Hoehn, A. et al. (2024) 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. BMJ Open, 14(3), e076704. (doi: 10.1136/bmjopen-2023-076704) (PMID:38431294) (PMCID:PMC10910677)
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Abstract
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 R2 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.
| Item Type: | Articles |
|---|---|
| Additional Information: | This work was supported by the UK Prevention Research Partnership (MR/S037578/2), which is funded by the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and Wellcome. In addition, this project received funding from the Medical Research Council (MC_UU_00022/5) as well as the Chief Scientist Office (SPHSU17 and SPHSU20). SVK acknowledges funding from the European Research Council (949582), and the Medical Research Council (MC_UU_00022/2). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal and Brown, Dr Denise and Elsenbroich, Dr Corinna and Hoehn, Dr Andreas and Meier, Professor Petra |
| Authors: | Hoehn, A., Lomax, N., Rice, H., Angus, C., Brennan, A., Brown, D., Cunningham, A., Elsenbroich, C., Hughes, C., Katikireddi, S. V., McCartney, G., Seaman, R., Tsuchiya, A., and Meier, P. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | BMJ Open |
| Publisher: | BMJ Publishing Group |
| ISSN: | 2044-6055 |
| ISSN (Online): | 2044-6055 |
| Published Online: | 01 March 2024 |
| Copyright Holders: | Copyright © Author(s) (or their employer(s)) 2024 |
| First Published: | First published in BMJ Open 14(3):e076704 |
| Publisher Policy: | Reproduced under a Creative Commons license |
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