Health statistics quarterly最新文献

{"title":"Trends in socio-economic inequalities in female mortality, 2001-08. Intercensal estimates for England and Wales.","authors":"Brian Johnson,&nbsp;Alaa Al-Hamad","doi":"10.1057/hsq.2011.16","DOIUrl":"https://doi.org/10.1057/hsq.2011.16","url":null,"abstract":"<p><strong>Background: </strong>This article presents estimates of annual mortality rates for women of working age by the National Statistics Socio-economic Classification (NS-SEC) for the period 2001 to 2008. Until recently, it was possible to produce such mortality rates only at the time of the decennial census when populations are enumerated by occupation and NS-SEC. In 2010, ONS published annual intercensal male mortality rates using the Labour Force Survey (LFS) to provide population estimates by age and NS-SEC. This article produces the corresponding estimates for women aged 25 to 59.</p><p><strong>Methods: </strong>The LFS was used to estimate female populations by age and NS-SEC for each year between 2001 and 2008. Numbers of deaths were obtained from death registrations. For both deaths and populations, the combined method of NS-SEC classification was used, whereby the most advantaged of a married woman's and her husband's NS-SEC was used to assign the woman to an NS-SEC class. Single women were classified according to their own NS-SEC. Age-standardised mortality rates were derived for each NS-SEC class by year and a number of measures of inequality estimated for each year so that any trends could be identified.</p><p><strong>Results: </strong>While overall mortality rates for women declined over the period, this was not true for all NS-SEC classes. Managerial and professional occupations and Routine occupations experienced a statistically significant decline in mortality rate over the period. There was no clear trend for the other classes. Absolute measures of inequality showed no clear trend over the period, but relative inequalities tended to increase. Routine occupations had the greatest decline in mortality rate over the period of approximately five deaths per 100,000 per annum.</p><p><strong>Conclusions: </strong>Socio-economic inequalities in the mortality rates of women appeared to increase between 2001 and 2008. However, the results for women were not as clear as for men with four out of the seven analytic NS-SEC classes not having a statistically significant downward trend in mortality. The degree of annual volatility in the measures suggests that at the current low levels of mortality of working age women, the LFS could not be used to provide population denominators below the national level. Possibly, three-year moving averages would be better trend indicators, but this would reduce the timeliness of the data to some extent.</p>","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 52","pages":"3-32"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30304077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on the harmonisation of disability data collection in UK surveys (part 2).","authors":"Chris White","doi":"10.1057/hsq.2011.13","DOIUrl":"https://doi.org/10.1057/hsq.2011.13","url":null,"abstract":"<p><strong>Background: </strong>This article reports on the field testing work undertaken, leading to the proposals for a primary harmonised standard for disability data inputs: designed to derive statistical measures of disability from social surveys using a face-to-face mode of data capture. These proposals were submitted to the National Statistics Harmonisation Group (NSHG) for approval in December 2010. The proposed primary harmonised standard data inputs are designed to meet the data needs arising from the equality legislation introduced in 2010 and improve international comparability: by better meeting the definitions for measures of longstanding illness and disability derived from the European Union's Statistics on Income and Living Conditions (EU-SILC).</p><p><strong>Methods: </strong>Field testing was conducted during two discrete periods: between October 2009 and February 2010 for stage 1 testing, and between May and July 2010 for stage 2 testing. The Office for National Statistics (ONS) Opinions Survey acted as the data collection vehicle and the design was a split sample in each case. In stage 1, question suite variants were compared, together with the Family Resources Survey (FRS) Disability Discrimination Act module running on the Opinions Survey in equivalent months. The second stage also applied a split sample to compare the revised proposed harmonised questions with the question on disability planned for the 2011 Census. Derivations of disability to meet measures required under the national Equality Act legislation and the European Union-Statistics on Income and Living Conditions were applied to field-test estimates to assess coherence with contemporaneous external sources.</p><p><strong>Results: </strong>The field test results found good comparability with estimates of disability used in the FRS publications and with the field tested 2011 Census disability question.In stage 1 testing, the measure of disability derived from the version 1 suite was closer to the FRS measure of disability used in FRS publications than that derived from version 2's questions. In stage 2, the proximity of the measure derived from the proposed harmonised questions to the FRS measure of disability improved, with a 0.5 percentage point difference.The stage 2 measure of disability was found to be consistent with the EU-SILC measure of disability in 2009 for the UK published on the Eurostat website. Furthermore, the harmonised questions produced a similar estimate of disability to the 2011 Census question, also field tested concurrently with the proposed harmonised questions.</p><p><strong>Conclusion: </strong>The harmonised questions tested provide appropriate data inputs to measure persistent illness, impairment and disability, consistent with the components of disability used in the disablement process and the International Classification of Functioning Disability and Health. Their implementation across social survey data sources using a face-to-face m","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 51","pages":"31-66"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29976459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking maternity data for England, 2005-06: methods and data quality.","authors":"Nirupa Dattani, Preeti Datta-Nemdharry, Alison Macfarlane","doi":"10.1057/hsq.2011.3","DOIUrl":"10.1057/hsq.2011.3","url":null,"abstract":"<p><strong>Introduction: </strong>Maternity Hospital Episode Statistics (HES) data were linked to birth registration and NHS Numbers for Babies (NN4B) data to bring together some key demographic and clinical data items not otherwise available at a national level. This project added to earlier work involving linkage of birth registration records to NN4B records.</p><p><strong>Methods: </strong>Birth registration and NN4B records were linked to Maternity HES delivery records and also Maternity HES baby records using the NHS Number or other indirect identifiers if NHS Number was missing.Data quality and completeness of Maternity HES were assessed in relation to birth registration data wherever possible. For information not collected at registration, NN4B data were used to validate quality of Maternity HES.</p><p><strong>Results: </strong>Overall, 91 per cent of Maternity HES delivery records could be linked to the birth registration/NHS Numbers for Babies records and 84 per cent of Maternity HES baby records were linked.In 2005 only 3 per cent of Maternity HES records had mother's NHS number missing, compared with 30 per cent in the NN4B dataset. This did not reflect the extent to which Maternity HES data items were missing or discordant. Over a quarter of all linked Maternity HES records for singleton babies had one or more of the following data items missing: birthweight, gestational age, birth status, sex, and date of birth of the baby. On the other hand, for data items where information was stated such as birthweight, birth status, and sex for singleton babies, there was good agreement between Maternity HES and linked birth registration and NN4B data.Although NN4B records the ethnic category of the baby as defined by the mother, and Maternity HES records mother's ethnic category, 87 per cent of the linked records had the same ethnic group.</p><p><strong>Conclusion: </strong>Even though a good linkage rate was obtained, the method used will be simplified before data for 2007 are linked. To gain the maximum benefit from this linkage in future years, improvements are urgently needed in the quality and completeness of the data contained in Maternity HES.List of Tables, 55.</p>","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 49","pages":"53-79"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29715524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative verdicts and their impact on mortality statistics in England and Wales.","authors":"Chris Hill,&nbsp;Lois Cook","doi":"10.1057/hsq.2011.4","DOIUrl":"https://doi.org/10.1057/hsq.2011.4","url":null,"abstract":"<p><strong>Background: </strong>Annually, there are around 30,000 coroner's inquests held in England and Wales that conclude with a verdict. 'Short form' verdicts such as accident or misadventure; natural causes; suicide; and homicide make up the majority of all verdict conclusions. 'Narrative' verdicts can be used by a coroner or jury, instead of a short form verdict, to express their conclusions as to the cause of death following an inquest. Since 2001 narrative verdicts have been more widely used, with over 3,000 narrative verdicts returned in 2009. In some cases, it can be difficult to code the underlying cause of death from the information provided in the narrative. For some time, the Office for National Statistics (ONS) and other organisations have been concerned about the impact of narrative verdicts on the quality of the statistics on cause of death. Our research investigated the impact of narrative verdicts on trends for deaths attributed to injury and poisoning in England and Wales.</p><p><strong>Methods: </strong>The research considered narrative verdicts received by ONS between 2001 and 2009. All available information provided by the coroner from the narrative verdict, together with the underlying cause of death, was used in the analysis. All causes of death where a narrative verdict was returned were investigated. More in-depth analysis of accidental deaths was undertaken, as classification of these deaths by intent is more difficult when the information from the coroner is imprecise. A sensitivity analysis of suicide rates (intentional self-harm and event of undetermined intent) was carried out. This involved using two different scenarios of reclassifying selected proportions of accidental hanging and poisoning deaths, where a narrative verdict was returned, as intentional self-harm. An exercise to measure the consistency of coding cause of death from narrative verdicts was also undertaken.</p><p><strong>Results: </strong>The increasing proportion of narrative verdicts involving injury and poisoning has not significantly affected published mortality rates for suicide (intentional self-harm and injury or poisoning of undetermined intent). However, if the rise in narrative verdicts continues at the same rate, the accurate reporting of injury and poisoning deaths, including suicides, is likely to be affected. The exercise to establish the consistency of coding the cause of death by ONS cause coders showed that the current coding rules were being applied uniformly.</p><p><strong>Conclusions: </strong>The increase in the use of narrative verdicts by coroners has not had a statistically significant impact on published suicide rates in England and Wales and so no revision to these rates is needed. A review of current coding practices and the handling of narrative verdicts will be undertaken by ONS with particular reference to deaths from intentional self-harm. A recommendation has been made to coroners to consider ways of recording narrati","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 49","pages":"81-100"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29714716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social inequalities in alcohol-related adult mortality by National Statistics Socio-economic Classification, England and Wales, 2001-03.","authors":"Veronique Siegler,&nbsp;Alaa Al-Hamad,&nbsp;Brian Johnson,&nbsp;Claudia Wells,&nbsp;Nick Sheron","doi":"10.1057/hsq.2011.7","DOIUrl":"https://doi.org/10.1057/hsq.2011.7","url":null,"abstract":"<p><strong>Background: </strong>This article is the first analysis of the social inequalities in adult alcohol-related mortality in England and Wales at the start of the 21st century, using the National Statistics Socio-economic Classification (NS-SEC). It presents the socio-economic patterns of alcohol-related mortality by gender, age and region, for England and Wales as a whole, Wales and the regions of England.</p><p><strong>Methods: </strong>Death registrations provided the number of deaths for working age adults, using the National Statistics definition of alcohol-related mortality. Population estimates for England and Wales in 2001-03 were used to estimate alcohol-related mortality rates by sex, five-year age group, NS-SEC and region. Inequalities were measured using ratios of alcohol-related mortality rates between the least and most advantaged classes.</p><p><strong>Results: </strong>There were substantial socio-economic variations in adult alcohol-related mortality, with the inequalities being greater for women than for men. The mortality rate of men in the Routine class was 3.5 times those of men in Higher and Managerial occupations, while for women the corresponding figure was 5.7 times. Greater socio-economic inequalities in mortality were observed for men aged 25-49 than for men aged 50-64; however the highest mortality rate of men occurred for Routine workers aged 50-54. Women in the Routine class experienced mortality rates markedly higher than other classes. The highest mortality rate of women also occurred for Routine workers, but at a younger age than for men (45-49). Within England, the North-West showed the largest inequalities, with particularly high rates in the Routine class for both sexes. In general, there was no association between levels of mortality and socio-economic gradients in mortality across the English regions and Wales.</p><p><strong>Conclusions: </strong>Rates of alcohol-related mortality in England and Wales increased significantly for people between the early 1990s and early 21st century, and were substantially greater for those in more disadvantaged socio-economic classes. There is also evidence that these socio-economic differences were greater at younger ages, especially for men at ages 25-49.</p>","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 50","pages":"4-39"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29917506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of the socio-demographic characteristics of sole registered births and infant deaths.","authors":"Julie Messer","doi":"10.1057/hsq.2011.9","DOIUrl":"https://doi.org/10.1057/hsq.2011.9","url":null,"abstract":"<p><strong>Background: </strong>Differences in birth characteristics and infant mortality rates by marital status and birth registration type reflect complex underlying factors. In particular, births registered solely by the mother are seen as a disadvantaged group. This article analyses the socio-demographic characteristics of births by registration type and parents' marital status and explores these differences for health outcomes.</p><p><strong>Methods: </strong>Birth notifications data from the NHS Numbers for Babies system was linked to birth registration data held by the Office for National Statistics (ONS) for births occurring in 2007 and 2008 in England and Wales. This dataset was further linked to death registration data to identify infants who died before their first birthday.Regression analysis was used to compare factors and health outcomes across marital and registration status groups. Regression models were calculated to determine the main risk factors for poor outcomes.</p><p><strong>Results: </strong>The registration groups differed in the age of the mother at birth, the proportion of young mothers, ethnic group distribution and measures of deprived circumstances. The joint registered-different address and sole registered groups were similar in the proportion of young mothers and the deprivation indices. The groups also differed in the proportion of low birthweight and premature babies. The joint registered-different address and sole registered groups both had higher percentages of 'small for gestational age' babies compared with the within-marriage and joint registered-same address groups. The stillbirth rate was highest in the sole registered group. Both the joint registered-different address and sole registered groups had higher infant mortality rates compared with the within-marriage and joint registered-same address groups. Multivariate analysis indicated that low birthweight was a key factor in infant mortality.</p><p><strong>Conclusions: </strong>Births registered solely by the mother were found to be a disadvantaged group but were also similar to the joint-registered group living at different addresses in their main socio-demographic characteristics and health outcomes. The joint-registered group living at the same address was similar to the within-marriage group across the same measures. This argues that, in the 21st century, the distinction between infants with 'resident' and 'nonresident' fathers is more meaningful for health outcomes than that between births inside and outside marriage.</p>","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 50","pages":"79-107"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29917962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability-free life expectancy: comparison of sources and small area estimates in England, 2006-08.","authors":"Michael P Smith,&nbsp;Olugbenga Olatunde,&nbsp;Chris White","doi":"10.1057/hsq.2011.8","DOIUrl":"https://doi.org/10.1057/hsq.2011.8","url":null,"abstract":"<p><strong>Background: </strong>Health expectancies (HEs) at sub-national geographies or by clusters of areas defined by relative deprivation are important tools to monitor inequalities in health. Previously, analyses have had limited usefulness due to a lack of timeliness or local relevance caused by limitations on the frequency or coverage of survey data. Here we explore the potential of the Annual Population Survey (APS) to provide robust estimates of disability-free life expectancy (DFLE) for men and women by clusters of area deprivation, English regions and local authority districts (LAs) in the period 2006-08.</p><p><strong>Methods: </strong>DFLE estimates for the UK were compared using the prevalence of limiting long-standing illness (LLSI) calculated using data from the APS and from the General Lifestyle Survey (GLF) covering Great Britain and equivalent data from the Continuous Household Survey (CHS) covering Northern Ireland, aggregated over the period 2006-08. The further use of APS data for England enabled the calculation of estimates of DFLE at age 16 and at age 65 for men and women by area deprivation quintiles (each quintile comprises a fifth of areas ranked according to their relative deprivation), English regions and LAs in order to measure inequality in DFLE between these population groupings.</p><p><strong>Results: </strong>The prevalence of LLSI and estimates of DFLE at national level were broadly comparable using APS and GLF/CHS data. Substantial inequality in DFLE was present between clusters of areas defined by relative deprivation and between English regions and LAs. The scale of inequality increased markedly with each finer geographical scale analysed.</p><p><strong>Conclusion: </strong>The APS is a viable data source to provide LLSI data for use in DFLE estimation across a range of areas and clusters of area deprivation. While increasingly fine-grained analysis decreases statistical precision, it is possible to detect clear differences between areas within regions and in making comparisons with the England average. The estimates presented here provide scope to set benchmarks for assessing the impact of interventions designed to reduce inequality in DFLE beyond the period 2006-08.</p>","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 50","pages":"40-78"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29917507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on the harmonisation of disability data collection in UK surveys (part 1).","authors":"Chris White","doi":"10.1057/hsq.2011.12","DOIUrl":"https://doi.org/10.1057/hsq.2011.12","url":null,"abstract":"<p><strong>Background: </strong>This article reports progress to date in the development of new National Statistics harmonised questions: measuring disability in established national social survey sources using a face-to-face interviewing mode of data capture. The harmonisation of these questions across these survey sources will enhance the availability of consistent disability statistics to government and the wider user community.This work began in response to the recommendation of the Review of Equality Data published in 2007: to develop and apply a principled approach to data collection to meet future data needs, following the introduction of equality legislation in 2010. It also contributes to improving international comparability, by better meeting the definitions for measures of long-standing illness and disability derived from the European Union's Statistics on Income and Living Conditions (EU-SILC).Further work is currently being undertaken to adapt questions for use in surveys applying different methods of data capture, such as paper-based and on-line surveys.The project also developed questions which measure disability as a restriction in participation in key areas of life such as employment, and the self-perceived social barriers affecting participation (that is aspects of society and the physical environment, which do not take adequate account of the needs of people with impairments). However, at the time of writing, a finalised standard had not been agreed: these data inputs will be reported on in a future Health Statistics Quarterly article.</p><p><strong>Methods: </strong>The National Statistics Harmonisation Group (NSHG) and its Health, Disability and Carers Sub-Group contain representation across government, related public sector bodies and academia. These groups agreed the following project objectives for disability data harmonisation:a) Establish a conceptual framework for disability definitionb) Develop question inputs to measure the definition for use in social surveys using a face-to-face interviewing method of data capturec) Test the performance of these questions for interpretability and consistency with established sources, and refine questions, where indicated, through the findings of testing and consultationd) Recommend harmonised standards for implementation across sourcesA process of question suite development included: user consultation, which gathered cross-sector views to clarify and prioritise data needs; cognitive testing, which guided question formats, content and terminology, and interviewer probes and instructions. The findings of these exercises were used in the construction of questions which were subsequently field tested for coherence with other data sources and described in an accompanying article in this issue of Health Statistics Quarterly.</p><p><strong>Results: </strong>The definition of disability developed to harmonise standard data inputs and outputs is founded on the Disablement Process (Verbrugge","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 51","pages":"3-30"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29976458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In brief","authors":"","doi":"10.1057/hsq.2011.15","DOIUrl":"https://doi.org/10.1057/hsq.2011.15","url":null,"abstract":"","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":"52 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58666509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of lengthening life expectancy on future pension and long-term care expenditure in England, 2007 to 2032.","authors":"Juliette Malley,&nbsp;Ruth Hancock,&nbsp;Mike Murphy,&nbsp;John Adams,&nbsp;Raphael Wittenberg,&nbsp;Adelina Comas-Herrera,&nbsp;Chris Curry,&nbsp;Derek King,&nbsp;Sean James,&nbsp;Marcello Morciano,&nbsp;Linda Pickard","doi":"10.1057/hsq.2011.17","DOIUrl":"https://doi.org/10.1057/hsq.2011.17","url":null,"abstract":"<p><strong>Background: </strong>The aim of this analysis is to examine the effect of different assumptions about future trends in life expectancy (LE) on the sustainability of the pensions and long-term care (LTC) systems. The context is the continuing debate in England about the reform of state pensions and the reform of the system for financing care and support.</p><p><strong>Methods: </strong>Macro and micro simulation models are used to make projections of future public expenditure on LTC services for older people and on state pensions and related benefits, making alternative assumptions on increases in future LE. The projections cover the period 2007 to 2032 and relate to England.</p><p><strong>Results: </strong>Results are presented for a base case and for specified variants to the base case. The base case assumes that the number of older people by age and gender rises in line with the Office for National Statistics' principal 2006-based population projection for England. It also assumes no change in disability rates, no changes in patterns of care, no changes in policy and rises in unit care costs and real average earnings by 2 per cent per year. Under these assumptions public expenditure on pensions and related benefits is projected to rise from 4.7 per cent of Gross Domestic Product (GDP) in 2007 to 6.2 per cent of GDP in 2032 and public expenditure on LTC from 0.9 per cent of GDP in 2007 to 1.6 per cent of GDP in 2032. Under a very high LE variant to the GAD principal projection, however, public expenditure on pensions and related benefits is projected to reach 6.8 per cent of GDP in 2032 and public expenditure on LTC 1.7 per cent of GDP in 2032.</p><p><strong>Conclusions: </strong>Policymakers developing reform proposals need to recognise that, since future LE is inevitably uncertain and since variant assumptions about future LE significantly affect expenditure projections, there is a degree of uncertainty about the likely impact of demographic pressures on future public expenditure on pensions and LTC.</p>","PeriodicalId":87183,"journal":{"name":"Health statistics quarterly","volume":" 52","pages":"33-61"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1057/hsq.2011.17","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30304078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}