Healthy life expectancy trends in the UK: a watershed moment

A healthy population is a nation’s most precious asset. Good health helps people to live fulfilling lives, fuels the economy by providing a productive labour force and supports people to contribute to their communities.

Healthy life expectancy at birth is a key measure of the population’s health. It is defined as ‘the average number of years a person born during a given period would expect to live in good health based on current mortality rates and the prevalence of self-reported good health’. By including both length and quality of life, healthy life expectancy provides a more comprehensive picture of the nation’s health than life expectancy alone.

Recently published data indicate the UK’s healthy life expectancy has declined in recent years. Our analysis examines how healthy life expectancy in the UK has changed over the past decade, how it varies across local areas and how these trends compare with other high-income countries.

Healthy life expectancy in the UK fell by over 2 years between 2012–14 and 2022–24, from 62.9 to 60.7 years for males and from 63.7 to 60.9 years for females. This decline reflects a reduction in the proportion of life spent in good health, from 79% to 77% for males and from 77% to 73% for females. England, Scotland and Wales experienced steep falls of over 2 years, while the decrease in Northern Ireland was more modest (Figure 1).

Compared with 20 high-income countries, the UK performs poorly on healthy life expectancy. Between 2011 and 2021, healthy life expectancy increased or remained stable in 16 countries; the UK experienced a decline alongside only the Netherlands, Canada, Germany and the United States, with the second largest reduction among these nations. As a result, the UK fell from 14th to 20th out of 21 countries and now only ranks above the United States.

On average, healthy life expectancy increased by 0.4 years across the 20 comparable countries. Had the UK followed similar trends, healthy life expectancy would have improved rather than declined. This suggests that the UK’s deterioration is not inevitable, but reflects country-specific factors. 

Healthy life expectancy in the UK has fallen markedly over the past decade, diverging from trends seen in most comparable high-income countries. Female healthy life expectancy fell more rapidly than for males, raising concerns about the worsening trend of women’s health. This decline is widespread, affecting the vast majority of local areas and all nations of the UK, though less pronounced in Northern Ireland. In most places, people on average can now expect to spend a period of their lives in ill health before reaching state pension age, with a substantial minority likely to experience more than a decade of poor health prior to retirement. Not only does this carry a substantial human cost, but a growing economic and fiscal impact: reducing workforce participation, increasing reliance on social security and limiting people’s ability to save for later in life.

This aligns with other evidence that highlights a decline in working-age health, including worsening mortality rates among 25–49 year olds compared with other countries, record numbers of people out of the workforce due to poor health and a rise in the number of 16–24 year olds not in education, employment or training due to work-limiting conditions. 

While healthy life expectancy has declined, life expectancy has remained broadly stable for the UK overall, indicating that the deterioration is not primarily driven by changes in mortality. However, in more deprived areas, life expectancy remains below pre-pandemic levels, suggesting mortality plays a greater role in reducing healthy life expectancy in these areas. Worsening self-reported health remains a key factor throughout the UK, highlighted by a falling proportion of life spent in good health and by wider evidence of declining health among the working-age population. 

Although the COVID-19 pandemic contributed to recent trends, it does not explain them. At the national level, life expectancy has remained broadly stable over the longer term, aside from a temporary dip during the pandemic. In some parts of the UK, declines in healthy life expectancy predate COVID-19. In Scotland, healthy life expectancy has been falling since 2015–17.

Inequalities in healthy life expectancy remain stark and increased over the period. On average, people living in more deprived areas can expect to spend substantially less time in good health and to enter ill health many years earlier than those in more affluent areas. This gap reflects not only differences in the burden of disease, but also the broader social, economic and environmental factors that affect health. 

International comparisons further strengthen this conclusion. While most peer countries have seen stable or improving healthy life expectancy, the UK has experienced a decline and fallen down the rankings. This suggests the UK’s trajectory is not inevitable, but the result of policy choices and underlying conditions that have left the population, particularly among working-age adults, more vulnerable to ill health.

The message from our analysis is unequivocal – the UK’s health is declining and falling behind most other comparable nations. Turning the rising tide of ill health requires a new approach that looks beyond the NHS to focus on the drivers of poor health. Successive governments – including Labour and its much vaunted but largely abandoned ‘health mission’ – have understood the importance of targeting improvements in healthy life expectancy, but have failed to take the necessary action. 

These findings should mark a watershed moment that sparks a new drive to rebuild the nation’s health, putting improving health on a par with delivering economic growth as a core objective of government policy. This could be supported by cross-government action on the wider factors that shape people’s health, a shift to prevention and a new strategy to address economic and health inequalities.