Ask how long a Londoner can expect to live, and the honest answer is: it depends which borough they were born in. Life expectancy by borough in London is not a footnote in public health reporting — it is one of the starkest, most consistently repeated findings in the data, and it is exactly the kind of borough-level reality this review exists to explain plainly.
The numbers: how far apart are London’s boroughs
Using the most recent published borough figures (2021–2023), the gap in overall life expectancy at birth is substantial. For women, the highest figure is in Kensington and Chelsea at 86.5 years; the lowest is in Barking and Dagenham at 81.0 years — a difference of 5.5 years. For men, the highest is in Richmond upon Thames at 82.5 years, against 77.3 years in Barking and Dagenham, a gap of 5.2 years. Taken across all boroughs and both sexes, the distance between the highest and lowest figures in London has been recorded at as much as seven years. That is roughly the same span as the gap between a healthy midlife adult and someone entering a materially higher-risk decade — except here it is a gap between two postcodes, not two ages.
Healthy life expectancy: the gap that matters more
Life expectancy counts every year, whether spent in good health or not. Healthy life expectancy (HLE) — the average number of years a person can expect to live in self-reported "good" or "very good" health — tells a sharper story, and it is the figure this briefing treats as the more meaningful one. Across London boroughs, HLE for women ranges from 57.0 years in Lewisham to 70.2 years in Richmond upon Thames. For men, it ranges from 57.8 years in Lewisham to 69.5 years in Richmond upon Thames. People born in the boroughs with the highest healthy life expectancy — Richmond upon Thames, Sutton and Bromley — can expect roughly a decade more of healthy life than those born in boroughs such as Lewisham, Haringey and Greenwich. Nationally, the gap in healthy life expectancy between the most and least deprived areas of England has widened, not narrowed, growing to 18.2 years for women and 17.9 years for men between 2011–2013 and 2021–2023.
| Measure | Highest borough | Lowest borough | Gap |
|---|---|---|---|
| Life expectancy, women | Kensington and Chelsea (86.5 yrs) | Barking and Dagenham (81.0 yrs) | 5.5 years |
| Life expectancy, men | Richmond upon Thames (82.5 yrs) | Barking and Dagenham (77.3 yrs) | 5.2 years |
| Healthy life expectancy, women | Richmond upon Thames (70.2 yrs) | Lewisham (57.0 yrs) | 13.2 years |
| Healthy life expectancy, men | Richmond upon Thames (69.5 yrs) | Lewisham (57.8 yrs) | 11.7 years |
Why the gap exists: deprivation, air and housing
None of this is random, and none of it is new. The 2010 Marmot Review, and its 2020 follow-up, established what remains the reference framework for understanding health inequalities in England: the more deprived an area, the steeper what researchers call the social gradient in life expectancy. In practical terms, that means income, employment, housing quality and access to services stack together, and their combined effect on health outcomes is larger than any one factor alone. In Lambeth, roughly one in four residents lives in poverty; in Southwark, over a third of the population lives in areas ranked among the most deprived in England. These are not marginal statistics — they describe the everyday conditions a large share of borough residents live in.
Air quality adds a second, more geographically specific layer. An estimated 3,600 to 4,100 deaths in Greater London in 2019 were attributable to human-made particulate matter and nitrogen dioxide pollution. Modelling has suggested that without mayoral air quality policy, a child born in London in 2013 would have lost 7 to 11 months of life expectancy to air pollution over their lifetime; with those policies in place, average life expectancy for that cohort is projected to improve by 5 to 6 months instead. The relationship is not simple, however — some London neighbourhoods with the highest recorded pollution levels also show relatively high life expectancy, because those same areas tend to have higher average incomes, which buys other protective advantages. Housing conditions round out the picture: the Marmot Review specifically named housing improvement as a necessary action on health inequalities, and London’s ongoing housing pressures, particularly the shortage of appropriate housing for its growing older population in inner boroughs, remain an active constraint rather than a solved problem.
A decade of warning signs, not just a snapshot
The borough gap is not static, and it has not been moving in a reassuring direction everywhere. Comparing 2020–2022 figures with 2011–2013, male life expectancy in Newham fell by around 20 months — the largest such drop recorded in any London borough over that period. Female life expectancy fell over the same period in Barking and Dagenham (down 20.5 months), Bexley (down 10.2 months) and Havering (down 9.4 months). Contributing factors identified alongside these falls include rising obesity levels and longer waits for NHS care, on top of the underlying deprivation and environmental drivers already described. A borough-by-borough approach to health reporting exists precisely because a single London-wide average life expectancy figure would hide movements like these entirely.
Why this belongs in a borough briefing
This is the kind of figure that gets summarised into a single national headline and, in doing so, loses everything that actually matters about it. "Better Health for London" was built on the premise that health outcomes in the capital could not be understood, or improved, by treating London as one place with one set of statistics. The borough life expectancy gap is the clearest possible demonstration of why that premise held up: a five-to-seven-year difference in how long people live, and a decade-wide difference in how many of those years are spent in good health, tracks closely with borough-level deprivation, air quality and housing conditions rather than anything about London as a whole. Reading the data borough by borough, rather than city-wide, is not an academic preference — it is the only way the numbers make honest sense.