Long-term Monitoring of Health Inequalities: Headline Indicators - October 2013

Healthy Life Expectancy at birth

Summary

• There continue to be inequalities in both relative and absolute terms. Between 2009-2010 and 2011-2012, although inequalities appear to have widened slightly, the changes were not statistically significant. Changes to the methodology from 2009 mean comparisons with earlier years cannot be made.

The Healthy Life Expectancy (HLE) indicator is based on two years of data to ensure large enough sample sizes.

Between 1999-2000 and 2007-2008, HLE increased by 3 years (4.5%) for males and by 2.3 years (3.4%) for females. In 2009, the format of the self-assessed health question, on which healthy life expectancy data is based, was changed to align with the European Union, leading to a major discontinuity in the series. The markedly lower estimates of HLE at birth from 2009 onwards cannot be considered as part of the same series as earlier years. A technical paper by the Scottish Public Health Observatory (ScotPHO) has more information on this change.^[5]

In 2011-2012, HLE at Scotland level was 59.8 years for males and 62.3 years for females, broadly in line with the 2009-2010 figures. HLE is lower in deprived areas than in areas of low deprivation. In 2011-2012, HLE of those living in the 10% most deprived areas was 23.8 years lower for males and 22.6 years lower for females than HLE of those living in the 10% least deprived areas.

The difference between HLE and life expectancy, i.e. expected years spent in 'not good' health, is greater in more deprived areas. In the most deprived areas, males spend 22.7 years in 'not good' health, compared to 11.9 years in the least deprived areas and 16.7 years for males in Scotland as a whole. Females in the most deprived areas spend 26.1 years in 'not good' health in the most deprived areas, compared with 12.0 years in the least deprived areas and 18.5 years for females in Scotland as a whole.

Inequalities gradient in the most recent year available

Note: the red bars indicate 95% confidence limits of each HLE estimate.

Relative Index of Inequality (RII) over time

Data not available for 2003-2004

Absolute range over time

Data not available for 2003-2004.

The red bars for each column indicate the uncertainties in each estimate based on 95% confidence intervals around each HLE estimate.

Scale / context

Current Methodology (5 point scale of self-assessed health), 2009-2010 and 2011-2012

Men

	Male HLE in years	95%LL	95%UL	Male LE in years	95%LL	95%UL	Estimated years spent in 'not good' health
2009-2010
Scotland	59.9	59.4	60.4	76.1	76.0	76.2	16.2
Most deprived decile	47.4	45.8	49.0	68.7	68.3	69.1	21.3
Least deprived decile	69.9	68.2	71.6	82.0	81.6	82.3	12.1
2011-2012
Scotland	59.8	59.3	59.3	76.6	76.4	76.7	16.7
Most deprived decile	46.4	44.7	44.7	69.2	68.8	69.6	22.7
Least deprived decile	70.2	68.5	68.5	82.1	81.8	82.4	11.9

Women

	Female HLE in years	95%LL	95%UL	Female LE in years	95%LL	95%UL	Estimated years spent in 'not good' health
2009-2010
Scotland	62.1	61.6	62.6	80.6	80.5	80.8	18.6
Most deprived decile	51.1	49.6	52.6	76.1	75.7	76.5	24.9
Least deprived decile	73.2	71.7	74.7	84.8	84.5	85.1	11.6
2011-2012
Scotland	62.3	61.8	62.9	80.9	80.8	81.0	18.5
Most deprived decile	50.2	48.6	51.8	76.4	76.0	76.7	26.1
Least deprived decile	72.8	71.2	74.5	84.8	84.5	85.2	12.0

1. From 2009, self-assessed health was measured on a five-point scale (Very good, Good, Fair, Bad, Very bad). For summary purposes, the final three categories (Fair, Bad, Very Bad) are collectively referred to as 'Not good health'. This is different to the category of 'Poor health' in the subsequent two tables.

Previous Methodology (3-point scale of self-assessed health), 1999-2000 to 2007-2008

Men

	Male HLE in years	95%LL	95%UL	Male LE in years	95%LL	95%UL	Estimated years spent in poor health1
1999-2000
Scotland	65.0	64.7	65.4	73.0	72.8	73.1	7.9
Most deprived decile	53.7	52.6	54.8	65.8	65.4	66.3	12.1
Least deprived decile	75.0	74.0	75.9	78.6	78.3	79.0	3.7
2001-2002
Scotland	65.9	65.6	66.2	73.4	73.3	73.5	7.5
Most deprived decile	55.0	53.9	56.1	65.8	65.4	66.3	10.8
Least deprived decile	75.7	74.8	76.6	79.5	79.1	79.9	3.8
2003-2004
Scotland				74.0	73.9	74.1	-
Most deprived decile				66.3	65.9	66.8	-
Least deprived decile				79.7	79.3	80.0	-
2005-2006
Scotland	67.4	67.1	67.7	74.8	74.7	74.9	7.4
Most deprived decile	57.0	55.9	58.1	67.5	67.1	67.9	10.5
Least deprived decile	76.8	75.8	77.8	80.7	80.4	81.1	3.9
2007-2008 - revised
Scotland	68.0	67.6	68.3	75.1	75.0	75.2	7.1
Most deprived decile	56.9	55.7	58.1	67.6	67.2	68.0	10.6
Least deprived decile	75.8	74.7	76.9	80.9	80.6	81.3	5.1

Women

	Female HLE in years	95%LL	95%UL	Female LE in years	95%LL	95%UL	Estimated years spent in poor health1
1999-2000
Scotland	68.2	67.8	68.5	78.4	78.3	78.5	10.3
Most deprived decile	59.8	58.6	61.0	74.2	73.9	74.6	14.4
Least deprived decile	77.1	76.1	78.1	81.8	81.5	82.1	4.7
2001-2002
Scotland	69.2	68.9	69.6	78.9	78.8	79.0	9.6
Most deprived decile	60.0	58.8	61.1	74.6	74.2	74.9	14.6
Least deprived decile	76.8	75.6	77.9	82.4	82.1	82.8	5.7
2003-2004
Scotland				79.1	79.0	79.2	-
Most deprived decile				74.8	74.4	75.2	-
Least deprived decile				83.0	82.6	83.3	-
2005-2006
Scotland	69.6	69.2	70.0	79.7	79.6	79.8	10.1
Most deprived decile	59.9	58.7	61.1	75.1	74.7	75.5	15.2
Least deprived decile	78.1	76.8	79.3	84.2	83.9	84.6	6.2
2007-2008
Scotland	70.5	70.1	70.9	80.0	79.8	80.1	9.5
Most deprived decile	60.9	59.5	62.2	75.5	75.2	75.9	14.7
Least deprived decile	77.6	76.3	78.8	84.3	84.0	84.6	6.7

1. Prior to 2009, self-assessed health was measured on a three-point scale (Good, Fairly good, Not good). For summary purposes, 'Not good' responses were counted as 'Poor health'. This is not comparable to the category of 'Not good health' used from 2009 onwards.