Transcript The scale of health inequalities in England: from region to

The scale of health inequality in
England; from region to local
authority district, 2006–2008
Gbenga Olatunde and Andrew Yeap, 2011
What we’re going to talk about
• Introduction
• Health Expectancy at ONS
• Annual Population Survey
• Disability-Free Life Expectancy
• Analysis at National level
• Analysis by English Regions
• Analysis by Area Deprivation
• Analysis at Local Authority level
Health Expectancy at ONS
•
Health Expectancy – years expected to be spent in a favourable or
unfavourable health state from a given age
•
Adds dimension of quality to Life Expectancy
•
ONS produce two HE metrics:
• Healthy Life Expectancy (very good/good health)
• Disability-Free Life Expectancy (Limiting long-standing
illness/disability)
•
Annual production of HEs at National level using large-scale surveys:
• General Lifestyle Survey (covers GB)
• Continuous Household Survey (covers NI)
• Sample size not large enough to allow statistically meaningful
comparisons at lower-level geographies
Annual Population Survey
• Collects data from private households around the UK
• Consists of waves 1 and 5 of the Labour Force
Survey, and additional boost cases for England,
Wales and Scotland
• Enables reliable analysis at lower level geographies
• Analysis based on cross-sectional component of the
APS
Data
• Over 475 000 people aged 16 and over for
2006-08
• Morbidity data from ONS Annual Population
Survey (APS)
• Combined with mortality and population data
to calculate DFLE according to the Sullivan
method
Limiting long-standing illness or disability
•
Do you have any health problems or disability that you expect will last
for a year or more?
‘Yes/No’
If ‘Yes’ the respondent is then asked;
•
Do these health problems or disabilities when taken singly or together,
substantially limit your ability to carry out normal day to day activities? If
you are receiving medication or treatment, please consider what the
situation would be without the medication or treatment
‘Yes/No’
People responding ‘Yes’ to both questions were identified as having a
limiting long-standing illness or disability
National level DFLE at age 16, APS 2006-08
Males
Females
UK
48.3
49.3
GB
48.4
49.3
England
48.8
49.8
Wales
45.3
46.1
Scotland
45.6
46.8
NI
46.9
48.1
From age 16, males and
females in the UK can
expect just under 50 more
years of life free from LLSI
England possess the highest DFLE and
Wales the lowest
Inequality between highest and lowest DFLE
is 3.5 years for males and 3.7 years for
females
Health Inequalities: Disability-free life
expectancy by English region, 2006-08
High
Men at age 16
44.2 years in North East
51.3 years in South East
Low
Women at age 16
45.2 years in North East
51.8 years in South East
Background
• Health inequalities have enormous social and
economic costs. Clear need to monitor population
health to assess impact of interventions
• If everyone in England had the same death and
illness rates as the most advantaged, those dying
prematurely as a result of health inequalities would
have gained 2.8 million person-years free from
limiting illness or disability
• Sub-national analyses previously restricted to
Census data or large aggregations of survey data
Life expectancy (LE) and disability-free life expectancy (DFLE)
for men and women at age 16; by area deprivation, 2006–2008
Years
70
65
Men
60
55
65.6
58.0
54.0
40.8
50
45
Women
40
35
Increasing deprivation
68.7
63.4
54.6
42.0
30
Health Inequalities: Disability-free life expectancy
by English local authority district, 2006–08
Men at age 16
41.2 years in Barnsley
56.8 years in Surrey Heath
High
Women at age 16
41.7 years in Knowsley
Low
60.2 years in Tandridge
Conclusions
• Substantial inequalities in LE and DFLE across
areas for men and women
• Inequalities in DFLE much greater than in LE
• Inequality in LE and DFLE between least and
most deprived areas greater for men than women
• For both men and women, the inequality in DFLE
doubles with increasingly detailed geographical
analysis
Future work
• Update the study: produce estimates for
2007–2009
• Explore the use of other survey sources to
provide proxy child data
• Use of the Integrated Household Survey to
produce estimates at national and subnational levels
Thanks…
• Any Questions?
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