The birdsong is what you hear first. It’s lunchtime, in the middle of town, on one of the main thoroughfares. But in Oakham, the usual thrum of traffic you would expect this close to a high street is conspicuous by its absence. The only cacophony comes from the cawing and screeching of birds.
Oakham is one of only two towns in Rutland, famously the smallest historic county in England. Less famously, Rutland is also the UK county with the highest male healthy life expectancy at birth. A boy born in this part of the East Midlands, nestled quietly on rural upland between the M1 and A1, can expect to live 71.5 healthy years.
This compares with a UK average healthy life expectancy at birth of 62.9 years for men, according to Office for National Statistics data covering 2017 to 2019.
Rutland also scores highly for overall male life expectancy, with the county’s men living to 83 years on average, compared with a UK average of 79.4, recent figures show. This means Rutland men survive longer than anywhere outside of London. (They are outlived only by those living in the capital’s affluent boroughs of Westminster and Kensington and Chelsea.)
Notwithstanding the caveat of the county’s small population – it hovered around 41,000 in the 2021 census – it is still “one of those places with consistently good life expectancy”, agrees Mike Sandys, director of public health at Rutland County Council. So what, then, is Rutland doing so right? What are the secrets to the long and healthy lives enjoyed by the men here, who can expect to clock up around a decade longer than their Glaswegian counterparts?
Rutland’s women – who generally outlive men – are also living longer than the average female, reaching an average of 85.4 years, against a UK average of 83.1.
Affluence, of course, is an important factor. Put simply, wealthier people tend to live longer – and Rutland is one of England’s most affluent counties. David Finch, assistant director for the healthy lives team at the Health Foundation charity, enumerates some of the reasons health follows wealth: “The access people have to resources, being able to afford to heat your home, to have good quality housing, quality of food, a healthy standard of living…”
But wealth is not the only determining factor for life expectancy. If it was, we might expect the list of the wealthiest local authorities in the country to always mirror exactly the list of those whose citizens live longest. Rutland is not the wealthiest in the UK. Amid its thatched cottages and picturesque villages, other answers must be lurking.
On a cold winter’s weekday in Oakham, there are plenty of locals out and about in town. Some are queuing patiently outside Hoagies sandwich shop on the high street, where customers can choose from some 30 fresh fillings and take away a sandwich for little more than £3. Over the road, in the smart surrounds of Otters Fine Foods, the restaurant and deli are doing a roaring trade, with a number of older adults among the diners – part of Rutland’s ageing population.
But it’s not all retirees keeping the town’s shops and cafés in business. Connie Taylor, a German potter who plies her wares in the Grade II listed Victoria Hall on the high street, is among those who have moved to Rutland to raise a family. Her three children now attend its local secondary schools. Why here?
“We liked the market town feel,” she says. “It’s lively on a Saturday, you can see people out walking their dogs, going to the market. It’s just the kind of atmosphere we want to be part of.”
She enthuses about the good schools, the supportive community, the rural feel and recalls her desire, some years back, to escape the London rat race, to be somewhere greener and cleaner. “We can just walk out of town straight into the landscape here. It just feels like coming home.”
Victoria Hall also hosts an arts society, yoga classes and University of the Third Age (u3a) events aimed at retirees. “It seems older people are active for longer here,” says Taylor.
Behind the counter at the local pharmacy, Catherine Thorpe paints a similar picture: of a predilection in the community for organic food and produce from the local butchers (of which Rutland has several), rather than processed food. “We’ve got people here aged 90 on no medication,” she says.
In the absence of some of the usual indoor attractions – the leisure parks, with their multiplex cinemas and chain restaurants that sprawl across out-of-town land up and down Britain – there is perhaps more of an impetus to spend leisure time outdoors. “We haven’t got a cinema. People tend to go on walks,” says Thorpe.
It helps that Rutland Water, a tranquil nature reserve spanning 4,200 acres, sits in the middle of the county, drawing ramblers, cyclists, anglers, birdwatchers and watersports enthusiasts to its shores. The county’s 52 villages are dotted around it, pretty as picture postcards. Until 2020, Rutland was England’s only McDonald’s-free county. “It is quite old-fashioned, quite stuck in its ways, quite conservative,” says Thorpe. Its tourist board prefers a different description: “The County of Good Taste.”
In Uppingham, Rutland’s only other town, the sense of stepping into a past that has elsewhere been long forgotten – or concreted over – is all the more apparent. By mid-afternoon, the high street is still and quiet, the calls of the birds even louder. The scene resembles not so much a slice of British life in 2023 but one of those reconstructed Victorian streets you sometimes find in history museums. There’s even an ironmongers, dating back to 1824, still with its original rows of green wooden drawers intact behind the counter. During lockdown, although the owners were allowed to stay open, they closed temporarily because “everyone was just coming in for a chat”.
If it’s quiet outdoors, perhaps it’s because everyone is busy taking afternoon tea at the Falcon Hotel, a 16th-century coaching inn on the high street. Eric and Anne Wilkes, aged 72 and 70, are on their way in to meet friends there. Why do they think men live so long here? “There’s not much in the way of pollution,” suggests Eric. “It’s being out in the country, the fresh air,” agrees Anne.
Eric’s father spent his younger years in London, where the smog aggravated his asthma. His doctor advised him to move to the country, and so he came to Rutland in his 40s. Sure enough, his asthma improved and he lived to see his 89th birthday, in good health until the last year of his life.
“And,” adds Anne, “my grandma who had nine children lived to 98, in the next village along.” Anne, says her husband, knows everyone around here. “It’s like one big family,” she nods. Anecdotal evidence maybe, but scientific evidence suggests that community – or the absence of loneliness and social isolation – is beneficial for health.
Both conditions have been linked to an elevated risk of heart disease and stroke as well as a weaker immune system and high blood pressure. Exposure to high levels of air pollution can, meanwhile, cause various adverse health outcomes, increasing the risk of respiratory infections, heart disease and lung cancer, according to the World Health Organisation. Rutland’s air quality, as its residents are quick to point out, ranks as relatively good.
There is no acute hospital in the county but access to good healthcare, while obviously important, is responsible in only a minor way for the longevity seen here. “About four fifths of what makes up good health will be broader health and social determinants and about a fifth will be clinical care,” says Sandys.
He cites Rutland’s low smoking rate – about 10 per cent compared with about 13 per cent nationally; its relatively low level of alcohol-related harms; its good employment rates, incomes and housing standards.
“I can’t see one magic silver bullet that determines why [life expectancy is long here], but this combination is probably what adds up to good health.”
There is likewise no single health campaign or scheme that has enjoyed such success it could be hailed as a certified winner when it comes to improving longevity. No daily supplement all the residents swear by.
It’s inevitably not that simple. “There’s something about the quality of life in Rutland that adds up to a good picture,” says Sandys. “But that’s not to say there aren’t pockets of ill health. Rutland has its challenges, particularly around dementia diagnosis.”
Dementia diagnosis rates in those aged 65 years and over are significantly worse, in fact, than the England benchmark goal.
But this aside, should we all be moving to Rutland if we want to live a long life? “No,” is the answer from Finch. “The place you live in will have an impact in terms of green spaces and air pollution, but the wider, longer term issues are more structural, [and include] the level of education you’ve received in the first place, which enables you to access better paid work.”
Naturally, those whose education has unlocked the door to better paid work tend to be the ones who can afford to move to areas like Rutland, where the average property price last year was almost £400,000. “And those people tend to be more healthy,” says Finch. “So there’s an ever-complex interaction.”
So what lessons can we learn from regional discrepancies in life expectancy? “The key thing it tells us is the lower health outcomes in other areas aren’t inevitable, and that it is possible to achieve higher levels of health,” says Finch. “But there’s never going to be a single way to achieve this. Even somewhere like Rutland will have varying levels of health within it. Even in Rutland you can’t be complacent about the health of everyone.”