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How do People Rate their General Health? An Analysis of General Health by Disability and Deprivation This product is designated as National Statistics

Released: 20 February 2014 Download PDF

Key Points

  • Across England and Wales one in 25 people (4.3 per cent of the usual private household population; 2.4 million people) are in ‘Good’ health despite a disability. 
  • Among the disabled population, younger people are more likely to be in ‘Good’ health; more than half of all disabled children are in ‘Good’ health (55.3 per cent) compared to a fifth (19.7 per cent) of the disabled population aged 85 and over. 
  • Disabled males were generally more likely to be in ‘Good’ health compared to disabled females, regardless of the extent of their disability. The overall proportion of boys, aged 0 to 15, in ‘Good’ health despite a disability that limited them a lot (0.9 per cent) was twice as high as it was for girls (0.4 per cent) at this same age in England. 
  • Among the disabled population, people living in the least deprived areas were most likely to report ‘Good’ health; from the age of 35 the proportion of disabled people in ‘Good’ health in the least deprived areas was around twice the proportion in the most deprived areas.  
  • Because rates of disability increase with age, the overall proportion of people with ‘Good’ health despite a disability was higher among the elderly; at the oldest ages, 85 and over, around one in six people were in ‘Good’ health despite a disability, compared to around one in 50 children; ages 0 to 15. 
  • In England, Weymouth and Portland local authority had the highest overall proportions of people reporting both ‘Good’ health and a disability (5.7 per cent). The lowest proportion was in the London Borough of Kensington and Chelsea (3.6 per cent).

Summary

Self-reported general health is an important measure of the health of the population and is commonly used in decisions relating to health and social care resource allocation. However, the care needs of those in ‘Good’ health but who also have a disability can be overlooked, particularly if self-reported general health measures are used in isolation.

A disability is not a barrier to self-reported ‘Good’ health. In this analysis of census data we have shown that substantial numbers of people in ‘Good’ health also have a disability (2.4 million people); around one in 25 of the total private household population of England and Wales.

There were variations in the proportions of people with both ‘Good’ health and a disability among the population of England and Wales who were living in private households. Higher proportions of older people, males (compared to females), and people living in more deprived areas (compared to less deprived areas) were in ‘Good’ health despite a disability.

In part these findings reflect differences in the overall prevalence of disability among these population groups; where the disabled population is greater there is an increased pool of people who could potentially be in ‘Good’ health despite their disability.

This information is useful in helping us to understand the limitations of the self-reported general health measure which if used in isolation, would overlook the health and social care needs of disabled people in ‘Good’ general health.

In contrast, differences in the proportions of people with ‘Good’ health among the disabled, rather than the total population helps to shed light on the factors that influence self-reported general health. Young disabled people, disabled males (compared to disabled females) and disabled people in less deprived areas (compared to more deprived areas) were more likely to be in ‘Good’ health despite their disability.

These findings may reflect different perceptions of what constitutes ‘Good’ health depending on a person’s age, gender, culture and area of usual residence. It is also possible that they reflect differences in health and social care provision among certain population groups, i.e. the young and those living in more affluent areas, making these people more likely to overlook the limitations of their disability when considering their general health.  

Further research comparing the types and duration of disability could help our understanding of how ‘Good’ health differs between population groups. The current analysis is limited in this respect as the census does not capture this information.

This analysis highlights the complexity of measuring population health and advocates a combined approach to assess the potential health and social care needs of the population. Taking account of both subjective general health and the more objective assessment of disability will give a more complete picture of health and social care need and wellbeing.

Introduction

This analysis describes the relationship between ‘Good’ health and disability by age, sex and area amongst the population living in private households in England and Wales.

Census data helps to describe the characteristics of people and households in detail, giving government, private and voluntary sector organisations information to support planning and decision making and to enable public debate.

 

Background

As we age, our general health declines and the likelihood that we will suffer some form of a disability increases. It is a great challenge to society to delay the onset and reduce the extent of poor health. Falling mortality rates and increases in metrics such as healthy life expectancy suggest that we are making progress. In England and Wales people are on the whole, living for longer and spending greater periods of their lives in ‘Good’ health than ever before. Despite this progress there remain stark inequalities in health across areas of residence and socioeconomic position.

One of the key challenges facing statisticians, healthcare professionals and policy makers alike is the measurement of health at the population level. Accurate and timely measurement can be used to understand the impact of health and social care intervention and help to make effective decisions about where to best focus our limited resources.

Surveys are commonly used to provide a snapshot view of population health. Questions relating to general health and disability are particularly important in this respect and these are harmonised in household surveys across Europe to provide international comparisons of health.

In England, the survey measurement of general health forms the basis of healthy life expectancy, an overarching indicator of the Public Health Outcomes framework 2013 to 2016 which sets out the desired outcomes for public health and how they will be measured.

The 2011 Census provides an opportunity to look in more detail at general health and disability across England and Wales.  ONS has already published a number of analyses relating to these topics; most recently focusing on how disadvantage matters most to health of the middle aged.

Variations in the proportion of people reporting both ‘Good’ health and a disability uncovers the limitations of measurements such as healthy life expectancy and disability-free life expectancy; the former focussing on health-related well-being, the latter focussing on functional health status. The health and social care needs of people with a disability are an important population for health and social care agencies to serve, and the health-related well-being of this population (measured in terms of self-assessed general health) can be used as an indicator of service performance. This analysis promotes the added value of using these health indicators in combination to better understand their use in informing met and unmet health and social care need.

The 2011 Census asked two questions related to health, Figure 1 and 2. The first asked about an individual’s general health:

Figure 1: General health question in the 2011 Census questionnaire

For this analysis we refer to people who are in either very good or good general health as having ‘Good’ health

The second health related question asked whether the individual had a long-term activity limiting health problem or disability.

Figure 2: Day-to-day activity limitations question in the 2011 Census questionnaire

For this analysis we refer to people who responded ‘yes, limited a little’ or ‘yes, limited a lot’ as having a disability.

The data used in this analysis are derived from tables DC3302EW (Long term health problem or disability by health by sex by age, all usual residents in households) and CT0205 (Sex by age by general health by long-term health problem or disability, 2011 Deciles (index of Multiple deprivation) IMD2010 from LSOAs in England). Further information regarding the measurement of deprivation across areas in England is provided in the background notes section. Further information regarding the Welsh index of multiple deprivation, 2011 (WIMD2011) is available. The European Standard Population 2013 has been used to age-standardise the rates of ‘Good’ health and disability within total population groups to remove the influence of differing age profiles among distinct populations that may otherwise skew the analyses. Further information is provided in the Background notes section.

It is important to note that figures for children, aged 0 to 15, will include the assessment of parents or carers completing the census form on their behalf.

 

‘Good’ health with a disability; England and Wales, 2011

In England and Wales in 2011, around one in 25 people (4.3 per cent of the usual private household population; 2.4 million people) were in ‘Good’ health despite also having a disability.

Figure 3: The prevalence of 'Good' health, disability and 'Good' health with a disability by age, usual residents of private households in England and Wales 2011

Figure 3: The prevalence of 'Good' health, disability and 'Good' health with a disability by age, usual residents of private households in England and Wales 2011
Source: Census - Office for National Statistics

Notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age.

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Among the total private household population of England and Wales the proportion of people who were in ‘Good’ health despite a disability increased with age from 2.1 per cent (219,000 people) at ages 0 to 15, to 16.4 per cent (174,000 people) at ages 85 and over. In part, this reflects the overall age-related change in the proportions of ‘Good’ health and disability; an increase in the overall proportion of disability in the population provides a greater potential pool of people who are in ‘Good’ health despite a disability. 

This information is useful in helping us to understand the limitations of self-reported general health. The health and social care needs associated with the disability of increasing proportions of people as they age are overlooked by a self-reported general measure that would classify these people as being in ‘Good’ health.  

Looking only at the population with a disability shows that the proportion of people in ‘Good’ health despite a disability actually declines with age. At the youngest ages, more than half (55.3 per cent) of children with a disability are in ‘Good’ health. While at the oldest ages a fifth (19.7 per cent) of people with a disability are in ‘Good’ health. 

This information is useful in helping us to understand more about how people judge their general health. High rates of ‘Good’ health among the young disabled population may reflect a relatively optimistic view of general health that is not present among the older disabled population. This finding may also indicate that the health and social care needs of the young disabled population are being more adequately met compared to the older disabled population, making young people more likely to overlook the limitations of their disability. Information relating to the types of health conditions that affect people as they age and the lengths of time that they are lived with would allow us to further understand what ‘Good’ health means to different people.

 

‘Good’ health and a disability by extent of limitation; England and Wales, 2011

Being in ‘Good’ health despite a disability was not restricted to those whose activities were limited only ‘a little’, Figure 4. 

Figure 4: The prevalence of 'Good' health with a disability, by extent of limitation and age, England and Wales 2011

Figure 4: The prevalence of 'Good' health with a disability, by extent of limitation and age, England and Wales 2011
Source: Census - Office for National Statistics

Notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age.

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Of the total population of England and Wales who lived in private households, 1.4 per cent (149,000 children) aged 0 to 15 were in ‘Good’ health despite a disability that limited them a little. This figure represents almost two-thirds (64.0 per cent) of the population at this age and with this extent of disability.

Less than 1 per cent (0.7 per cent, 70,000 children) aged 0 to 15 were in ‘Good’ health despite a disability that limited them a lot. This figure represents more than two-fifths (42.9 per cent) of the population at this age and with this extent of disability.

At the other end of the age spectrum, aged 85 and over, around one in ten (11.3 per cent; 119,000 people) were in ‘Good’ health despite a disability that limited them a little. This figure represents more than one-third of the population with a disability that limits them a little. 

Around one in twenty (5.2 per cent; 55,000 people) of the total private household population aged 85 and over were in ‘Good’ health despite a disability that limited them a lot. This figure represents almost one in ten (9.8 per cent) of the population at this age and with this extent of disability.

England

Table 1: 'Good' health with a disability among the total private household population by extent of limitation, age and sex, England 2011

Per cent
England   'Good' health limited a little and a lot  'Good' health limited a little  'Good' health limited a lot
 Males   Females   Males   Females   Males   Females 
 0 – 15                   2.6                  1.5                  1.7                  1.1                  0.9                  0.4
 16 – 24                   2.7                  2.2                  1.9                  1.7                  0.8                  0.5
 25 – 34                   2.3                  2.2                  1.8                  1.8                  0.6                  0.4
 35 – 49                   3.0                  3.2                  2.4                  2.6                  0.7                  0.6
 50 – 64                   4.4                  5.1                  3.6                  4.3                  0.8                  0.8
 65 – 74                   8.1                  8.6                  6.8                  7.4                  1.3                  1.2
 75 – 84                 12.5                12.6                10.2                10.3                  2.3                  2.3
 85+                 17.0                16.2                12.0                11.0                  5.1                  5.2

Table source: Office for National Statistics

Table notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age.
  2. Percentages of 'Good' health limited a little and 'Good' health limited a lot may not equal percentages of 'Good' health limited a little and a lot due to rounding.

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Among the total private household population of England, a slightly higher proportion of males compared to females were in ‘Good’ health despite a disability from birth up until the age of 35 and then again at the oldest ages, 85 and over, regardless of the extent of the limitation, see table 1.

The differences between males and females are most notable at younger ages, particularly when people have a disability that limits them a lot. At the youngest ages (0 to 15), the proportion of boys who were in ‘Good’ health despite a disability that limited them a lot (0.9 per cent; 45,000 boys) was more than twice that of girls (0.4 per cent; 21,000 girls). 

Table 2: 'Good' health among those with a disability by extent of limitation, age and sex, England 2011

Per cent
England   'Good' health limited a little and a lot  'Good' health limited a little  'Good' health limited a lot
 Males   Females   Males   Females   Males   Females 
 0 – 15                 57.7                51.6                66.2                60.7                46.0                37.7
 16 – 24                 51.1                43.1                61.1                51.4                36.6                27.6
 25 – 34                 38.0                34.8                48.9                44.1                22.6                18.5
 35 – 49                 27.3                25.5                38.9                36.5                13.2                10.8
 50 – 64                 19.7                21.1                30.5                32.0                  7.4                  7.1
 65 – 74                 21.2                22.0                31.2                32.4                  7.9                  7.6
 75 – 84                 21.4                20.0                33.1                31.6                  8.4                  7.5
 85+                 21.4                19.1                37.6                36.5                10.6                  9.5

Table source: Office for National Statistics

Table notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age.

  2. Percentages of 'Good' health limited a little and 'Good' health limited a lot may not equal percentages of 'Good' health limited a little and a lot due to rounding.

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Considering the disabled private household population of England alone shows a similar pattern; there were higher proportions of males in ‘Good’ health among the disabled population compared to females from birth up until the age of 49 and then from age 75 and over, see table 2.

Among this population, the greatest proportional differences were at ages 16 to 24 when there was an 8 percentage point difference between young men and women. A little more than half (51.1 per cent; 81,000 men) of all disabled men aged 16 to 24 were in ‘Good’ health compared to a little more than two-fifths (43.1 per cent; 63,000 women) of all disabled women at this age. It is also notable that males had the highest proportions of ‘Good’ health across all ages when the disability limited them a lot, compared to females.

Wales

Table 3: 'Good' health with a disability among the total private household population by extent of limitation, age and sex, Wales 2011

Per cent
Wales  'Good' health limited a little and a lot  'Good' health limited a little  'Good' health limited a lot
 Males   Females   Males   Females   Males   Females 
 0 – 15                   3.0                  1.7                  2.0                  1.2                  1.0                  0.5
 16 – 24                   3.0                  2.4                  2.2                  1.9                  0.9                  0.5
 25 – 34                   3.0                  2.8                  2.2                  2.2                  0.8                  0.6
 35 – 49                   3.7                  3.8                  2.9                  3.1                  0.8                  0.8
 50 – 64                   5.3                  5.9                  4.3                  5.0                  1.0                  0.9
 65 – 74                   9.5                  9.7                  7.7                  8.1                  1.8                  1.6
 75 – 84                 13.1                12.6                10.2                10.0                  2.9                  2.6
 85+                 16.4                15.2                11.2                  9.9                  5.2                  5.3

Table source: Office for National Statistics

Table notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age. 

  2. Percentages of 'Good' health limited a little and 'Good' health limited a lot may not equal percentages of 'Good' health limited a little and a lot due to rounding.

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The proportions and trends in the prevalence of ‘Good’ health despite a disability among males and females in the total private household population of Wales were similar to those in England, table 3.

Up until the age of 35 and then again from age 75 there were higher proportions of males in ‘Good’ health despite a disability compared to females.  For those with a disability that limited them ‘a lot’, the proportions of ‘Good’ health for boys (1.0 per cent) were again twice as high as they were for girls (0.5 per cent).

Table 4: 'Good' health among those with a disability by extent of limitation, age and sex, Wales 2011

Per cent
Wales  'Good' health limited a little and a lot  'Good' health limited a little  'Good' health limited a lot
 Males   Females   Males   Females   Males   Females 
 0 – 15                 56.2                49.6                65.3                59.1                44.0                35.0
 16 – 24                 48.5                41.6                60.0                50.5                33.0                25.8
 25 – 34                 35.3                32.2                48.3                43.4                20.0                15.9
 35 – 49                 25.4                23.6                38.9                36.8                11.7                  9.6
 50 – 64                 18.1                19.2                31.4                32.1                  6.5                  6.1
 65 – 74                 19.7                20.0                32.6                32.6                  7.4                  6.8
 75 – 84                 19.6                18.1                33.9                31.5                  7.9                  6.9
 85+                 19.6                17.3                38.2                35.8                  9.6                  8.8

Table source: Office for National Statistics

Table notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age.
  2. Percentages of 'Good' health limited a little and 'Good' health limited a lot may not equal percentages of 'Good' health limited a little and a lot due to rounding.

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As with England, among the disabled private household population of Wales, there were higher proportions of males with a disability in ‘Good’ health compared to females from birth until the age of 49 and then again from ages 75 and over, see table 4.

The greatest proportional difference was again for those aged 16 to 24 where the proportion of disabled young men in ‘Good’ health (48.5 per cent; 5,500 men) was around 7 percentage points higher than the proportion of disabled young women in ‘Good’ health (41.6 per cent; 4,200 women). As with England it is again notable that males had the highest proportions of ‘Good’ health across all ages when the disability limited them a lot, compared to females. 

It is interesting that the greatest differences between males and females in both England and Wales are among children and young adults. The reasons behind this finding are complex but may reflect different social and cultural attitudes to health between males and females at younger ages.

 

‘Good’ health and a disability across English regions, 2011

Table 5: 'Good' health with a disability among the total private household population by age, English regions 2011

Per cent
  0 – 15 16 – 24 25 – 34 35 – 49 50 – 64 65 – 74 75 – 84 85+
 North East                   2.3                  2.6                  2.7                  3.5                  5.1                  8.5                10.8                12.9
 North West                   2.2                  2.6                  2.7                  3.6                  5.2                  8.8                12.4                15.6
 Yorkshire and The Humber                   2.0                  2.4                  2.5                  3.2                  4.9                  8.4                11.6                14.5
 East Midlands                   2.1                  2.5                  2.5                  3.2                  4.9                  8.7                12.5                14.7
 West Midlands                   2.2                  2.5                  2.5                  3.2                  4.8                  8.6                12.4                15.2
 East of England                   2.1                  2.5                  2.2                  2.8                  4.5                  8.3                12.9                17.4
 London                   1.8                  2.1                  1.8                  2.8                  4.5                  7.7                11.5                16.0
 South East                   2.1                  2.5                  2.2                  2.7                  4.3                  7.9                13.4                18.8
 South West                   2.1                  2.5                  2.5                  3.2                  4.8                  8.5                13.7                18.4

Table source: Office for National Statistics

Table notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age.

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Among the total private household populations of English regions, the highest proportions of people in ‘Good’ health despite a disability tended to be in the north of England, where the overall rates of disability are relatively high and the overall rates of ‘Good’ health are relatively low, see table 5.

Interestingly there was a shift in this pattern at ages 75 and over when the highest proportions of people in ‘Good’ health despite a disability were in the South East and South West; regions which typically have the lowest overall rates of disability. 

Table 6: 'Good' health among those with a disability by age, English regions 2011

Per cent
  0 – 15 16 – 24 25 – 34 35 – 49 50 – 64 65 – 74 75 – 84 85+
 North East                 54.3                45.7                33.4                24.3                17.4                17.9                16.0                15.1
 North West                 54.9                46.2                34.7                24.9                18.6                19.9                19.2                18.5
 Yorkshire and The Humber                 53.9                47.1                35.0                25.4                19.4                20.0                18.3                17.2
 East Midlands                 56.1                48.6                36.3                26.9                20.7                21.5                19.9                17.4
 West Midlands                 54.1                46.5                35.0                25.4                19.2                20.7                19.4                17.8
 East of England                 57.0                48.0                37.5                28.4                22.8                24.1                22.2                21.1
 London                 52.9                45.9                38.1                25.0                19.0                19.5                19.0                19.7
 South East                 58.3                49.2                38.1                29.2                23.8                25.0                24.2                23.4
 South West                 56.7                47.9                36.9                28.2                23.2                24.8                23.5                22.4

Table source: Office for National Statistics

Table notes:

  1. Data from census table DC3302EW - Long-term health problem or disability by general health by sex by age.

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Looking only among the population with a disability, the lowest proportions of people in ‘Good’ health were in the North East at all ages and the highest proportions are in the South East, see table 6.

Interestingly, the proportional difference between these regions increases with age, from a 4.0 percentage point difference at ages 0 to 15 to an 8.3 percentage point difference at ages 85 and over.

This may again reflect different expectations. High rates of ‘Good’ health among the disabled population in areas with relatively high overall ‘Good’ health rates may reflect a relatively optimistic view of general health that is not present among the population of areas with relatively poor overall health rates. It may also be that the health and social care needs of the disabled population in regions with relatively high overall ‘Good’ health rates are being more adequately met compared to the disabled population in areas with relatively poor overall health rates.

 

‘Good’ health and a disability across local authorities in England, 2011

Table 7: 'Good' health with a disability among the total private household population¹, top and bottom five local authorities in England 2011

  Per cent 'Good' health and a disability Overall rank of 'Good' health² Overall rank of disability³ Rank of deprivation (IMD2010)4
England 4.6 - - -
Top 5
Weymouth and Portland 5.7 189 83 88
Wirral 5.4 243 48 103
Plymouth 5.3 256 51 80
Torbay 5.3 240 61 49
Barrow-in-Furness 5.3 290 10 37
Bottom 5
City of London 3.8 10 315 259
Westminster 3.8 197 167 75
Richmond upon Thames 3.7 16 317 261
Elmbridge 3.7 5 325 322
Kensington and Chelsea 3.6 91 277 98

Table source: Office for National Statistics

Table notes:

  1. Proportions given are age standardised to the European standard population.

  2. The overall rank of 'Good' health is on a scale where 1 is the area with the highest overall rates of 'Good' health and 326 is the area with the lowest overall rates of 'Good' health.

  3. The overall rank of disability health is on a scale where 1 is the area with the highest overall rates of disability and 326 is the area with the lowest overall rate of disability.

  4. The rank of deprivation is on a scale where 1 is the most deprived area 326 the least deprived. Further information about the IMD2010 is provided in the background notes.

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The local authority in England with the highest proportion of people with both ‘Good’ health and a disability among the total private household population was Weymouth and Portland (5.7 per cent), 25.8 per cent higher than the England average (4.6 per cent) and 60.1 per cent higher than Kensington and Chelsea which had the lowest proportion at 3.6 per cent, (21.4 per cent lower than the England average), see table 7.

Local authorities with the highest proportions of people with ‘Good’ health and a disability among the total private household population were located on both the south coast and the north of England. These areas tend to have relatively high levels of deprivation, a low overall rank of ‘Good’ health and high overall ranks of disability. Authorities with the lowest proportions were located in London and the South East with relatively low deprivation, high overall rates of ‘Good’ health and low overall rates of disability.   

A comparison of people in ‘Good’ health among those with a disability has not been made across local authorities in England because small population numbers in some areas may give rise to misleading proportional differences between those areas. 

 

‘Good’ health and a disability across unitary authorities in Wales, 2011

Table 8: 'Good' health with a disability among the total private household population¹, top and bottom five unitary authorities in Wales 2011

  Per cent 'Good' health and a disability Overall rank of 'Good' health² Overall rank of disability³ Rank of deprivation (WIMD2011)4
Wales 5.2 - - -
Top 5
Neath Port Talbot 5.6 18 3 6
Denbighshire 5.6 10 11 10
Swansea 5.6 13 8 8
Conwy 5.5 6 16 18
Gwynedd 5.5 1 20 17
Bottom 5
Powys 4.9 3 21 20
Newport 4.9 14 10 4
Cardiff 4.8 12 12 5
Merthyr Tydfil 4.8 22 1 1
Monmouthshire 4.7 2 22 21=

Table source: Office for National Statistics

Table notes:

  1. Proportions given are age standardised to the European standard population.

  2. The overall rank of 'Good' health is on a scale where 1 is the area with the highest overall rates of 'Good' health and 22 is the area with the lowest overall rates of 'Good' health.

  3. The overall rank of disability health is on a scale where 1 is the area with the highest overall rates of disability and 22 is the area with the lowest overall rate of disability.

  4. The rank of deprivation is on a scale where 1 is the most deprived area 21= the least deprived (as two ares share this status). Further information about the WIMD2011 is available in the Background notes.

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The unitary authority in Wales with the highest proportion of people with both ‘Good’ health and a disability among the total private household population was Neath Port Talbot (5.6 per cent), 8.5 per cent higher than the Wales average (5.2 per cent) and approximately 18 per cent higher than Monmouthshire which had the lowest proportion (4.7 per cent), 8.3 per cent lower than the Wales average, see table 8.

The relationship between ‘Good’ health and a disability, and deprivation and the overall health or prevalence of disability was more mixed for local areas in Wales compared to England. Areas that were among both the best and worst rankings in terms of deprivation and ‘Good’ health or disability appeared in the top and bottom five unitary authorities when ranked by the proportion of people in ‘Good’ health despite a disability. 

A comparison of people in ‘Good’ health among those with a disability has not been made across unitary authorities in Wales since small population numbers in some areas may give rise to misleading proportional differences between those areas.

‘Good’ health and a disability across deciles of deprivation, England, 2011

Table 9: 'Good' health with a disability among the total private household population by IMD2010 area deprivation, England 2011

Per cent
   0 – 15   16 – 24   25 – 34   35 – 49   50 – 64   65 – 74   75 – 84   85+ 
1 (most deprived)                  2.4                  2.9                  3.1                  4.2                  5.3                  8.3                  9.9                11.5
2                  2.4                  2.6                  2.6                  3.8                  5.2                  8.5                10.5                13.0
3                  2.3                  2.5                  2.4                  3.5                  5.1                  8.7                11.4                14.1
4                  2.2                  2.4                  2.2                  3.3                  5.0                  8.6                12.0                15.1
5                  2.1                  2.4                  2.2                  3.1                  4.9                  8.6                12.5                16.1
6                  2.0                  2.3                  2.1                  2.9                  4.7                  8.5                12.9                17.1
7                  1.9                  2.3                  2.0                  2.8                  4.6                  8.4                13.2                17.5
8                  1.8                  2.3                  2.0                  2.6                  4.5                  8.3                13.5                18.2
9                  1.7                  2.2                  1.9                  2.5                  4.3                  8.1                13.7                18.8
10 (least deprived)                  1.6                  2.2                  1.9                  2.2                  4.0                  7.9                14.1                20.1

Table source: Office for National Statistics

Table notes:

  1. Data from census table CT0205 - Long-term health problem or disability by general health by sex by age, 2011 deciles from LSOAs in England.

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Until the age of 65, the proportion of people with ‘Good’ health despite a disability among the total private household population declines in a linear fashion from the most to the least deprived areas in England, see table 9. The greatest difference between areas was among people aged 35 to 49 when the proportion of people with ‘Good’ health and a disability was almost twice as high in the most deprived (4.2 per cent; 45,000 people) compared to the least deprived areas (2.2 per cent; 26,000 people), see table 9.  

As with English regions it is interesting to note the switch in the relationship between area and the proportion of the total private household population in ‘Good’ health despite a disability at age 75. Prior to this age, the most deprived areas had the highest proportions of people with ‘Good’ health and a disability, whereas at ages 75 and over the picture reversed to one in which the highest proportions of people in ‘Good’ health despite a disability were in the least deprived areas. This finding is illustrated in Figure 5, below.

Figure 5: The prevalence of 'Good' health with a disability by age in the least and most deprived areas, England 2011

Figure 5: The prevalence of 'Good' health with a disability by age in the least and most deprived areas, England 2011
Source: Census - Office for National Statistics

Notes:

  1. Data from census table CT0205 - Long-term health problem or disability by general health by sex by age, 2011 deciles from LSOAs in England.

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Table 10: 'Good' health among those with a disability by IMD2010 area deprivation, England 2011

Per cent
  0 – 15 16 – 24 25 – 34 35 – 49 50 – 64 65 – 74 75 – 84 85+
1 (most deprived)                50.4                41.6                30.9                19.1                12.5                13.9                13.4                13.2
2                52.0                44.4                33.4                21.7                14.9                16.1                14.9                15.1
3                53.9                46.2                35.3                23.7                17.1                18.2                17.0                16.6
4                55.5                47.2                36.8                25.9                19.2                19.8                18.6                17.9
5                56.2                48.4                38.4                27.8                21.0                21.7                20.1                19.2
6                57.2                49.5                39.3                29.6                23.1                23.3                21.5                20.6
7                58.3                50.4                40.2                31.5                24.7                24.6                22.8                21.3
8                59.3                51.0                41.2                33.2                26.2                25.8                23.8                22.4
9                59.8                51.5                41.3                34.8                27.9                27.0                25.0                23.2
10 (least deprived)                61.5                53.2                43.2                37.2                30.8                29.5                27.3                25.3

Table source: Office for National Statistics

Table notes:

  1. Data from census table CT0205 - Long-term health problem or disability by general health by sex by age, 2011 deciles from LSOAs in England.

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Considering the disabled population alone, the proportion of disabled people with ‘Good’ health increases in a linear fashion as relative deprivation declines. The highest proportions of disabled people with ‘Good’ health are in the least deprived areas and the lowest proportions are in the most deprived areas, see table 10.

Between the ages of 0 to 15, half of all disabled people (50.4 per cent; 31,000 people) in the most deprived areas were in ‘Good’ health compared to three fifths (61.5 per cent, 16,000 people) in the least deprived areas. At the oldest ages, 85 and over, around one in ten (13.2 per cent; 8,000 people) disabled people in the most deprived areas are in ‘Good’ health compared to a quarter (25.3 per cent; 18,000 people) in the least deprived areas.

In fact, from the age of 35 the proportion of disabled people in ‘Good’ health in the least deprived areas was around twice that or higher than the proportion in the most deprived areas.

These differences may again be due to issues relating to optimism, people living in more affluent areas have a more positive view of their general health despite a disability. People living in less deprived areas may also have better access to health and social care provision which might make them more likely to overlook the limitations of their disability when considering their general health, compared to people living in the most deprived areas.

Analysis of the types and duration of disability among different population groups will further our understanding of health perception among the disabled population.

 

Background notes

  1. Census day was 27 March 2011.

  2. 2011 Census data contained in this story uses data tables DC3302EW and CT0205.

  3. The European Standard Population 2013 (ESP) was published by Eurostat, the statistical institute of the European Commission, on 11 July 2013. The publication of the ESP 2013 provides an up-to-date standard population which reflects the average age structure of European countries from 2010-2030; this is important because of population ageing since the original ESP in 1976. ONS held a public consultation on the implementation of the ESP 2013 in UK official statistics which closed on 3 October 2013. Plans for future use of the ESP 2013 in UK official statistics will be published in the near future.

  4. The health rates for comparisons of all people across different areas reported in this short story have been standardised to match the age profile of the ESP 2013. Age-standardised estimates are used to allow comparison of populations with differing age structures. Age-standardisation is a process where the age specific health rates for a particular area or area grouping are applied to a hypothetical population, the ESP.

  5. A spreadsheet detailing the calculation of age-standardised rates to the European Standard Population can be found on the ONS website (63.5 Kb Excel sheet) .

  6. In England there were 32,844 Lower Super Output Areas (LSOAs) with enumerated populations in 2011, 362 more than there were in 2001; use of the ONS Census Geography lookup file enables the old LSOA boundaries to be mapped to the 2011 Census boundaries. The Department for Communities and Local Government (DCLG) Indices of Deprivation 2010 used the old boundaries to assign a deprivation score to LSOAs, so an adjustment has been made to the published IMD2010 scores in areas affected by changes to LSOA boundaries in 2011 to enable their continued use with the latest LSOA boundaries. These adjusted scores were used to rank LSOAs from the most to least deprived, and aggregated into ten groups (deciles) of broadly similar population size based on their ranking. The most deprived tenth were allocated to decile 1 and the least deprived to decile 10. Those people residing in LSOAs allocated to decile 1 have the highest exposure to the domains of deprivation shown over and those in decile 10 the lowest exposure, with the intervening deciles having levels of exposure between these extremes. The responsibility for producing these adjusted deprivation scores lies purely with Public Health England (PHE) - the figures have neither been quality assured nor endorsed by DCLG. The adjusted scores can be used for analytical purposes where data are required for 2011 LSOA-level geographies. The adjusted scores do not replace DCLG's official 2010 English Indices of Deprivation, which are based on 2001 LSOA boundaries.

  7. Further information about the WIMD2011 is available.

  8. Details of the policy governing the release of new data are available by visiting www.statisticsauthority.gov.uk/assessment/code-of-practice/index.html or from the Media Relations Office email: media.relations@ons.gsi.gov.uk

Content from the Office for National Statistics.
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