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Indicator 24. Health
Life Expectancy ( LE) and Healthy Life Expectancy ( HLE) at birth (years)
Year | 1991-
1993 | 1992-
1994 | 1993-
1995 | 1994-
1996 | 1995-
1997 | 1996-
1998 | 1997-
1999 | 1998-
2000 | 1999-
2001 | 2000-
2002 | 2001-
2003 |
|---|
Males - LE | 71.5 | 71.7 | 71.9 | 72.1 | 72.2 | 72.4 | 72.6 | 72.8 | 73.1 | 73.3 | 73.5 |
|---|
Males - HLE | 65.3 | 65.0 | 64.6 | 65.0 | 65.3 | 65.5 | 65.3 | 65.3 | 64.9 | 65.3 | |
|---|
Females - LE | 77.1 | 77.3 | 77.4 | 77.7 | 77.9 | 78.0 | 78.2 | 78.4 | 78.5 | 78.8 | 78.8 |
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Females - HLE | 67.9 | 67.7 | 67.8 | 68.1 | 68.5 | 68.7 | 68.2 | 67.8 | 67.8 | 68.4 | |
|---|
Sources :
Life Expectancy - General Register Office for Scotland 1
Healthy Life Expectancy - Information and Statistics Division ( NHS) 2
Healthy Life Expectancy - based on General Household Survey up to 1998-2000 and Scottish Household Survey from 1999-2001
The relevance of the indicator
Sustainable development includes a healthy nation in which everyone can live a long life in good health or has access to help if that is not the case.
Choice of Indicator
Life Expectancy shows how long people are living, whereas Healthy Life Expectancy gives an indication of how many year of life, on average, are spent in good health.
Detailed definition and source details
Life Expectancy at birth for a particular time period is an estimate of the number of years a new born baby would survive if they were to experience the average age specific mortality rates of that time period throughout their entire life. Therefore, the figures reflect the mortality rates at the particular time period and not the number of years that a baby born in that time period could expect to live, since death rates are likely to change in the future. The figures have been compiled by the General Register for Scotland. Life expectancy figures are presented as 3 year rolling averages to smooth out variation in death rates between years.
Healthy Life Expectancy at birth is defined as the number of years people can, on average, expect to live in good health. The figures have been compiled by the Information and Statistics Division of the NHS and take account of life expectancy estimates as well as survey data from the General Household Survey and more recently from the Scottish Household Survey on self-assessed general health. Figures are also presented as 3 year rolling averages.
Trends
Since the early 1990s, life expectancy at birth has continued to increase steadily for both males and females. On average, there has been an annual increase of around 0.2 years of life for both males and females.
Throughout the 1990s, healthy life expectancy has fluctuated for both males and females with no improvement in trend. This means that although people are living longer they are not spending those additional years in good health.
Further disaggregation
Life expectancy estimates by NHS Boards in Scotland are available on the Office of National Statistics website 3. In 2001-2003, Orkney had the highest life expectancy for both males (75.9) and females (81.0), whilst Greater Glasgow had the lowest life expectancy for males (71.0) and females (77.5).
In 2000-2002, the highest healthy life expectancy for males (70.7) was in Orkney and for females (75.6) was in Shetland. The lowest healthy life expectancy for males (61.3) was in Greater Glasgow for females (65.1) was in Lanarkshire.
Further analysis of levels of inequalities in life expectancy in Scotland was included in the Scottish Executive Report on Inequalities in Health 4. In 2000-02, there was an inequality gap of 7.95 years in male life expectancy between the most affluent areas (77.03) and the most deprived areas (69.08) in Scotland. For females, the inequality gap in life expectancy was 4.52 years between the most affluent areas (80.86) and the most deprived areas (76.34). These areas were defined by the 20% most affluent and 20% most deprived postcode sector areas, using the Carstairs Deprivation Index.
The inequality gap in healthy life expectancy is even greater than for life expectancy. The NHS report (2) shows that in 2000, the inequality gap in healthy life expectancy for males was 17.4 years between the most affluent areas (73.3) and the most deprived areas (55.9). For females, the inequality gap in healthy life expectancy was 11.1 years between the most affluent areas (72.7) and the most deprived areas (61.6).
Target
The Health White Paper, Improving Health in Scotland - The Challenge 5 (2003) contains the following objectives for Health Improvement :
By 2010-12, improve life expectancy and healthy life expectancy for all men and women living in all areas of Scotland. Also reduce inequalities between the most affluent and most deprived groups.
By 2020-22, further improve life expectancy and healthy life expectancy of men and women living in all areas of Scotland. Also further reduce inequalities between the most affluent and most deprived groups.
Action
The policy framework for improving health and tackling health inequalities is set out in Towards a Healthier Scotland6 (1999) and Improving Health in Scotland: The Challenge (March 2003) 5 The aim is to improve health for all and to reduce the health gap between those living in the most and least affluent communities. Action is specified on three levels:-
addressing the many wider causes of ill health by addressing life circumstances;
influencing lifestyles to minimise the health related lifestyle behaviours that lead to preventable early death; and
focusing on priority health topics, concentrating on the major preventable diseases and on improving child, mental, oral and sexual health.
The Challenge urged integrated action focused around four themes which recognise the importance of healthy beginnings and set the foundations for healthy working years and beyond. The themes are: early years; the teenage transition; the workplace; and the community. There are also seven special focus programmes: smoking; alcohol; healthy eating; physical activity; sexual health; health and homelessness; and mental health and well-being.
Building a Better Scotland, Spending Proposals 2005 - 2008 specifically seeks to reduce health inequalities by increasing the rate of improvement across a range of indicators for the most deprived communities by 15% by 2008. Six indicators have been chosen to monitor progress: under 75 CHD mortality; under 75 cancer mortality; adults smoking; smoking during pregnancy; teenage pregnancy (aged 13 -15); suicides in young people (aged 10 - 24). In addition, setting our targets within the wider context of the Executive's Closing the Opportunity Gap ( CTOG) work, recognizes that a real impact on health inequalities can be made only through the inter-action of related activity streams (housing, education, etc.)
Community Planning Partnerships are the main vehicles for development of local health inequalities strategies which will set tackling health inequalities in the context of wider anti-poverty work and the CTOG agenda. We continue to work with COSLA to develop the local authority role in health improvement and consider joint outcomes. There is growing evidence demonstrating unequal access to and uptake of NHS services by different groups, particularly those in the lowest socio-economic groups. The NHS clearly has a key role to play in tackling such health inequalities. Primary care settings are likely to be key to NHS action on inequalities as set out in the recent Kerr Report 7 which recommended anticipatory care in deprived communities.
Footnotes1 www.gro-scotland.gov.uk/statistics/library/03reference-tables/03reference-table5.html
2 www.isdscotland.org/HLE
3 www.statistics.gov.uk/downloads/theme_population/LEResultsScotland15oct2004.xls
4 www.scotland.gov.uk/library5/health/hirnov03.pdf
5 www.scotland.gov.uk/library5/health/ihis-00.asp
6 www.scotland.gov.uk/library/documents-w7/tahs-00.htm
7 www.scotland.gov.uk/Publications/2005/05/23141307
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