Gap in life expectancy between classes narrows, but disparity in disea
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《英国医生杂志》
Men and women living in the poorest areas of England not only die younger than those living in more affluent districts, they also spend twice as many years in poor health, says a report in Health Statistics Quarterly, a publication of the Office for National Statistics.
The gap between life expectancy in rich and poor areas has narrowed slightly in recent years, concludes the author, Madhavi Bajekal, but the gap in disease-free life expectancy is far wider and showed no sign of movement between 1994 and 1999, when the data were collected.
Dr Bajekal抯 conclusions are based on the annual health survey for England, which each year asks about 20 000 people to rate their health on a five point scale from "very good" to "very bad." The respondents, who totalled 100 686 over the six year period, were stratified into tenths of deprivation according to the electoral ward in which they lived.
The resulting tables show a clear linear progression of worsening health and life expectancy in the lower tenths. But the health gap between England抯 richest and poorest areas is far larger for men than for women, the data suggest. The life expectancy of men living in the least deprived tenth of electoral wards was 77.4 years, whereas for those in the most deprived tenth it was 71.4 years, a six year difference.
Among women, the difference was only three years. Women抯 life expectancy was 81.2 years in the least deprived wards and 78.0 years in the most deprived wards. Women in the poorest areas therefore tend to narrowly outlive even men living in the richest areas.
But women抯 health advantage decreases when healthy or disability-free life expectancy is measured. On average, men in England spend 59.1 years in good health and 15.9 years in poor health, while women spend 61.4 years in good health and 18.6 years in poor health.
It is in the poorest areas that long years of ill health are most common. Men抯 healthy life expectancy was 66.2 years in the richest tenth but only 49.4 years in the poorest tenth.
There was no trend over the study period to suggest that these figures are improving or that the gulf between rich and poor in healthy life expectancy is narrowing. The wealth gap is narrowing, however, in terms of crude life expectancy at age 15. The difference between richest and poorest areas was 4.4 years in 1994, and 4.0 years in 1999.
Professor Mike Kelly, director of evidence and guidance for the Health Development Agency, a public body charged with reducing health inequalities, said the report "focuses much needed attention on the stark impact of health inequalities."
He continued: "Smoking accounts for at least half of the health inequalities between the poorest and the wealthiest in England. We need to have an environment which ensures that every person in this country, irrespective of social circumstance, has the opportunity to make healthy lifestyle choices. Last year抯 Wanless report highlighted prevention as the answer to turning the tide of ill health swamping the country."(London Owen Dyer)
The gap between life expectancy in rich and poor areas has narrowed slightly in recent years, concludes the author, Madhavi Bajekal, but the gap in disease-free life expectancy is far wider and showed no sign of movement between 1994 and 1999, when the data were collected.
Dr Bajekal抯 conclusions are based on the annual health survey for England, which each year asks about 20 000 people to rate their health on a five point scale from "very good" to "very bad." The respondents, who totalled 100 686 over the six year period, were stratified into tenths of deprivation according to the electoral ward in which they lived.
The resulting tables show a clear linear progression of worsening health and life expectancy in the lower tenths. But the health gap between England抯 richest and poorest areas is far larger for men than for women, the data suggest. The life expectancy of men living in the least deprived tenth of electoral wards was 77.4 years, whereas for those in the most deprived tenth it was 71.4 years, a six year difference.
Among women, the difference was only three years. Women抯 life expectancy was 81.2 years in the least deprived wards and 78.0 years in the most deprived wards. Women in the poorest areas therefore tend to narrowly outlive even men living in the richest areas.
But women抯 health advantage decreases when healthy or disability-free life expectancy is measured. On average, men in England spend 59.1 years in good health and 15.9 years in poor health, while women spend 61.4 years in good health and 18.6 years in poor health.
It is in the poorest areas that long years of ill health are most common. Men抯 healthy life expectancy was 66.2 years in the richest tenth but only 49.4 years in the poorest tenth.
There was no trend over the study period to suggest that these figures are improving or that the gulf between rich and poor in healthy life expectancy is narrowing. The wealth gap is narrowing, however, in terms of crude life expectancy at age 15. The difference between richest and poorest areas was 4.4 years in 1994, and 4.0 years in 1999.
Professor Mike Kelly, director of evidence and guidance for the Health Development Agency, a public body charged with reducing health inequalities, said the report "focuses much needed attention on the stark impact of health inequalities."
He continued: "Smoking accounts for at least half of the health inequalities between the poorest and the wealthiest in England. We need to have an environment which ensures that every person in this country, irrespective of social circumstance, has the opportunity to make healthy lifestyle choices. Last year抯 Wanless report highlighted prevention as the answer to turning the tide of ill health swamping the country."(London Owen Dyer)