversity in sexual expression. The most recent surveys show ongoing evolution in online sexual activity and gender identities, with data on partner numbers and sexual practices showing substantial variation over time. Natsal-4, conducted 2022–2024, will be the first comprehensive picture of post-pandemic Britain’s sex lives, including online sexual activities and expanded measures of gender identities. The interpretation of these data will be refined as new results are published.

Author: Soazig Clifton (University College London).

Mental health

Since 2000, mental health has become a public health priority in the UK. There have been major shifts in attitudes toward mental health, with parity of esteem increasingly shaping NHS policy and the expansion of community-based care, talking therapies, and social prescribing. Yet challenges remain, including adverse childhood experiences, trauma, and continuing access gaps. Stresses from debt, housing, and work contribute to rising days lost to mental health problems, and workforce shortages place increasing pressure on NHS services. The overall goal is a healthcare system that prioritises prevention, compassionate care, and timely support across society.

Author: Kevin Stone, Sarah Vicary (Open University).