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Strong relationship between self-assessed health and area deprivation in England and Wales

Highest percentages of ‘Good’ health were clustered to the south and west of London in 2011

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

In the 2011 Census, residents of England and Wales were asked two questions related to health. The first question asked about an individual’s general health. (Residents were also asked about their activity limitations)

In England and Wales, 80.1% (21.7 million) of males and 79.5% (22.2 million) of females assessed their health as 'Very Good' or 'Good'.

Strong relationship between self-assessed ‘Good’ general health and area deprivation

For the purposes of this story, an individual assessing their health as 'Very Good' or 'Good' has been categorised as having ‘Good’ health. Similarly, those who assessed their health as 'Fair', 'Bad' or 'Very Bad' have been categorised as having ‘Not Good’ health.

In England, the ten local authorities with the highest percentages of ’Good’ health were clustered in an area to the south and west of London. In contrast, the bottom ten was composed of predominantly urban centres in the North, Midlands and London, where levels of deprivation are high.

Self-assessed health is better in England than Wales, but inequality is higher in England

Overall, males in Wales assessed their general health more favourably than females but both genders had less favourable self-assessed health than their counterparts in England. However, the inequality in health between administrative areas was lower in Wales than in England, but a similar pattern of worse health with rising levels of deprivation exposure was observed.

In England, the London borough of Tower Hamlets had the lowest age-standardised percentage of self-assessed ‘Good’ general health for females and the second lowest for males; while Hart in Hampshire had the highest percentage for males and the second highest for females. Rates are age-standardised to produce results which are comparable across populations with different age structures (some local authorities have  markedly younger or older populations).

Residents of Hart aged 50-64 assessed their general health more favourably than residents in Tower Hamlets aged 35-49, while Hart residents aged 75-84 assessed their health more favourably than Tower Hamlets residents aged 50-64, despite the former being 15 years their senior on average and more than ten years older than the state pension age for males in 2011.

Among residents in Wales, the unitary authority of Gwynedd had the most favourable self-assessed health for females and second most favourable for males. The lowest percentage of self assessed ‘Good’ health for both males and females was in Merthyr Tydfil.

Such information provides a context for comparing health and social care need across local authority populations and indicating the proportion of the population of working age and beyond the state pension age that are likely to be fit for work. These variations across local authorities provide further evidence of the influence of deprivation on health status and its role in perpetuating health inequalities between the residents of England and Wales. It also confirms the health divide at younger ages between those resident in the most and least deprived authorities.


Background notes

For the purpose of this analysis an individual responding to the general health question on the 2011 Census has been categorised as 'Good' if they answered 'Very Good' or 'Good'.

The analysis refers to 324 Local Authorities as City of London has been merged with Hackney and Isles of Scilly has been merged with Cornwall due to small population counts.

European Standard Population (ESP 2013) is used to standardise self-assessed general health responses to enable comparison allowing for differences in age structure.

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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