Relationship between poverty and healthy life expectancy by neighbourhood

This chart shows the relationship between male healthy life expectancy and the percentage of households living in relative poverty in 2013/14 in neighbourhoods (a small local area of around 8,000 people) in England. A household is considered to be living in poverty if the household’s income is below 60% of the UK median income, after adjusting for household size, composition and housing costs.

Poverty can affect health when financial resources are insufficient to meet basic living needs, such as adequate heating for the home, appropriate clothing or adequate nutrition.

The chart shows a strong negative relationship between healthy life expectancy and poverty.

• The percentage of households living in poverty ranges from 6.7% (a Bromley neighbourhood) to 63.7% (a Leicester neighbourhood). Male healthy life expectancy ranges from 46.3 years (a Salford neighbourhood) to 80.2 years (a Kensington and Chelsea neighbourhood).
• A total of 17 of the 50 neighbourhoods with the highest percentage of households living in poverty are in Birmingham, which is more than any other local authority. 
• Just over a quarter (26) of the 100 neighbourhoods with the highest percentage of households living in poverty are in the West Midlands, which is more than any other region. Conversely, just over a quarter (26) of the 100 neighbourhoods with the lowest percentage of households living in poverty are in the South East region, which is more than any other region. 
• Half of the top 50 neighbourhoods with an average healthy life expectancy above what would be expected, given the prevalence of household poverty, are in London. This pattern could be due to high levels of income inequality within neighbourhoods, where those on higher incomes may have better health and pull up the average healthy life expectancy. The ‘healthy migrant’ effect may also increase average healthy life expectancy as migrants are considered to have a better than average health status.
• Many neighbourhoods with an average healthy life expectancy below what would be expected, given the prevalence of household poverty, are in the North West (46% of the top 50) and Yorkshire and The Humber (34% of the top 50) regions.
• The relationship between the prevalence of household poverty and healthy life expectancy at neighbourhood level appears to flatten at higher rates of household poverty. This indicates that in areas with higher levels of poverty, healthy life expectancy might be maintained by other social or environmental factors, such as community cohesion, charitable assistance or green space, or that there is a floor to living standards.

A similar relationship is seen for female healthy life expectancy and average annual income.

Living with poorer health is more likely for those living in poverty. Neighbourhoods in the West Midlands and Yorkshire and The Humber regions have some of the highest rates of household poverty in the country. Efforts to decrease the prevalence of household poverty should focus on these regions.

• Household poverty is defined as a household with a combined income below 60% of the UK median income.
• Income is adjusted for household size and composition to reflect economies of scale. For example, a household of four needs more income for the same standard of living as a household of one, but not four times as much.
• Housing costs are deducted from income, to reflect that people with lower incomes have less choice about their cost of housing, relative to their income. 
• Healthy life expectancy is defined as the number of years an individual is expected to live in good health, based here on period life expectancy and a self-rated measure of good health. Period life expectancy is calculated using current mortality rates.
• There are 7,201 middle layer super output areas (MSOAs) in England and Wales, each containing around 8,000 people.

Source: Office for National Statistics, Health State Life Expectancies for MSOAs, England: 2009-13 , Office for National Statistics, Households in Poverty estimates for middle layer super output areas, England and Wales: 2013/14