J Epidemiol Community Health 66:874-880 doi:10.1136/jech-2011-200251
  • Functional status

Trends and inequalities in late-life health and functioning in England

  1. Carol Jagger3
  1. 1RAND Corporation, Arlington, Virginia, USA
  2. 2University of Michigan, Ann Arbor, Michigan, USA
  3. 3Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Linda G Martin, RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202, USA; lmartin{at}
  1. Contributors LGM led the statistical analysis and drafted the manuscript. RFS led the study design and assisted in the analysis and interpretation of the data and revision of the manuscript. PMA had overall responsibility for data acquisition and programming and assisted in the revision of the manuscript. CJ assisted in the interpretation of the data and revision of the manuscript.

  • Accepted 5 September 2011
  • Published Online First 6 December 2011


Background Recently, late-life disability rates have declined in several countries of the Organisation for Economic Co-operation, but no national-level trend analysis for England has been available. The authors provide such analysis, including measures both early and late in the disablement process, and the authors investigate the extent to which temporal trends are associated with population changes in socioeconomic position (SEP).

Methods The authors fit logistic models of trends in self-reports and nurse measures of 16 health indicators, based on cross-sectional data from those aged 65 years and older from the 1992 to 2007 Health Survey for England.

Results Overall, prevalence rates of limitations in seeing, hearing and usual activities declined (p<0.05); ever smoking, measured high blood pressure, high cholesterol, and high C reactive protein decreased (p<0.05); and the proportion with limitations in self-care activities remained stable. But obesity and limitations in walking 200 yards and climbing stairs increased (p<0.05). Increases over time in education and non-manual social class membership were associated with declines in smoking, C reactive protein and problems with usual activities. Had the changes in SEP not occurred, the increases in problems walking and climbing would have been greater. People with less education or of manual social classes experienced relatively worse trends for hearing, mobility functions and usual activities. The opposite was true for seeing.

Conclusions Recent trends in late-life health and functioning in England have been mixed. A better understanding of which specific activities pose challenges, how the environment in which activities are conducted influences functioning and the causes of relatively worse trends for some SEP groups is needed.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data from the Health Survey for England are publicly available.