Diolch, Lywydd. Ahead of today's short debate, I proactively reached out to all political parties representing the city of Cardiff, and have received confirmation from Anthony Slaughter, Shav Taj and Leticia Gonzalez, who wish to contribute, and I look forward to hearing their contributions.
Members of the Senedd, a baby boy is born in Cardiff on the same night as another baby boy only a few miles away. One is born in Adamsdown, within Cardiff's southern arc, and the other is born in Lisvane. They will grow up under the same national health service, the same city council, the same education system. They will breathe the same air drifting in from the coast and walk streets under the same Welsh sky. And yet the evidence before us shows that one of those boys can expect to live more than a decade longer than the other and spend a significantly greater proportion of his life in good health. That is not fate; it is structure.
I have chosen to bring forward this contribution on life expectancy inequalities in Cardiff's southern arc because it is here that the consequences of deprivation are most concentrated and where the gap between communities within the same city becomes most stark. The picture is not simple and it is not driven by a single cause. Life expectancy trends in Cardiff over the past decade show only modest changes overall. Some measures have risen slightly and others have fallen. More recently, life expectancy has largely returned to pre-pandemic levels. And on the surface, that can appear like stability, but healthy life expectancy tells a very different and more troubling story. It has fallen over the past decade. In 2021-23, healthy life expectancy stood at 60.3 years for males and 59.6 years for females, both lower than a decade earlier. In other words, while some people are living longer, fewer of those years are being lived in good health. This matters because healthy life expectancy is a national indicator under the Well-being of Future Generations (Wales) Act 2015, measuring not just how long we live, but how fairly and how well those years are shared.
In Cardiff's southern arc, that inequality becomes visible in its most acute form. If the southern arc were a single local authority, it would be by some margin the most income-deprived in the whole of Wales. Within it are communities in my constituency such as Trowbridge, Llanrumney, Pentwyn, Rumney and Adamsdown, where deprivation is lived through income pressure, housing insecurity and poorer health. These consequences are seen in early mortality. Between 2015 and 2024, premature death rates for under-75s in parts of Plasnewydd were six times higher than in the least deprived parts of the city. When we look at life expectancy itself, the gap within Cardiff reaches over a decade. So, to take that, the gap in male life expectancy is 10.3 years between the most and least deprived areas of the city, and for women it is a gap of 13.2 years, and these inequalities begin long before adulthood.
In Adamsdown, almost 40 per cent of children live in low-income families after housing costs, in contrast to other parts of the city where that figure is below 10 per cent. That inequality then carries forward into daily life. Around 21 per cent of people in Wales experience food insecurity, with almost 30 per cent of those in Cardiff's most deprived communities reporting that they skip meals, reduce their portion sizes or go without food completely.
Fuel poverty, while reduced since its peak during the energy crisis, remains above pre-crisis levels, meaning that, for many households, heating and eating are still competing necessities. These pressures accumulate into health outcomes that are visible across the life course. Of course, these inequalities are not produced by a single factor. They arise from a complex interaction of income, housing, education, employment, the environment and access to services. Socioeconomic conditions account for a large share of variation in premature mortality, though not all of it. Some will argue that such variation is inevitable in any city, that differences in health outcomes reflect individual behaviour or wider societal complexity, and that systems cannot fully equalise these outcomes. And there is truth in the complexity, but the pattern is still consistent and persistent.
The gap in life expectancy within Cardiff is around eight to nine years, and the gap in healthy life expectancy is around 18 to 20 years. And this carries wider consequences. Poor health that prevents people working costs Wales an estimated £19.4 billion per year through lost output, lost tax revenue, increased welfare spending and pressure on our services. But the most profound cost is not to the economy. It is the loss of healthy years of life—years lived with illness, limitation or preventable poor health. This is why healthy life expectancy matters as a national indicator under the Well-being of Future Generations (Wales) Act 2015. It is intended to show whether progress is real and whether it is shared. And on that measure, the direction of travel remains concerning. Healthy life expectancy has declined since 2011 to 2013 for both males and females, and the gap between the most and least deprived areas has widened again after periods of fluctuation.
So, the question becomes one of response. Because health is not only created in our hospitals. It is shaped in homes, schools, workplaces and communities, in whether families can afford nutritious food, whether housing is secure and whether prevention is prioritised. That is why approaches such as the Marmot principles, early years investment through childcare support and place-based community health models matter, because they focus on the wider determinants of health, rather than only treating the consequences. And it is why current calls for action on food environments are relevant—improving access to affordable fresh fruit and vegetables for low-income households, strengthening nutrition in public settings and reducing the presence and promotion of ultra-processed, high-fat, salt, and sugar foods where public bodies have influence. Because, if we are serious about narrowing the gap in healthy life expectancy, prevention must be practical, local and sustained.
So, I return to where I began: two boys born in the same city on the same night, a few miles apart in geography, but worlds apart in lived experience. One will likely live more than a decade longer than the other and spend far more of his life in good health. The city does not change between them, but their chances in life do.