1. Main Points
Healthy life expectancy (HLE) at birth in the UK showed no significant change between 2015 to 2017 and 2018 to 2020.
In Scotland, there was a statistically significant decrease of more than a year in male HLE at birth between 2015 to 2017 and 2018 to 2020; other constituent countries of the UK saw no significant change.
For females at age 65 years, HLE in the UK and England increased significantly by 4.8 months between 2015 to 2017 and 2018 to 2020.
Disability-free life expectancy (DFLE) at birth in the UK decreased significantly for both males and females between 2015 to 2017 and 2018 to 2020; this change was driven by decreases in England and Scotland.
DFLE at age 65 years showed no significant change in the UK and its constituent countries between 2015 to 2017 and 2018 to 2020.
The estimates in this publication relate to the period 2018 to 2020 and therefore include mortality and health state prevalence data collected in 2020 during the coronavirus (COVID-19) pandemic.
| Males | Females | |||||||
|---|---|---|---|---|---|---|---|---|
| HLE at birth in 2018 to 2020 (years) | Change since 2015 to 2017 | HLE at birth in 2018 to 2020 (years) | Change since 2015 to 2017 | |||||
| Years | Months | Years | Months | |||||
| UK | 62.8 | -0.3 | -3.6 | 63.6 | 0.0 | 0.0 | ||
| England | 63.1 | -0.2 | -2.4 | 63.9 | 0.1 | 1.2 | ||
| North East | 59.1 | -0.4 | -4.8 | 59.7 | -0.7 | -8.4 | ||
| North West | 61.5 | 0.3 | 3.6 | 62.4 | 0.2 | 2.4 | ||
| Yorkshire and the Humber | 61.1 | -0.6 | -7.2 | 62.1 | 0.5 | 6.0 | ||
| East Midlands | 62.0 | -0.8 | -9.6 | 61.8 | -0.3 | -3.6 | ||
| West Midlands | 61.9 | -0.2 | -2.4 | 62.6 | -0.2 | -2.4 | ||
| East of England | 64.6 | 0.5 | 6.0 | 65.0 | 0.4 | 4.8 | ||
| London | 63.8 | -0.1 | -1.2 | 65.0 | 0.4 | 4.8 | ||
| South East | 65.5 | -0.6 | -7.2 | 65.9 | -0.2 | -2.4 | ||
| South West | 64.7 | 0 | 0.0 | 65.5 | 0.4 | 4.8 | ||
| Wales | 61.5 | 0 | 0.0 | 62.4 | 0.3 | 3.6 | ||
| Scotland | 60.9 | * | -1.4 | -16.8 | 61.8 | -0.9 | -10.8 | |
| Northern Ireland | 61.5 | 0.3 | 3.6 | 62.7 | -0.1 | -1.2 | ||
Download this table Table 1: Healthy life expectancy (HLE) at birth estimates, UK, constituent countries and English regions, 2018 to 2020
.xls .csv
| Males | Females | |||||||
|---|---|---|---|---|---|---|---|---|
| DFLE at birth in 2018 to 2020 (years) | Change since 2015 to 2017 | DFLE at birth in 2018 to 2020 (years) | Change since 2015 to 2017 | |||||
| Years | Months | Years | Months | |||||
| UK | 62.0 | * | -0.8 | -9.6 | 60.7 | * | -1.2 | -14.4 |
| England | 62.4 | * | -0.7 | -8.4 | 60.9 | * | -1.2 | -14.4 |
| North East | 56.9 | * | -2.4 | -28.8 | 56.3 | * | -3.0 | -36.0 |
| North West | 60.2 | -0.2 | -2.4 | 59.1 | * | -1.1 | -13.2 | |
| Yorkshire and the Humber | 60.0 | * | -1.3 | -15.6 | 58.5 | * | -1.9 | -22.8 |
| East Midlands | 62.0 | -0.5 | -6.0 | 60.0 | -0.7 | -8.4 | ||
| West Midlands | 61.6 | -0.9 | -10.8 | 59.9 | * | -2.1 | -25.2 | |
| East of England | 64.3 | 0.3 | 3.6 | 61.9 | -1.0 | -12.0 | ||
| London | 64.4 | -0.5 | -6.0 | 63.3 | -0.6 | -7.2 | ||
| South East | 64.3 | * | -1.0 | -12 | 63.0 | -1.0 | -12.0 | |
| South West | 62.6 | -0.9 | -10.8 | 61.0 | * | -1.3 | -15.6 | |
| Wales | 59.4 | -0.5 | -6.0 | 59.0 | -0.5 | -6.0 | ||
| Scotland | 60.3 | * | -1.1 | -13.2 | 59.5 | * | -1.7 | -20.4 |
| Northern Ireland | 60.7 | -0.4 | -4.8 | 61.5 | -0.2 | -2.4 | ||
Download this table Table 2: Disability-free life expectancy (DFLE) at birth estimates, UK, constituent countries and English regions, 2018 to 2020
.xls .csv2. Healthy life expectancy in the UK
Across the UK, Scotland saw the most notable change in healthy life expectancy (HLE) (Figure 1).
Figure 1. Scotland saw a significant reduction of 1.4 years in male healthy life expectancy at birth between 2015 to 2017 and 2018 to 2020
Change in healthy life expectancy at birth by sex, between 2015 to 2017 and 2018 to 2020, UK constituent countries
Source: Office for National Statistics
Notes:
- 0 on the Y axis represents no change in HLE.
Download this chart Figure 1. Scotland saw a significant reduction of 1.4 years in male healthy life expectancy at birth between 2015 to 2017 and 2018 to 2020
Image .csv .xlsThis is the first time that we have seen a significant decrease in HLE for males in Scotland since 2011 to 2013. There was an increase in HLE for males in Northern Ireland (0.3 years) between 2015 to 2017 and 2018 to 2020, but it was not statistically significant. Increases in female HLE at birth in Wales (0.3 years) and England (0.1 years) were also not statistically significant.
Changes in healthy life expectancy (HLE) at all ages in relation to life expectancy
Looking at HLE over the whole age range, it is possible to show how changes in life expectancy and HLE affect the years lived in different health states at different ages. It is informative to assess whether the years lived in good health and poorer states of health are reducing or increasing at different ages since our time series began in 2011 to 2013.
Between 2011 to 2013 and 2018 to 2020, HLE in the UK showed small decreases for males aged 4 years and under, although these were not statistically significant. At all other ages, HLE either increased or did not change for males (Figure 2), with the increases being statistically significant from the age of 35 years to 84 years.
HLE decreased for females aged 4 years and under; this was not statistically significant. Female HLE increased for those aged 10 years and over between 2011 to 2013 and 2018 to 2020, with the increases being statistically significant in those aged 20 years and over (Figure 2).
Figure 2. In the UK, female healthy life expectancy for those aged 45 to 59 years grew by around three-quarters of a year between 2011 to 2013 and 2018 to 2020
Change in healthy life expectancy by sex and age, between 2011 to 2013 and 2018 to 2020, UK
Source: Office for National Statistics
Notes:
- 0 on the Y axis represents no change in HLE.
Download this chart Figure 2. In the UK, female healthy life expectancy for those aged 45 to 59 years grew by around three-quarters of a year between 2011 to 2013 and 2018 to 2020
Image .csv .xlsImprovements in HLE at older ages were occurring at a time when life expectancy was stalling or even reducing in some of the oldest age groups. This caused the years lived in poorer states of health to reduce in these age groups. In contrast, because of decreases in HLE at the youngest ages, the time spent in poorer states of health has increased in these populations because of small improvements in life expectancy (Figure 3).
Figure 3. Females aged 35 to 79 years in the UK saw the number of years lived in poorer states of health fall by over half a year between 2011 to 2013 and 2018 to 2020
Change in the number of years lived in poorer states of health by age and sex, between 2011 to 2013 and 2018 to 2020, UK
Source: Office for National Statistics
Notes:
“Years lived in poorer states of health” is the difference between life expectancy and HLE.
0 on the X axis represents no change in “Years lived in poorer states of health”.
Download this chart Figure 3. Females aged 35 to 79 years in the UK saw the number of years lived in poorer states of health fall by over half a year between 2011 to 2013 and 2018 to 2020
Image .csv .xls3. Disability-free life expectancy in the UK
Figure 4. Disability-free life expectancy (DFLE) at birth reduced by 0.7 years for males and 1.2 years for females in the UK between 2015 to 2017 and 2018 to 2020
Disability-free life expectancy at birth and years lived with disability by sex and period, UK
Source: Office for National Statistics
Notes:
- Years lived disability-free is an estimate of the average number of years lived without activity restriction resulting from a long-lasting physical or mental health condition; it is based upon a self-rated assessment of how health conditions and illnesses reduce an individual's ability to carry out day-to-day activities. Conversely, years with disability are the years lived with activity restriction.
Download this chart Figure 4. Disability-free life expectancy (DFLE) at birth reduced by 0.7 years for males and 1.2 years for females in the UK between 2015 to 2017 and 2018 to 2020
Image .csv .xlsAmong the constituent countries of the UK, there were notable reductions in DFLE at birth for both sexes in England and Scotland (Figure 5).
Figure 5: Scotland and England saw statistically significant reductions of 1.7 years and 1.2 years in female disability-free life expectancy at birth between 2015 to 2017 and 2018 to 2020, respectively
Change in disability-free life expectancy at birth by sex, between 2015 to 2017 and 2018 to 2020, UK constituent countries
Source: Office for National Statistics
Notes:
- 0 on the Y axis represents no change in DFLE.
Download this chart Figure 5: Scotland and England saw statistically significant reductions of 1.7 years and 1.2 years in female disability-free life expectancy at birth between 2015 to 2017 and 2018 to 2020, respectively
Image .csv .xlsThe reductions in DFLE for each sex in Northern Ireland and Wales were not statistically significant (Figure 5).
Changes in DFLE at all ages in relation to life expectancy
The time series for DFLE estimates begins in 2014 to 2016, rather than 2011 to 2013 as seen with healthy life expectancy (HLE)
The years lived with a disability is the difference between life expectancy and DFLE. It is used to assess whether improvements in length of life are comparable to improvements in years lived without a long-term illness that limits daily activities.
Between 2014 to 2016 and 2018 to 2020, female and male DFLE in the UK decreased among those aged 35 to 39 years and under, and falls were substantially greater among females. However, for those aged 55 to 59 years and over, there were small improvements for both sexes, although these were not statistically significant (Figure 6).
Figure 6. Female DFLE at birth reduced by 1.4 years in the UK between 2014 to 2016 and 2018 to 2020, and in general male and female DFLE decreased at younger ages
Change in disability-free life expectancy at birth by sex, between 2014 to 2016 and 2018 to 2020, UK
Source: Office for National Statistics
Notes:
- 0 on the Y axis represents no change in DFLE.
Download this chart Figure 6. Female DFLE at birth reduced by 1.4 years in the UK between 2014 to 2016 and 2018 to 2020, and in general male and female DFLE decreased at younger ages
Image .csv .xlsThe changes in Figure 6 occurred at a time when life expectancy at most ages was also falling. Changes in both life expectancy and DFLE have an impact on the number of years people can expect to live with a disability (Figure 7).
Figure 7: Between 2014 to 2016 and 2018 to 2020, the years lived with disability increased in females aged under 55 years but reduced or did not change for all others; the years reduced for males aged 35 years and over but increased or did not change for all younger males
Change in the number of years lived with disability by age and sex, between 2014 to 2016 and 2018 to 2020, UK
Source: Office for National Statistics
Notes:
- 0 on the X axis represents no change in “Years spent with disability”.
Download this chart Figure 7: Between 2014 to 2016 and 2018 to 2020, the years lived with disability increased in females aged under 55 years but reduced or did not change for all others; the years reduced for males aged 35 years and over but increased or did not change for all younger males
Image .csv .xlsFemales in the UK aged under 55 years were expected to live more years with a disability, as the reduction in DFLE at these ages far exceeded life expectancy falls. In contrast, at older ages, DFLE improved while life expectancy reduced, causing the years lived with a disability to decrease.
Males observed a different pattern, with those aged 30 and over seeing a reduction in the years lived with a disability, with the largest fall occurring for those aged 50 to 54 years.
Back to table of contents4. Health state expectancies for local areas
Figure 8: Healthy life expectancy at birth and at aged 65 years by sex, local areas of the UK, 2011 to 2013 and 2018 to 2020
Embed code
Notes:
Healthy life expectancy figures are not available for Isles of Scilly and City of London because of insufficient population size.
If you wish to more objectively compare the improvement in healthy life expectancy across the time series between areas, you need to take into account the confidence intervals provided in the pivot table.
Download the data
Figure 9: Disability-free life expectancy at birth and at aged 65 years by sex, local areas of the UK, 2011 to 2013 and 2018 to 2020
Embed code
Notes:
Disability-free life expectancy figures are not available for Isles of Scilly and City of London because of insufficient population size.
If you wish to more objectively compare the improvement in disability-free life expectancy across the time series between areas, you need to take into account the confidence intervals provided in the pivot table.
Download the data
The accompanying data tables provide a time series, which contains estimates of healthy life expectancy (HLE) and disability-free life expectancy (DFLE) at local area level across the UK.
Back to table of contents5. Health state life expectancies data
Health and disability-free adjustment factor
Dataset | Released 4 March 2022
The proportions used while estimating the good health and disability-free prevalence rates for health state life expectancies in the UK.
Health and disability-free census prevalence
Dataset | Released 4 March 2022
The census prevalence used while estimating the good health and disability-free prevalence rates for health state life expectancies in the UK.
Health state life expectancy, all ages, UK
Dataset | Released 4 March 2022
Pivot tables for health state life expectancy by sex and area type, divided by three-year intervals starting from 2009 to 2011.
Health state life expectancy estimates template
Dataset | Released 11 December 2019
Template for creating life expectancy and health expectancies estimates.
6. Glossary
Period life expectancy
Life expectancy estimates reported in this bulletin are period-based. Period life expectancy (LE) at a given age for an area is the average number of years a person would live, if he or she experienced the particular area's age-specific mortality rates for that time period throughout his or her life.
Health state life expectancy
A generic term for summary measures of health that add a quality dimension to estimates of life expectancy by dividing expected lifespan into time spent in different states of health. In this release, health state life expectancy encompasses measures based on health-related wellbeing (healthy life expectancy) and functional health status (disability-free life expectancy).
Healthy life expectancy
An estimate of lifetime spent in "very good" or "good" health, based on how individuals perceive their general health.
Disability-free life expectancy
An estimate of lifetime free from a limiting persistent illness that limits day-to-day activities; it is based upon a self-rated assessment of how health conditions and illnesses reduce an individual's ability to carry out day-to-day activities. Day-to-day activities include:
washing and dressing
household cleaning
cooking
shopping for essentials
using public or private transport
walking a defined distance and climbing stairs
remembering to pay bills
lifting objects from the ground or a work surface in a kitchen
other moderate manual tasks such as gardening, and gripping objects such as cutlery
95% confidence intervals
A measure of the uncertainty around a specific estimate. It is expected that the interval will contain the true value on 95 occasions if repeated 100 times. As intervals around estimates widen, the level of uncertainty about where the true value lies increases. At a national level, the overall level of error will be small compared with the error associated with a local area.
Statistical significance
The term "significant" refers to statistically significant changes or differences. Significance has been determined using the 95% confidence intervals, where instances of non-overlapping confidence intervals between estimates indicate the difference is unlikely to have arisen from random fluctuation. In some circumstances, significance has also been tested using z scores.
Back to table of contents7. Measuring the data
This statistical bulletin presents estimates of life expectancy, healthy life expectancy and disability-free life expectancy for the UK, constituent countries, regions, local government administrations including combined authorities and Welsh health boards.
Data sources
Life expectancy uses death registrations data held by the Office for National Statistics (ONS). Mid-year population estimates by age, sex and geographical area are used in combination with death registrations to calculate age-specific mortality rates used in life tables.
In addition, health state life expectancies use data collected as part of the Annual Population Survey (APS) (PDF, 689KB) and data from the 2011 Census.
Health state prevalence rates are obtained from the three-year reweighted APS dataset used in healthy life expectancy and disability-free life expectancy calculations.
As the method requires imputation and modelling, data from the 2011 Census are used to produce imputation adjustment factors and census-based health state prevalence. These figures are made available with the datasets accompanying the release.
There were boundary changes in this release that had differential impacts for life expectancy and health state life expectancy.
Northamptonshire county has been abolished and, in its place, two new unitary authorities have been created, which are North Northamptonshire and West Northamptonshire.
The estimates for the new boundaries have been made available back to the period from 2011 to 2013.
The boundary changes are shown in Table 4.
| Old code | Old name | New code | New name |
|---|---|---|---|
| E10000021 | Northamptonshire | E06000061 | North Northamptonshire |
| E06000062 | West Northamptonshire |
Download this table Table 3: Boundary changes in England affecting this release
.xls .csvMethod for estimating life expectancy
The health state life expectancy estimates reported in this bulletin are period-based and estimated using a Sullivan life table. A Health state life expectancy estimates template is available, which shows how the Sullivan life table is deployed to derive these estimates.
Abridged life tables are used in preference to complete life tables for smaller populations because death counts can be too sparse for examining mortality for single years of age. These tables are also used because mid-year population estimates are not available or sufficiently reliable to produce these by single year of age.
Subnational estimates
Subnational life expectancy estimates for Scotland's council areas and Northern Ireland's local government districts have been calculated using the same method as for England and Wales. Responsibility for the production of other statistics for Scotland and Northern Ireland is with the National Records of Scotland (NRS) and the Northern Ireland Statistics and Research Agency (NISRA), respectively. Estimates contained in this report may differ from estimates produced separately by constituent countries because of survey source and methodological differences.
Quality
Early access for quality assurance purposes
We provide early access for quality assurance purposes to a small number of external bodies including Public Health England, the Department of Health and Social Care, Welsh Government, National Records of Scotland, the Northern Ireland Research and Development Agency, and Public Health Wales. The recipients are not permitted to share the findings or the report wider within their organisations or to external organisations.
More quality and methodology information (QMI) is available in the Health State Life Expectancies QMI.
Back to table of contents8. Strengths and limitations
The strengths of the health state life expectancies release are that:
it covers all UK local areas, and estimates are comparable with countries and regions
the estimates using abridged life tables align closely with those based on complete life tables
the mortality data used have complete population coverage; estimates have high precision and are representative of the underlying population at risk
it provides a quality-of-life dimension to length of life, which is useful for assessing health and social care needs and fitness for work to changing state pension ages
The limitations of the health state life expectancies release are that:
the APS sample sizes for some local authority populations are small, leading to volatility in estimates and wide confidence intervals
survey data are not routinely collected for those aged under 16 years, and only sparsely for those aged 85 years and over, requiring imputation of prevalence from census data for these age groups
the measures of health status are subjective self-reports