I’m a runner. I don’t tend to talk about this, since doing so induces eye-glazing vacancy amongst listeners after more than 20 seconds. Besides, talking about running rarely makes for a successful memoir. So don’t worry, this post is not about running, it’s about EU policy (although EU policies can have the same eye-glazing effect upon me at times). But it was provoked by a thought I had whilst running a race at the weekend. Specifically, I was wondering why there are so many incredibly fit old runners. And why they all run faster than me.
In order to test my theory that older runners are getting faster (and in the hope of disproving the hypothesis that I am just getting slower) I engaged in what used to be called academic research, but is now called Googling. And this is what I found.
A 2003 study examined marathon times in the New York city marathon between the years 1983 to 1999, and found that the number of older runners (aged 50 plus) running marathons is increasing faster than any other age group, and that the times of the fastest older runners are improving faster than any other age group as well (Master’s performance in the New York City Marathon 1983–1999, P Jokl, P M Sethi, A J Cooper Br J Sports Med 2004;38:408-412). The relative increase in participation by older runners applies to both men and women, as do the improvements in running times. In fact, while younger runners have not got any faster over the last 25 years, older marathon runners are closing the gap – the results of the fastest runners aged between 70-79 reveals an annual mean improvement of nearly 2 minutes per year over the course of the study. The graph above shows the results of women runners by age category, where the improvements in average times over the years by older runners is even more pronounced than amongst men. So there are more older runners, and they are running faster.
The authors of this study hail these results as an illustration of the benefits of active ageing, suggesting that looking at these ‘elite’ older runners demonstrates the increasing potential for healthy ageing for all of us.
So what’s the secret to running a marathon at 70+? Is it a smart training programme? Good nutrition? Or even good genes?
Well, while all of those may be useful, the biggest secret lies elsewhere. And, whatever age you are, it’s already too late to have the biggest impact on your chances of being in marathon-running shape at 70. In fact, it was too late from the moment you were born, thanks to the way in which good health is socially determined.
The graph below shows the differences in health outcomes between those born in the most and least deprived neighbourhoods in England. The top line shows life expectancy, the bottom shows the maximum age at which you can expect to enjoy a life free of disability or serious illness.
The x-axis shows the difference according to whether you were born in a poor neighbourhood, or a rich area. The green band in between shows the retirement age. The average difference in disability-free life expectancy between the richest and most-deprived areas is 17 years. So if you happened to be born into a deprived neighbourhood – even within one of the richest countries in the world – you can forget about your marathon-running retirement, because the chances are, you’ll already be suffering from a serious disability or illness before you reach retirement age.
The graph is taken from Fair Society, Healthy Lives, the review of health inequalities in England carried out by Professor Michael Marmot and team and published earlier this year. Marmot’s work (including his global report on social determinants of health for the World Health Organisation) is now being picked up at EU-level, by public health activists, including through projects such as the Equity Channel and Gradient (disclosure: I’ve worked with EuroHealthNet, which is involved in both initiatives).
The European Commission produced a Communication on the issue late last year. Now it’s fair to say that Communications are not the most…shall we say powerful of all of the instruments at the Commission’s disposal. They tend to be used to open a discussion, test the water for future action, or as an acknowledgment that something must be done, but we’re not sure what, or whether we have the power to do it. In this case, it’s also down to the fact that health inequalities are not exactly an easy issue to solve. You can’t just produce a Directive to Make Society Fairer… well, maybe that’s not a bad idea actually, but it’s not going to happen just yet.
To be fair, the Communication does point out that the EU is already trying to address this problem through actions in a number of policy areas. But looking down the list, it’s difficult to see that health inequalities are a major priority in some areas – and the Communication acknowledges that, ‘currently few EU policy actions are evaluated after implementation in relation to their impact on health inequality’. In other words, lots of policies should be reducing health inequalities, but we’re not sure that they are doing so. So there is a battle being fought to push this up the agenda, but it’s far from won for now.
It’s interesting that as part of its regional policy the EU has a convergence objective which aims to reduce economic differences between regions, but we don’t seem so happy to target convergence in terms of reducing inequalities between different groups of people.
Of course, one of the reasons why health inequalities is not at the top of the policy agenda is because recognising that health depends (largely) upon socio-economic factors also means recognising the fundamental unfairness within our societies. And that’s a bit too uncomfortable. We might even have to ask why life’s marathon is a race which some have lost before they begin.