This new small area analysis by 2011 Census wards in England and Wales between 2009 and 2013 is consistent with a previous analysis at small area level, which showed substantial inequalities in health between small populations classified to different small area boundaries within local government administrations. However, this analysis differs due to 2011 Census wards having different boundaries to Middle layer Super Output Areas (MSOAs).
In the period 2009 to 2013, males born in Knightsbridge and Belgravia in Westminster ward were expected to live more than three decades longer in “Good” general health than males in an equivalently-sized area of Bloomfield in Blackpool (79.1 years compared with 47.1 years respectively). Bloomfield also had the shortest life expectancy (LE) in England and Wales at 68.2 years compared with Warfield Harvest Ride in Bracknell Forest at 90.3 years; a gap of 22.1 years.
For females, the gap in healthy life expectancy (HLE) at birth for the equivalent time period was 35.4 years; where in one small area, Middlehaven of Middlesbrough, HLE was only 47.6 years, compared with 83.0 years in a small area, Blackheath and Wonersh of Waverly in the South East of England. In contrast, females in Great Corby and Geltsdale in Carlisle could expect the longest life (97.2 years) compared with females born in Gwersyllt West in Wrexham (72.6 years).
A data visualisation shows life expectancy and healthy life expectancy by ward and sex.
Figure 1: Life expectancy (LE) and healthy life expectancy (HLE) at birth for males and females by 2011 Census wards, England and Wales, 2009 to 2013
Wrexham, a Welsh unitary authority (UA), had the widest inequality in healthy life expectancy (HLE) for males at birth of 25.3 years (derived by taking the difference between the wards with the highest and lowest HLE within its local area boundary). This inequality in HLE was twice as wide as the median inequality between local areas in England and Wales (12.8 years).
Overall, HLE in this UA was 62.1 years, which was lower than the median HLE (64.2 years) for males within England and Wales. Despite having the longest HLE, Westminster followed closely with the second widest inequality in HLE of 24.4 years.
Purbeck, a local government district in the South West of England, had the smallest health inequality at 3.8 years for males at birth. The London borough of Newham had the second smallest inequality at 4.1 years. For males, Purbeck and Newham had quite a similar size of inequality in HLE; however, the males living in the wards of Newham were living much fewer years in “Good” health than males living in the wards of Purbeck. This demonstrates that although the within authority inequality was similar in Newham and Purbeck, the vast proportion of the population in these local areas had very contrasting health outcomes. Purbeck’s low inequality and high HLE is the preferable health landscape for an authority to aspire to. Living long healthy lives with narrow within authority small area disparities is the aim of government policy. For instance, HLE at birth for males across all 2011 Census wards in Purbeck exceeded 64.7 years, which was substantially higher than the overall HLE of Newham borough (57.9 years).
For females at birth, City of Westminster had the widest level of health inequality at 25.3 years, which was almost twice as wide as the median inequality in HLE for females, which was 13.1 years for England and Wales. Westminster had an overall HLE of 65.3 years, which was just shy of the median HLE for females in England and Wales at 65.4 years. Bradford had the second-widest level of health inequality at 23.6 years.
On the other hand, the lowest level of inequality observed for females was in the county district of Eden in Cumbria at 3.6 years, which had a HLE of 68.4 years. Females in Purbeck experienced the second smallest health inequality at 4.1 years and a similar HLE of 68.7 years.
A data visualisation shows inequalities in healthy life expectancy by small areas and sex.
Figure 2: Inequality in healthy life expectancy at birth within local areas in England and Wales, 2009 to 2013
- The term "local areas" refers to local authority districts and these include unitary authorities, London boroughs, metropolitan districts and non-metropolitan districts in England and Wales; there were 346 local areas altogether included in this analysis.
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Figure 3: Life expectancy, healthy life expectancy and inequality for males and females at birth and age 65 by 2011 Census wards, England and Wales, 2009 to 2013
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