Healthy life expectancy: policy context
Although life expectancy (LE) and healthy life expectancy (HLE) have been increasing in Scotland in recent years, both tend to be worse (lower) in Scotland than in the UK as a whole. Indeed, due to its relatively high death rates, Scotland has one of the lowest levels of LE in Western Europe (see international comparisons).
The aim of increasing HLE is included as part of the high level purpose target on Population set out by the Scottish Government in Scotland Performs:
Government Economic Strategy Target 4: "To match average European (EU15) population growth over the period from 2007 to 2017, supported by increased healthy life expectancy in Scotland over the period from 2007 to 2017."
Methodological changes and limited availability of data have complicated the assessment of time trends in HLE. However, estimates of HLE at birth based on self-assessed health from both the Scottish Health Survey and Scottish Household Survey suggest an increasing general trend between 2003 and 2011 for both males and females (see Scotland Performs chart). This suggests that progress is being made towards the target for the period 2007 to 2017.
Equally Well is the Scottish Government’s social policy framework on reducing health inequalities initiated by the Ministerial Task Force on Health Inequalities. This sets out a series of recommendations addressing the social determinants of health – including education, poverty and employment – and the need for preventative action in the early years. In 2008 the Ministerial Task Force called for analysis to support long-term monitoring of inequalities in a number of high level indicators, of which HLE was one.
The 2015 Long-term Monitoring of Health Inequalities report, published by the Scottish Government on 27 October 2015, includes a section on Healthy life expectancy at birth. It concludes that there have been no clear changes to inequalities in male or female healthy life expectancy (HLE) since 2009-2010. Changes to the methodology from 2009 mean comparisons with earlier years cannot be made.
At a European level, the pilot European Innovation Partnership on Active and Healthy Ageing has an overarching target to increase the average healthy lifespan in Europe by two years by 2020. It is focused on three areas: prevention and health promotion; care and cure; and active and independent living of elderly people.