Disability‐free life expectancy: comparison of sources and small area estimates in England, 2006–08

Abstract

Health expectancies (HEs) at sub-national geographies or by clusters of areas defined by relative deprivation are important tools to monitor inequalities in health. Previously, analyses have had limited usefulness due to a lack of timeliness or local relevance caused by limitations on the frequency or coverage of survey data. Here we explore the potential of the Annual Population Survey (APS) to provide robust estimates of disability-free life expectancy (DFLE) for men and women by clusters of area deprivation, English regions and local authority districts (LAs) in the period 2006-08. DFLE estimates for the UK were compared using the prevalence of limiting long-standing illness (LLSI) calculated using data from the APS and from the General Lifestyle Survey (GLF) covering Great Britain and equivalent data from the Continuous Household Survey (CHS) covering Northern Ireland, aggregated over the period 2006-08. The further use of APS data for England enabled the calculation of estimates of DFLE at age 16 and at age 65 for men and women by area deprivation quintiles (each quintile comprises a fifth of areas ranked according to their relative deprivation), English regions and LAs in order to measure inequality in DFLE between these population groupings. The prevalence of LLSI and estimates of DFLE at national level were broadly comparable using APS and GLF/CHS data. Substantial inequality in DFLE was present between clusters of areas defined by relative deprivation and between English regions and LAs. The scale of inequality increased markedly with each finer geographical scale analysed. The APS is a viable data source to provide LLSI data for use in DFLE estimation across a range of areas and clusters of area deprivation. While increasingly fine-grained analysis decreases statistical precision, it is possible to detect clear differences between areas within regions and in making comparisons with the England average. The estimates presented here provide scope to set benchmarks for assessing the impact of interventions designed to reduce inequality in DFLE beyond the period 2006-08.