General health, England and Wales: Census 2021

This page is also available in Welsh (Cymraeg) (PDF, 378KB).

• Age-standardised proportions (ASPs) are used throughout this bulletin; they allow for comparison between populations over time and across geographies, as they account for differences in the population size and age structure.

• In England, the proportion of people reporting very good health increased (from 45.0% in 2011, to 47.5% in 2021), whereas there were decreases in the proportion of people reporting good health (from 34.8% in 2011, to 34.2% in 2021), bad health (from 4.6% in 2011, to 4.1% in 2021) and very bad health (from 1.4% in 2011, to 1.2% in 2021).

• The North East was the region in England with the highest proportion of people reporting very bad health, at 1.6% of the population.

• In Wales, there were increases in the proportion of people who reported very good health (from 45.7% in 2011, to 46.6% in 2021) and good health (from 31.4% in 2011, to 32.5% in 2021), and decreases in the proportion of people who reported bad health (from 6.0% in 2011, to 5.1% in 2021) and very bad health (from 1.9% in 2011, to 1.6% in 2021).

• The local authorities with the highest proportions of people reporting very good health (Kensington and Chelsea, 58.0%) and very bad health (Tower Hamlets, 2.5%) were both in London.

• In Wales, Gwynedd (51.5%) was the local authority with the highest proportion of people reporting very good health and Merthyr Tydfil (2.4%) was the local authority with the highest proportion of people reporting very bad health.

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Respondents were asked to assess their general health on a five-point scale: "Very good", "Good", "Fair", "Bad", or "Very bad".

Census 2021 was conducted during the coronavirus (COVID-19) pandemic. This may have influenced how people perceive and rate their health and therefore may have affected how people chose to respond. See Section 8: Strengths and limitations for more information.

Percentages in this bulletin have been age-standardised. Health and age are closely related, with older people being more likely to be in poorer health. Age-standardised proportions (ASPs) account for different age structures in populations and are more appropriate than crude percentages when drawing comparisons over time and across areas. The numbers being reported here are the actual number who responded in each category. You can download both age-standardised and non-age standardised datasets. Read more in our blog Age-standardising data: What does this mean and why does it matter?

General health in England and Wales

Across England and Wales, there was an increase in the proportion of people reporting very good health and a decrease in the proportion of people reporting very bad health, compared with the 2011 Census.

The census data on general health show:

• an increase in the proportion of people reporting their health as very good to 47.5% (28.8 million) in 2021 (from 45.0%, 26.4 million, in 2011)

• a smaller proportion but larger number of people reporting their health as good, to 34.1% (20.0 million) in 2021 (from 34.6%, 19.1 million in 2011)

• a decrease in the proportion of people reporting their health as fair, to 13.1% (7.6 million) in 2021 (from 14.3%, 7.4 million in 2011)

• a smaller proportion, but similar number of people reporting their health as bad, to 4.2% (2.4 million) in 2021 (from 4.7%, 2.4 million in 2011)

• a decrease in the proportion of people reporting their health as very bad, to 1.2% (715,000) in 2021 (from 1.4%, 716,000 in 2011)

Figure 1: Age-standardised general health, 2011 and 2021, England and Wales

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Further data for specific areas provide a more detailed understanding of general health in England and Wales. The data show that the proportion of people reporting very good health increased in almost every local authority in England and Wales. Only in a small minority were there increases in the proportion of people reporting bad or very bad health.

General health in England

In England, the data on health show an increase in the proportion of people reporting very good health, and decreases in all other categories. There was:

• an increase of 2.5 percentage points in the proportion of people reporting very good health, from 45.0% (25.0 million) in 2011 to 47.5% (27.4 million) in 2021

• a decrease of 0.6 percentage points in the proportion of people reporting good health (from 34.8% in 2011 to 34.2% in 2021), although the overall number who reported good health increased (from 18.1 million in 2011 to 19.0 million in 2021)

• a decrease of 1.2 percentage points in the proportion of people reporting fair health, from 14.2% (7.0 million) in 2011 to 13.0% (7.1 million) in 2021

• a decrease of 0.5 percentage points in the proportion of people reporting bad health, from 4.6% (2.3 million) in 2011 to 4.1% (2.2 million) in 2021

• a decrease of 0.2 percentage points in the proportion of people reporting very bad health (from 1.4% in 2011 to 1.2% in 2021), although there was a small increase in the overall number who reported very bad health (from 661,000 in 2011 to 663,000 in 2021)

The trends for the regions in England generally followed this nationwide pattern. In 2021, the region with the highest proportion of people reporting very good health was the South East (49.6%, 4.6 million), which was also true in 2011 (47.5%, 4.2 million). The South East also had the lowest proportion of people reporting very bad health, at 0.9% (86,000).

Conversely, the North East had the highest proportion of people reporting very bad health (1.6%, 43,000) and the lowest proportion reporting very good health (44.7%, 1.2 million). However, when compared with 2011 this was a decrease in the proportion reporting very bad health (from 1.8%, 44,000) and an increase in the proportion reporting very good health (from 42.7%, 1.1 million), showing that health in the North East has improved.

At the local authority level, the areas of England with the highest proportion of people reporting very good health were Kensington and Chelsea (58.0%), Elmbridge (57.7%), and Richmond-upon-Thames (57.6%). The lowest proportion was in Stoke-on-Trent (40.2%).

The 14 local authorities with the largest increases in the proportion of the population reporting very good health (ranging from 4.7 to 6.7 percentage points) were all in London. The area with the greatest increase was Hackney, which rose from 41.8% in 2011 to 48.5% in 2021.

Out of all English local authorities, Tower Hamlets had the highest proportion of people reporting both very bad health (2.5%) and bad health (7.0%). Tower Hamlets also had the highest proportions in 2011, however, this was a decrease compared with 3.3% reporting very bad health and 8.7% reporting bad health.

There were only five local authorities where the proportion of people reporting very bad health increased (ranging from 0.1 to 0.3 percentage point increases). These were the Isles of Scilly (0.8%), Guildford (0.8%), Calderdale (1.3%), Mid Devon (1.0%) and South Cambridgeshire (0.8%).

Figure 2: Age-standardised general health, 2011 and 2021, England

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General health in Wales

The data for general health in Wales showed increases in the proportion of people reporting very good or good health, and decreases in the other categories. There was:

• an increase of 0.9 percentage points in the proportion of people reporting very good health, from 45.7% (1.4 million) in 2011 to 46.6% (1.4 million) in 2021

• an increase of 1.1 percentage points in the proportion of people reporting good health, from 31.4% (953,000) in 2011 to 32.5% (1.0 million) in 2021

• a decrease of 0.9 percentage points in the proportion of people reporting fair health, from 15.0% (448,000) in 2011 to 14.1% (450,000) in 2021

• a decrease of 0.9 percentage points in the proportion of people reporting bad health, from 6.0% (178,000) in 2011 to 5.1% (164,000) in 2021

• a decrease of 0.3 percentage points in the proportion of people reporting very bad health, from 1.9% (55,000) in 2011 to 1.6% (52,000) in 2021

The local authorities with the highest proportion of people reporting very good health were Gwynedd (51.5%) and the Isle of Anglesey (50.7%). The lowest proportion was in Blaenau Gwent (41.5%), and the greatest increase was for Merthyr Tydfil (from 42.1% in 2011 to 44.6% in 2021).

Merthyr Tydfil was also the Welsh local authority with the highest proportion of people describing their health as very bad (2.4%). However, this was also the area with the largest decrease of people reporting very bad health (0.7 percentage point decrease, from 3.1% in 2011). Denbighshire (1.6%) was the only Welsh local authority which saw an increase in the proportion of people reporting very bad health, up from 1.5% in 2011.

The local authorities with the next highest proportions of people describing their health as very bad were Blaenau Gwent (2.3%) and Neath Port Talbot (2.1%). The lowest proportion of people reporting very bad health was for Gwynedd (1.0%).

Some of the local authorities in Wales with larger proportions of people reporting very bad health are also areas in which larger proportions of people provided unpaid care. For more information, please see our Unpaid care, England and Wales: 2021 statistical bulletin.

Figure 3: Age-standardised general health, 2011 and 2021, Wales

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Figure 4: How general health (age-standardised) varied across local authorities in England and Wales, 2021

Source: Office for National Statistics – Census 2021

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More detailed data and analysis on health, disability and unpaid care will be published in the coming months, alongside the release of multivariate data. Read more about our health, disability and unpaid care analysis plans and the release plans for Census 2021 more generally.

General health

A person's assessment of the general state of their health from very good to very bad. This assessment is not based on a person's health over any specified period of time.

Usual resident 

For Census 2021, a usual resident of the UK is anyone who, on Census Day, was in the UK and had stayed or intended to stay in the UK for a period of 12 months or more, or had a permanent UK address and was outside the UK and intended to be outside the UK for less than 12 months.

Age-standardised proportions

Age-standardised proportions (ASPs) allow for fairer comparison between populations over time and across geographies, as they account for differences in the population size and age structure. The 2013 European Standard Population is used to standardise proportions.

Reference date 

The census provides estimates of the characteristics of all people and households in England and Wales on Census Day, 21 March 2021. It is carried out every 10 years and gives us the most accurate estimate of all the people and households in England and Wales. 

We are responsible for carrying out the census in England and Wales but will also release outputs for the UK in partnership with the Welsh Government, the National Records of Scotland (NRS) and the Northern Ireland Statistics and Research Agency (NISRA). The census in Northern Ireland was also conducted on 21 March 2021, whereas Scotland's census was moved to 20 March 2022. All UK census offices are working closely together to understand how this difference in reference dates will affect UK-wide population and housing statistics, in terms of both timing and scope. 

Response rate 

The person response rate is the number of usual residents for whom individual details were provided on a returned questionnaire, divided by the estimated usual resident population.

The person response rate for Census 2021 was 97% of the usual resident population of England and Wales, and over 88% in all local authorities. Most returns (89%) were received online. The response rate exceeded our target of 94% overall and 80% in all local authorities. 

Read more about question-specific response rates at local authority level in Section 4 of our Measures showing the quality of Census 2021 estimates methodology.

Quality considerations, along with the strengths and limitations of Census 2021 more generally, can be found in our Quality and Methodology Information (QMI) for Census 2021 report. Read more about the Health, disability and unpaid care quality information for Census 2021.

Further information on our quality assurance processes is provided in our Maximising the quality of Census 2021 population estimates report.