Abstract
SummaryBackgroundHigh-resolution data for how mortality and longevity have changed in England, UK are scarce. We aimed to estimate trends from 2002 to 2019 in life expectancy and probabilities of death at different ages for all 6791 middle-layer super output areas (MSOAs) in England.MethodsWe performed a high-resolution spatiotemporal analysis of civil registration data from the UK Small Area Health Statistics Unit research database using de-identified data for all deaths in England from 2002 to 2019, with information on age, sex, and MSOA of residence, and population counts by age, sex, and MSOA. We used a Bayesian hierarchical model to obtain estimates of age-specific death rates by sharing information across age groups, MSOAs, and years. We used life table methods to calculate life expectancy at birth and probabilities of death in different ages by sex and MSOA.FindingsIn 2002–06 and 2006–10, all but a few (0–1%) MSOAs had a life expectancy increase for female and male sexes. In 2010–14, female life expectancy decreased in 351 (5·2%) of 6791 MSOAs. By 2014–19, the number of MSOAs with declining life expectancy was 1270 (18·7%) for women and 784 (11·5%) for men. The life expectancy increase from 2002 to 2019 was smaller in MSOAs where life expectancy had been lower in 2002 (mostly northern urban MSOAs), and larger in MSOAs where life expectancy had been higher in 2002 (mostly MSOAs in and around London). As a result of these trends, the gap between the first and 99th percentiles of MSOA life expectancy for women increased from 10·7 years (95% credible interval 10·4–10·9) in 2002 to reach 14·2 years (13·9–14·5) in 2019, and for men increased from 11·5 years (11·3–11·7) in 2002 to 13·6 years (13·4–13·9) in 2019.InterpretationIn the decade before the COVID-19 pandemic, life expectancy declined in increasing numbers of communities in England. To ensure that this trend does not continue or worsen, there is a need for pro-equity economic and social policies, and greater investment in public health and health care throughout the entire country.FundingWellcome Trust, Imperial College London, Medical Research Council, Health Data Research UK, and National Institutes of Health Research.
Highlights
Health and health inequalities are receiving unpre cedented attention in the UK and other advanced economies for at least two reasons
We found four reports on snapshots of life expectancy for middle-layer super output areas (MSOAs), which had combined data for 5 years to overcome the issue of small numbers of deaths
Mid-year population data by MSOA, age group, year, and sex were obtained from the UK Office for National Statistics.[11]
Summary
Health and health inequalities are receiving unpre cedented attention in the UK and other advanced economies for at least two reasons. Inequalities in health, income, and education have undermined social cohesion and created economic and political uncertainty.[1,2] Second, the COVID-19 pandemic has rapidly and starkly increased mortality and revealed its inequalities.[3,4,5] As a result, national and local governments, international agencies, and politicians across the political spectrum have stated the need to address inequalities and drawn up plans in which to do so. The absence of consistent, high-resolution trend data limits our ability to target policies and interventions for addressing health inequalities, and to measure the effects of such policies including the so-called levelling up policies, which aim to address geographical inequalities in the UK.[10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
