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Health inequality widest in older middle-aged census analysis shows

What are the health differences between residents of more and less disadvantaged areas in England?

The latest ONS analysis reveals that area deprivation in England affects people’s health across all ages, but this is most intense among older middle-aged men and women. This is useful information for health organisations as it allows them to focus their resources and actions to help improve the fitness and lifespan of the population. This analysis poses questions for how evenly health care should be distributed between people in areas with the highest and lowest levels of deprivation. If health is declining earlier and more drastically among people in deprived areas, this has consequences for fitness to work, productivity in the economy, dependency on state benefits and reliance on health care services.

Proportional healthcare only way to resolve health deficit

To achieve the levels of good health existing in the least deprived areas of England, around 1.7 million more men and 1.8 million more women would have had to assess their health as either very good or good in the 2011 Census. Having regard to reducing health inequality is now a statutory duty for health organisations (NHS England, Public Health England) and it is clear from the census data that much action is needed to close the gap on this health deficit.

Disabling health problems were highest in the most deprived areas

Disability prevalence increases strongly in relation to age, with those under 40 having the lowest levels (under 10%) and those over 85 (80%) having the highest;  but deprivation also has an effect too with a large divergence between more and less deprived areas after ages 30-34. This gap grows steadily up to ages 65-69 when the percentage difference between most and least deprived areas exceeds 33%, or two and a half times higher.

In the least deprived areas disability is below 10% for men and 11% for women up to ages 50-54, yet this amount is the same as 25-29 year olds in deprived areas. While disability is under 25% for 65-69 year olds in the least deprived areas, it is over 50% in the most deprived. Such differences in disability prevalence suggest fitness to enjoy retirement is more likely among those experiencing less deprivation, as is their ability to continue in the labour market with the proposed rises to the state pension age.

Area deprivation affects middle aged most

Health status is strongly related to age, for instance those aged under 20 generally have the best health, then it deteriorates gradually, with those between the ages of 65 and 85+ having the worst health. However the analysis shows health deteriorates in line with increasing levels of deprivation too.

For instance, in the most deprived areas the amount of people with poor health starts to increase sharply from age 20 with a difference of 36% between early middle-aged men (30-34) and later middle age men (55-59), compared with a difference of 20% in England generally and only 11% in the least deprived areas. A similar difference occurs for women too.

Better health in retired non-deprived women than deprived 40 year olds

Men living in deprived areas experienced health declines much earlier on in life with the health divide intensifying across the working ages of 20 to 64. In non-deprived areas poor health remained below 10% up to ages 40-44.  For example, at ages 35-39, those in the most deprived areas had similar levels of poor health (20.5%) to those aged 60-64 in the least deprived areas. Also, those aged 60-64 in England generally have a similar rate of poor health (33.6%) to those aged 45-49 (33.2%) in the most deprived areas.

The deprivation difference with women is again stark, those aged 30-34 in the most deprived areas have worse health than those aged 55-59 in the least deprived areas.  At the key ages post retirement up to ages 80-84, women in the least deprived areas are as healthy or healthier compared with females in the most deprived areas 20-25 years their junior. The increase between ages 65-69 and 85+ in poor health was sharper than for men, with a 38.1% difference rather than 31.4%.

Where can I find out more about health statistics?

These statistics were analysed by Health Analysis team at ONS. This analysis is based largely on data from the Census, carried out by ONS. If you would like to find out more about the latest health statistics, you can read the release, or visit the Census analysis page. If you have any comments or suggestions, we would like to hear them! Please email us at: healthineq@ons.gsi.gov.uk.

Terminology

Deprivation: This analysis uses the English Indices of Deprivation 2010. This measure of deprivation is a wider concept than simply poverty and instead it reveals the general lack of resources and opportunities.
Measures: The two measures of health status are self assessed general health and self assessed activity limitation (disability). The deprivation is measured in the 32,844 lower super output areas (LSOAs) in England.

Categories: Health and Social Care, Health of the Population, Health Inequalities, Disability and Self-reported Health
Content from the Office for National Statistics.
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