The number of years people in the UK spend in good health is falling, according to a new report.
Over the past decade healthy life expectancy (HLE) has dropped by around two years to just under 61 for both men and women.
The UK is one of only five of the richest 21 countries to see HLE decline and its fall was the second steepest.
The Health Foundation, which produced the analysis, said there was a significant economic cost to this trend and the findings should act as a watershed moment.
It said poverty, poor housing and lifestyle factors such as obesity were to blame along with the impact of the Covid pandemic.
The analysis, based on data from the Office for National Statistics between 2022-24 and 2012-2014, found those in the wealthiest 10% of areas could expect to have around 20 more years of good health than those in the poorest.
In England, Richmond in London had the highest rates of HLE at 69 for men and 70 for women.
In comparison, in Blackpool it was 51 for men and in Hartlepool it was 51 for women.
London was the only region that saw an improvement in HLE over the period.
In more than 90% of areas the HLE was now below the state pension age of 66 or 67 and in one in 10 it was below 55.
The report said this had a significant impact on the ability of people to work and said this aligns with other figures showing high numbers out of work because of ill-health.
The global comparison, based on World Health Organization data, compared the UK to other nations in western Europe, the Nordics, North America and Oceania. It is now ranked 20th out of 21 with only the US seeing its population live for fewer years in good health.
HLE is the technical term used by experts for an estimate of how much of a lifetime is spent in good health, based on how people feel and report in surveys, as well as on mortality data.
The Health Foundation said the findings revealed a stark decline in the nation's health and that this should be a wake-up call for policymakers.
Andrew Mooney, the think tank's principal data analyst, said: "The UK has the highest levels of obesity in western Europe and there has been a surge in mental ill health, especially among young people."
This had created "a significant economic cost, with poor health driving people out of the workforce and locking young people out of education, employment and training", he added.
In comparison to HLE, the Health Foundation found that overall life expectancy had remained broadly stable.
Dr Layla McCay, policy director at the NHS Alliance, said: "The figures are a stark reminder of how deeply health inequalities are affecting people's lives, with too many communities in deprived areas spending more years in poor health.
"Our members have been clear that the answer has to be prevention first - tackling the wider determinants of health, strengthening community-based care and improving access to support closer to home."
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