This is the final Opinions and Lifestyle Survey report using the 2012 data, following the Smoking Habits Amongst Adults, 2012 and Drinking Habits Amongst Adults, 2012 reports. This report focuses on the prevalence of long-standing illness or disability in Great Britain, and how it varies by different groups of society.
The Opinions and Lifestyle reports follow on from the General Lifestyle reports, which ended following publication of the 2011 data.
In 2012, 34% of adults living in Great Britain said that they had a long-standing illness or disability (LSI), and 19% said that they had a limiting LSI (that is, an LSI that limits activity in any way). These proportions have remained relatively consistent since 2005.
As expected, the prevalence of LSIs and limiting LSIs was closely associated with age, with higher prevalence amongst older people, Fig 1. To give an indication of the strength of this relationship, LSI prevalence amongst those aged 75 and over (67%) was almost five times higher than amongst those aged 16 to 24 (14%). Limiting LSI prevalence was eight times higher amongst those aged 75 and over (48%) than amongst those aged 16 to 24 (6%).
Our analysis shows that on average an increase in age of one year was associated with a 3% increased risk of having an LSI, and a 2% increased risk of having a limiting LSI.
There was little difference in LSI or limiting LSI prevalence between men and women, regardless of age. However once other factors such as income and employment status have been accounted for, women were 12% less likely than men to have an LSI, and 19% less likely to have a limiting LSI.
For those of working age, unemployed people (that is, those not working but looking for work) were almost twice as likely as employed people to have a limiting LSI (17% compared with 9%), Fig 2. They were also more likely to have an LSI (31% compared with 22%). Findings from the Labour Force Survey have also shown that throughout 2012 the unemployment rate was higher amongst those with a long-standing health problem or disability (216 Kb Excel sheet) than amongst those without.
People of working age who were economically inactive (that is, neither in work nor looking for work) had the highest prevalence of LSIs (42%) and limiting LSIs (31%). Economic inactivity is related to age. However, further analysis suggests that prevalence was still highest amongst economically inactive people once other factors, such as age and income, have been accounted for.
The higher a person’s gross income, the lower the likelihood was that they had an LSI or limiting LSI, Fig 3. However, for those belonging to income groups beyond £30,000 a year no significant changes in the prevalence of LSIs or limiting LSIs were observed.
As noted earlier having a LSI/limiting LSI is closely related to a person’s age. There is also a relationship between age and income, income tends to increase with age. However, if we remove the affect of other factors such as age and economic activity, higher incomes remain associated with a lower risk of having an LSI or limiting LSI. For example, a person was on average 10% less likely to have an LSI than someone who shared their characteristics, but had half their income. They were also on average 14% less likely to have a limiting LSI.
LSI prevalence was higher amongst those who were widowed/divorced/separated (54%) and married (35%) than it was amongst those who were single (23%) or cohabiting (25%). However widowed/divorced/separated and married people tend to be older than those who are single or cohabiting. If we remove the affect of factors such as age, then there was little difference in LSI and limiting LSI prevalence by relationship status.
LSI prevalence was higher amongst those from white ethnic groups than it was amongst those from non-white ethnic groups (36% compared with 21%). Limiting LSI prevalence amongst those from white ethnic groups was almost double the prevalence amongst those from non-white ethnic groups (20% compared with 11%). This is still true when factors such as age and income have been accounted for, although the difference between the groups is smaller.
Limiting LSI prevalence was lowest in London (15%) when compared with other regions of Great Britain, as was LSI prevalence (27%). However our analysis suggests that once other factors such as age, income and ethnicity have been accounted for, prevalence in London was no lower than most other regions.
Wales had the highest prevalence of limiting LSIs, at 26%, compared with other regions of Great Britain. This remains true once other factors, such as age, income and ethnicity have been accounted for. Prevalence in other regions ranged from 15% to 22%.
Smokers (23%) and ex-smokers (26%) were more likely to have a limiting LSI than those who had never smoked (15%), Fig 4. There were also variations in the prevalence of LSIs and limiting LSIs within the group of smokers, with increased prevalence associated with heavier smoking.
Respondents were asked whether they had any physical or mental health conditions lasting (or expected to last) 12 months or more. Those who reported conditions were then asked how these affected their functioning.
Generally, physical health conditions were more prevalent than mental health conditions. However, there was little difference in the proportions whose vision (4.1%), memory (3.8%) or mental health (3.6%) were affected by physical or mental health conditions lasting (or expected to last) 12 months or more, Fig 5.
Mobility (13%) and stamina, breathing or susceptibility to fatigue (9%) were most commonly affected by physical or mental health conditions.
As expected, the likelihood of having a physical health condition increased with age (see reference tables, table 3). The likelihood of experiencing conditions which affected memory also increased with age, but this was not the case with other kinds of mental health conditions. It is known that life expectancy is lower amongst those who experience mental health issues, with some studies suggesting that the gap could be as wide as 20 years. This could explain in some part why the likelihood remains stable with age.
The recent ONS publication Disability-free life expectancy at birth, and at ages 50 and 65 by Clinical Commissioning Groups, England, 2010-2012 provides more information on disability-free life expectancy.
Change in survey vehicle
In 2012, the survey vehicle for collecting health data changed from the General Lifestyle Survey (GLF) to the Opinions and Lifestyle Survey (OPN).
The OPN uses the same initial approach to sampling as the GLF. That is, a random sample of addresses is drawn from the Postcode Address File (PAF). Initially, a sample of postcode sectors is drawn, and from within those, a list of addresses is chosen. The design means that every address and every person in Great Britain has an equal chance of selection. The PAF is ordered by region and other socio-demographic indicators provided by the census. Ordering the PAF helps to ensure the sample represents the general population of Great Britain. GLF analysis was based on four waves of longitudinal data, weighted to produce cross-sectional estimates. The OPN only produces cross-sectional estimates.
Both the OPN and GLF surveys use Computer Aided Personal Interviewing (CAPI). Interviewers visit sampled addresses and interview respondents with the aid of a laptop. Face to face interviewing helps to maximise participation in the survey, which is around 60% of sampled addresses for both surveys.
All of the trends reported on in this release are based on the same questions previously included on GLF. Therefore, no trend changes will have been introduced as a result of changing question wording.
After data collection, the results are 'weighted' to ensure they represent the general population of Great Britain. The approach to weighting is the same for both surveys. Firstly, an adjustment is made to account for those respondents who chose not to take part in the surveys (or, for OPN, the chances of selection within a household - see 'What are the differences?', below). Secondly, the samples are grossed up to total the GB population, taking account of the age and gender profile of the population, as well as the distribution of people across Local Authorities.
What are the differences?
The primary difference between these two surveys is the approach to interviewing residents of sampled addresses. The GLF aimed to interview all residents in the household aged 16 or above. The OPN only interviews one person aged 16 or above in each sampled household. The OPN randomly selects a resident for interview, thus reducing the potential for selection bias. Despite a different approach to within household sampling selection, the achieved number of interviews is broadly the comparable between the two surveys. The GLF achieved approximately 13,500 adult interviews per year compared to approximately 13,000 adult interviews per year on the OPN.
There was a reduction in the number and detail of questions migrated from the GLF to the OPN. Details of the questions that were moved from the GLF to the OPN are provided in Appendix A of the Future of the GLF (108.9 Kb Pdf) update.
What do these differences mean for comparability?
Every effort has been made to minimise the potential for discontinuity between the results from the two surveys. Our analysis shows that the results of the OPN are comparable with those of the GLF.
The reduction in achieved sample size has not led to significant loss in precision. The confidence intervals around key estimates, such as the proportion of adults in Great Britain who had a long-standing illness or disability, are comparable between the GLF and OPN. Results have been found to follow the same patterns by various socio-demographic characteristics such as age, gender and employment status. The comparability of these estimates is deemed sufficient to make comparisons between 2012 and previously reported results.
However, the reduction in questions asked on topics covered by the GLF has led to a discontinuation of some outputs. For example, in the case of smoking, the age at which people started smoking is no longer reported on, as the source data is not collected on the OPN. Similarly, questions on tobacco dependency were no longer asked from January 2012.
Comparisons between groups
Where comments state that two groups are different, the differences have been tested for statistical significance. Complex standard errors, taking into account the survey design, have been used for these tests.
Differences that have been commented on are significant at 5% level (it should be noted that not every single statistically significant difference as been commented on).
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