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

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...

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Main Authors: Gerry McCartney, Rosie Seaman, Srinivasa Vittal Katikireddi, Colin Angus, Petra Meier, Alan Brennan, Andreas Höhn, Denise Brown, Ceri Hughes, Corinna Elsenbroich, Nik Lomax, Hugh Rice, Anne Cunningham, Aki Tsuchia
Format: Article
Language:English
Published: BMJ Publishing Group 2024-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/3/e076704.full
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author Gerry McCartney
Rosie Seaman
Srinivasa Vittal Katikireddi
Colin Angus
Petra Meier
Alan Brennan
Andreas Höhn
Denise Brown
Ceri Hughes
Corinna Elsenbroich
Nik Lomax
Hugh Rice
Anne Cunningham
Aki Tsuchia
author_facet Gerry McCartney
Rosie Seaman
Srinivasa Vittal Katikireddi
Colin Angus
Petra Meier
Alan Brennan
Andreas Höhn
Denise Brown
Ceri Hughes
Corinna Elsenbroich
Nik Lomax
Hugh Rice
Anne Cunningham
Aki Tsuchia
author_sort Gerry McCartney
collection DOAJ
description 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.
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spelling doaj-art-3fe6035d53804fb5bb8c94e5e2dd464b2025-08-20T02:13:53ZengBMJ Publishing GroupBMJ Open2044-60552024-03-0114310.1136/bmjopen-2023-076704Estimating quality-adjusted life expectancy (QALE) for local authorities in Great Britain and its association with indicators of the inclusive economy: a cross-sectional studyGerry McCartney0Rosie Seaman1Srinivasa Vittal Katikireddi2Colin Angus3Petra Meier4Alan Brennan5Andreas Höhn6Denise Brown7Ceri Hughes8Corinna Elsenbroich9Nik Lomax10Hugh Rice11Anne Cunningham12Aki Tsuchia13School of Social and Political Sciences, University of Glasgow, Glasgow, UKMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UKSchool of Medicine and Population Health, The University of Sheffield, Sheffield, UKMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKSchool of Medicine and Population Health, University of Sheffield, Sheffield, UKMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKManchester Institute of Education, The University of Manchester, Manchester, UKMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKSchool of Geography, University of Leeds, Leeds, UKSchool of Geography, University of Leeds, Leeds, UKSchool of Medicine and Population Health, University of Sheffield, Sheffield, UKSchool of Medicine and Population Health, University of Sheffield, Sheffield, UKObjectives 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.https://bmjopen.bmj.com/content/14/3/e076704.full
spellingShingle Gerry McCartney
Rosie Seaman
Srinivasa Vittal Katikireddi
Colin Angus
Petra Meier
Alan Brennan
Andreas Höhn
Denise Brown
Ceri Hughes
Corinna Elsenbroich
Nik Lomax
Hugh Rice
Anne Cunningham
Aki Tsuchia
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url https://bmjopen.bmj.com/content/14/3/e076704.full
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