Life expectancy and risk of death in 6,791 communities in England from 2002 to 2019
Date: October 2021
Research using secure data found that an increasing number of communities in England experienced a decline in life expectancy in the decade before the Covid-19 pandemic. In 2019, there was a 20.6-year gap between the geographical areas with the highest and lowest life expectancies for women. For male life expectancies, this gap between areas was 27 years. The findings from this research reiterate the need for greater investment in public health and national healthcare. This research is fundamental to the work at the Small Area Health Statistics Unit, which estimates levels and trends of health outcomes in the UK.
This research used a statistical model to estimate trends from 2002 to 2019 in life expectancies at different ages for all 6,791 middle-layer super output areas (a geographic area) in England. This is one of the highest-resolution life expectancy studies ever performed. It is also the first time that life expectancy estimates have been produced for single years at the geographic area level in England.
Researchers extracted de-identified data for all deaths in England from 2002 to 2019 - a total of 8,646,878 records. They performed a high-resolution spatiotemporal analysis (used to investigate space-time variation) of this data, accounting for differences in age, sex, and geographic area.
Geographic area of residence was determined using the postcode of a residence at death registration. Researchers used geographic area boundaries from the 2011 Census, which divide England into 6,791 geographic areas. The model also used population counts by age, sex, and geographic area, which were supplied by the ONS.
To analyse how estimated life expectancy was associated with socioeconomic status, researchers used data from 2004 (data for 2002 was unavailable) and 2019. This data related to poverty (income deprivation), unemployment (employment deprivation), and low formal education (formal education, skills, and training deprivation) - the English Indices of Deprivation.
Researchers used a Bayesian hierarchical model - a model often used to borrow strength (improving the accuracy of estimates) between similar population subgroups - to obtain estimates of death rates by sharing information across age groups, geographic area, and years. As mortality and trends differ by sex, all analyses were separated into female and male. Life table methods were used to calculate life expectancy at birth and the probability of dying at specific ages by sex and geographic area.
In 2019, there was a 20.6-year gap for women between the geographic area with the highest life expectancy (an area in Camden, London; 95.4 years) and the geographic area with the lowest life expectancy (an area in Leeds; 74.7 years). The gap was 27 years for men, between an area in Kensington and Chelsea, London (95.3 years) and an area in Blackpool (68.3 years).
Between 2010-14, female life expectancy decreased in 351 (5.2%) of the 6,791 geographic areas. By 2014-19, the number of geographic areas with declining life expectancy was 1,270 (18.7%) for women and 784 (11.5%) for men.
All but a few (0-1%) geographic areas had a life expectancy increase for both sexes in 2002-06 and 2006-10. The life expectancy increase from 2002 to 2019 was smaller in geographic areas where life expectancy had been lower in 2002 (mostly northern urban geographic areas), and larger in geographic areas where life expectancy had been higher in 2002 (mostly geographic areas in and around London).
Researchers found that there was substantial variation in life expectancies across geographic areas at any level of poverty or unemployment. From 2002 to 2019, there were smaller average gains in life expectancies in the geographic areas with the highest levels of unemployment, poverty, and low formal education than in those with the lowest levels - especially for women.
Similar to life expectancy, there were large inequalities in the probability of surviving from birth to 80 years. These ranged from 42% to 87% in women, and 27% to 85% in men across geographic areas in 2019. These large survival inequalities were present at every stage, including childhood and early adolescence (0-15 years), young adulthood (15-30 years), working ages (30-70 years), and older ages (70-80 years).
This research demonstrates that a substantial proportion of areas in England were declining during the five years before the Covid-19 pandemic. Moreover, the areas declining were often the areas starting with the lowest life expectancies, thus increasing inequalities between areas. These inequalities have only been exacerbated by the Covid-19 pandemic. The findings from this research reiterate the need for greater investment in public health and healthcare throughout the entire country.
Publications and reports
- The Lancet article, October 2021: Life expectancy and risk of death in 6791 communities in England from 2002 to 2019: high-resolution spatiotemporal analysis of civil registration data
Blogs, news posts, and videos
- Imperial College London press release, October 2021: Life expectancy declining in many English communities even before pandemic
- BBC News article, October 2021: Life expectancy falling in parts of England before pandemic - study
- The Telegraph news article, October 2021: Decades-long drop in life expectancy leaves the North more exposed to Covid
- Sky News article, October 2021: Life expectancy declines in England before COVID hit with big North-South divide, new data shows
- Daily Mail news article, October 2021: Life expectancy was falling in up to fifth of English communities even BEFORE the Covid pandemic struck, study claims
- Evening Standard news article, October 2021: Life expectancy falling in England even before pandemic, research shows
- Independent news article, October 2021: ‘Alarming’ decline in life expectancy in northern England
- Metro news article, October 2021: Life expectancy varies by nearly 30 years depending on where you live in England
- The Guardian news article, October 2021: Austerity in England linked to more than 50,000 extra deaths in five years
- The Guardian opinion article, October 2021: Tory austerity caused misery – and now they want to make it worse
- Politics news article, October 2021: Life expectancy declined in parts of the North over past decade
- Financial Times news article, March 2023: Why are Americans dying so young?
Presentations and awards
- 6th Human Mortality Database Symposium, INED, 2022: The changing mortality patterns in 6791 communities in England
- European Public Health Conference, 2021: High-resolution spatiotemporal analysis in 6791 English areas reveals declines in life expectancy
About the ONS Secure Research Service
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