Estimating quality-adjusted life expectancy (QALE) for local authorities in Great Britain and its association with indicators of the inclusive economy: a cross-sectional study.
Andreas Höhn, Nik Lomax, Hugh Rice, Colin Angus, Alan Brennan, Denise Brown, Anne Cunningham, Corinna Elsenbroich, Ceri Hughes, Srinivasa Vittal Katikireddi, Gerry McCartney, Rosie Seaman, Aki Tsuchia, Petra Meier
Author Information
Andreas Höhn: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK andreas.hoehn@glasgow.ac.uk. ORCID
Nik Lomax: School of Geography, University of Leeds, Leeds, UK. ORCID
Hugh Rice: School of Geography, University of Leeds, Leeds, UK. ORCID
Colin Angus: School of Medicine and Population Health, University of Sheffield, Sheffield, UK. ORCID
Alan Brennan: School of Medicine and Population Health, University of Sheffield, Sheffield, UK. ORCID
Denise Brown: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. ORCID
Anne Cunningham: School of Medicine and Population Health, University of Sheffield, Sheffield, UK. ORCID
Corinna Elsenbroich: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. ORCID
Ceri Hughes: Manchester Institute of Education, The University of Manchester, Manchester, UK. ORCID
Srinivasa Vittal Katikireddi: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. ORCID
Gerry McCartney: School of Social and Political Sciences, University of Glasgow, Glasgow, UK. ORCID
Rosie Seaman: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. ORCID
Aki Tsuchia: School of Medicine and Population Health, University of Sheffield, Sheffield, UK. ORCID
Petra Meier: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK. ORCID
OBJECTIVES: Quantifying area-level inequalities in population health can help to inform policy responses. We describe an approach for estimating quality-adjusted life expectancy (QALE), a comprehensive health expectancy measure, for local authorities (LAs) in Great Britain (GB). To identify potential factors accounting for LA-level QALE inequalities, we examined the association between inclusive economy indicators and QALE. SETTING: 361/363 LAs in GB (lower tier/district level) within the period 2018-2020. DATA AND METHODS: We estimated life tables for LAs using official statistics and utility scores from an area-level linkage of the Understanding Society survey. Using the Sullivan method, we estimated QALE at birth in years with corresponding 80% CIs. To examine the association between inclusive economy indicators and QALE, we used an open access data set operationalising the inclusive economy, created by the System Science in Public Health and Health Economics Research consortium. RESULTS: Population-weighted QALE estimates across LAs in GB were lowest in Scotland (females/males: 65.1 years/64.9 years) and Wales (65.0 years/65.2 years), while they were highest in England (67.5 years/67.6 years). The range across LAs for females was from 56.3 years (80% CI 45.6 to 67.1) in Mansfield to 77.7 years (80% CI 65.11 to 90.2) in Runnymede. QALE for males ranged from 57.5 years (80% CI 40.2 to 74.7) in Merthyr Tydfil to 77.2 years (80% CI 65.4 to 89.1) in Runnymede. Indicators of the inclusive economy accounted for more than half of the variation in QALE at the LA level (adjusted R females/males: 50%/57%). Although more inclusivity was generally associated with higher levels of QALE at the LA level, this association was not consistent across all 13 inclusive economy indicators. CONCLUSIONS: QALE can be estimated for LAs in GB, enabling further research into area-level health inequalities. The associations we identified between inclusive economy indicators and QALE highlight potential policy priorities for improving population health and reducing health inequalities.
