Healthy life expectancy in England and Wales: between 2011 to 2013 and 2021 to 2023

• In 2021 to 2023, males in England could expect to spend 61.5 years of their lives in good health, compared with 60.3 years in Wales; for females, it was 61.9 years in England and 59.6 years in Wales.

• In 2021 to 2023, males aged 65 years in England could expect to spend 10.1 years in good health, compared with 9.8 years in Wales; for females, it was 11.2 years in England and 10.4 years in Wales.

• Since the pre-coronavirus (COVID-19) pandemic period (2017 to 2019), male healthy life expectancy (HLE) at birth in England has fallen by 1.7 years, and in Wales by 1.1 years; for females, it fell by 1.9 years in England and 2.2 years in Wales.

• A large difference in HLE between the highest and lowest ranked areas in England was observed for males (17.9 years), growing by 22.0% since 2011 to 2013; for females it was 18.2 years, growing by 17.1% since 2011 to 2013.

• In Wales, the difference was smaller (11.0 years for males, 12.6 years for females) but these gaps increased by 13.3% and 16.5%, respectively.

• In 2021 to 2023, in England, HLE at birth was highest in Wokingham (69.7 years for males, 70.8 years for females); it was lowest in Blackpool for males (51.7 years), and in Barnsley for females (52.6 years).

• In Wales, HLE at birth in 2021 to 2023 was highest in Monmouthshire (65.9 years for both males and females) and lowest in Torfaen (54.9 years and 53.3 years, respectively).

 Regional healthy life expectancy at birth

Among the regions of England, the highest male healthy life expectancy (HLE) at birth was observed in London (63.9 years), 7.0 years higher than in the North East (56.9 years). For females, the highest HLE at birth was observed in the South East (64.4 years), 6.9 years more than in the North East (57.5 years).

Most regions of England experienced a fall in HLE at birth since the pre-coronavirus (COVID-19) pandemic period (2017 to 2019). For males, the largest fall was observed in the North West (31.0 months), but in London there was a small improvement of 2.2 months. For females, all regions experienced a fall, ranging from 32.4 months in the South West to 0.7 months in London.

Looking at the trend over the decade, all regions other than London experienced a fall in both male and female HLE at birth since the 2011 to 2013 period (more information is available in our accompanying dataset).

Local area healthy life expectancy at birth

In the 2021 to 2023 period, the majority of local areas, both in England and in Wales, had lower HLE at birth than in the pre-pandemic period, 2017 to 2019.

In England, the local area with the largest increase in male HLE at birth since 2017 to 2019 was Hillingdon, gaining 5.8 years. The largest fall was observed in Cheshire West and Chester (5.2 years). Overall, 132 areas (87.4%) saw male HLE at birth fall since the 2017 to 2019 period.

The local area in England with the largest rise in female HLE at birth was also Hillingdon, gaining 6.3 years; the largest fall was observed in Peterborough (6.0 years). Overall, 131 areas (87.0%) saw female HLE at birth fall since 2017 to 2019.

In Wales, around two-thirds of local areas (15 of 22) had lower male HLE at birth in 2021 to 2023, compared with 2017 to 2019. The local area with the largest increase was Caerphilly, gaining 1.8 years, while the largest fall was observed in Flintshire (4.0 years).

Almost all local areas in Wales (20 of 22) saw a decrease in female HLE at birth, compared with 2017 to 2019. The local area with the largest increase was also Caerphilly, gaining 1.1 years, while the largest fall was observed in Torfaen (5.4 years).

Our interactive dynamic map (Figure 1) allows the sex-specific trends in HLE, at birth and at the age of 65 years, to be visualized across England and Wales. It enables users to focus on a specific local area by clicking on the map or searching for a local area in the search bar.

Figure 1: Healthy life expectancy in 2021 to 2023 remained lower than in 2017 to 2019 in most local areas

Healthy life expectancy at birth and at aged 65 years by sex across local areas of England and Wales, between 2011 to 2013 and 2021 to 2023

Notes

1. All differences stated in this release, such as change (months), are calculated using unrounded data.
2. Isles of Scilly and City of London have been excluded from the map because of insufficient population counts.

Period life expectancy

The life expectancy estimates reported in this bulletin are period-based. Period life expectancy at a given age for an area is the average number of years a person would live if they experienced the area's age-specific mortality rates for that time-period throughout their lives. More information can be found in our Period and cohort life expectancy explained methodology.

Healthy life expectancy

A summary measure of health that adds a quality dimension to estimates of life expectancy by dividing expected lifespan into time spent in different states of health. Healthy life expectancy measures health-related wellbeing and represents the average time an individual is expected to live in "very good" or "good" general health, based on how individuals perceive their general health.

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. Confidence intervals around healthy life expectancy estimates are calculated from the variance of health state prevalence. Confidence intervals can be found in our accompanying datasets.

This statistical bulletin publishes estimates of healthy life expectancy for local areas of England and Wales, including countries, regions, local government administrations and Welsh health boards. Data for Scotland and Northern Ireland will be added when Scottish 2022 Census health data and 2023 population estimates for Northern Irish local government districts are available.

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). It also uses data from the 2011 Census and 2021 Census to obtain health state prevalence rates. The method requires imputation and modelling because survey data are not routinely collected for those aged under 16 years, and only sparsely for those aged 85 years and over. For this reason, data from the 2011 Census and 2021 Census are also used to produce imputation adjustment factors and census-based health state prevalence. These figures are made available with the datasets accompanying the release.

Method for estimating healthy life expectancy

Healthy life expectancy estimates reported in this bulletin are period-based and estimated using a tool know as a Sullivan life table (928KB). A Sullivan life table is an extension to the abridged life table, partitioning the years lived in good health and not good health in grouped ages. 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.

Quality and methodology information

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in our Health state life expectancies, UK quality and methodology information (QMI) report.

Official statistics in development

The estimates in our current release are official statistics in development because, as explained in this open letter, published on the Office for Statistics Regulation (OSR) website the accredited official statistics status of ONS outputs using Annual Population Survey (APS) data has been suspended. This release uses a new methodology to estimate the prevalence of "good" health to reduce the effect of the recent decrease in the APS's sample size. More information can be found in our Estimating "good" health prevalence for use in healthy life expectancy outputs article.