Comparison of Limiting Long-term Illness Levels of 2001 with 1991

A comparison of LLI levels in the 2001 and 1991 Censuses was also undertaken (see Table 2.1 and Figure 2.1). This reveals a substantial increase in reported LLI in England and Wales over this period. Overall, the proportion of the population reporting a long-term health problem or disability that limits their daily activity, including work, has increased from 12.3% in 1991 to 18.2% in 2001. For the working age population (16-64), this figure was 14.3% in 2001, compared to 8.9% in 1991 (an increase of 60.4%). The prevalence of LLI is also much higher for people in the older working age group 50-64 (26.6% in 2001 vs 20.1% in 1991). Thus, it would appear that the health of the working age population has deteriorated over the last ten years. However, it may appear surprising that increases in LLI rate are reported across the board (gender, age as well as ethnic group) in the 2001 Census. This raises the question of whether the observed increase is real or a data artefact; other possible reasons might include a change in people's perception of their health or an increased desire for entitlement to social security benefits.

Table 2.1 and Figure 2.1 show the prevalence of LLI by age and ethnic group. Because of the change in the 2001 ethnic classification, for certain ethnic groups the comparable 1991 ethnic category is presented in parentheses; for example, the 1991 Other Ethnic group is comparable to the Mixed and Other Ethnic groups in the 2001 Census. For the working age population as a whole, most ethnic minority groups (except the Irish) report a similar prevalence of LLI to that of the British (White) population; only the Chinese report a lower rate. However, this pattern changes for the 50-64 age group (see Figure 2.1). Here, higher rates are reported for most ethnic groups (including the Irish), with particularly high rates reported by the Bangladeshi and Pakistani communities. Table 2.1 shows no marked gender differentials between 1991 and 2001 in overall LLI rates for different working age groups. However, for specific ethnic groups in the 50-64 age category (i.e. Indian, Pakistani and Black African populations), the 2001 prevalence among females is higher by 7-9 percentage points than for males. In contrast, Bangladeshi men aged 50-64 reported higher rates of LLI than their female counterparts in both 1991 and 2001.

It is also possible to examine the prevalence of limiting long-term illness reported by different ethnic minority groups in 1991 and 2001, compared to that reported by the population in England and Wales as a whole. Figures 2.2a and 2.2b show this ratio by ethnic group for all people of working age (16-64) and for those aged 50-64; Figures 2.2c and 2.2d provide data for the 50-64 age group broken down by gender. For the working age population, relative levels of LLI have remained similar between 1991 and 2001 for each of the 11 comparable ethnic groups (except for the Indian category). Thus, Irish, Pakistani, Bangladeshi and Black Caribbean people of working age have consistently reported a higher prevalence of LLI than the overall average in both 1991 and 2001. This pattern is reversed for the Other Asian, Black African, Other Black, Chinese and Other/Mixed ethnic groups. However, ethnic differences become more distinct if the analysis is limited to people in the 50-64 age group (Figure 2.2.b). In this case, all ethnic minority groups except the Chinese have reported higher levels of limiting long­

term illness than the overall average in both 1991 and 2001. The Other Asian category reported a higher level in 2001 but a lower level in 1991 when compared with the overall average. When LLI levels for this age group are broken down by gender (Figures 2.2c and 2.2d), a similar pattern is visible for females in the 50-64 age group; but for males, in addition to the Chinese,

Table 2.1 Limiting long-term illness in working age and whole population by ethnic group, 1991 & 2001, England & Wales LLI Rate Males LLI Rate Females Ethnic Groups 16-49 50-64 16-64 All Ages 16-49 50-64 16-64 All Ages 2001 1991 2001 1991 2001 1991 2001 1991 2001 1991 2001 1991 2001 1991 2001 1991 All Ethnic Groups 9.8 5.4 27.0 21.7 14.5 9.4 17.3 11.8 9.5 5.1 26.3 18.5 14.1 8.4 19.1 12.8 White (White+Irish) 9.8 5.4 26.7 21.7 14.6 9.5 17.7 12.1 9.5 5.0 25.7 18.2 14.2 8.4 19.7 13.1 British (White) 9.9 5.4 26.6 21.6 14.7 9.4 17.8 12.0 9.6 5.0 25.7 18.2 14.3 8.4 19.8 13.1 Irish 11.8 6.9 33.6 24.7 20.2 13.7 25.7 17.7 10.1 6.0 29.2 19.5 17.7 11.0 25.5 16.4 Other White 6.9 22.7 9.7 12.5 6.5 22.9 9.5 13.3 Mixed 11.1 31.4 13.1 10.1 10.2 31.7 12.3 9.6 White and Black 12.6 33.1 14.0 10.3 11.1 35.7 12.7 9.3 Caribbean White and Black 11.5 32.4 13.4 10.2 10.4 34.6 12.5 9.7 African White and Asian 9.9 29.0 12.0 9.5 9.6 29.0 11.9 9.4 Other Mixed 10.7 32.5 13.3 10.7 9.5 30.8 12.1 10.2 Asian 9.3 5.9 36.4 28.8 13.5 10.3 13.3 8.6 10.5 6.0 43.8 30.5 15.7 9.5 14.8 8.0 Indian 7.7 5.2 32.0 25.4 12.2 9.0 12.9 8.3 9.0 5.6 40.9 31.5 14.8 9.8 15.5 8.9 Pakistani 11.2 8.1 45.5 34.4 15.4 13.3 13.9 9.7 12.6 7.4 53.2 33.8 17.5 11.0 14.9 7.9 Bangladeshi 10.8 6.9 55.7 40.0 15.4 16.1 13.6 10.4 11.7 7.9 52.7 28.8 16.5 10.6 12.6 6.9 Other Asian 9.2 3.7 29.4 18.0 12.7 5.7 12.8 5.5 10.0 3.7 33.7 19.8 14.3 5.5 14.0 5.6 Black or Black British 9.4 5.9 30.5 21.3 12.5 9.4 13.2 9.1 9.6 6.2 36.1 27.4 13.6 10.0 13.9 9.3 Black Caribbean 11.1 6.1 33.4 21.4 15.4 10.9 17.6 11.1 10.7 6.1 37.8 27.7 16.0 11.3 18.1 11.3 Black African 7.2 5.2 23.8 19.2 8.9 6.8 8.4 6.9 8.0 6.4 32.0 24.6 10.4 7.8 9.3 7.3 Other Black 12.1 6.3 33.3 25.4 14.0 7.7 12.1 6.2 11.9 6.1 36.8 27.6 13.9 7.4 12.1 5.7 Chinese or Other Ethnic 5.4 22.0 7.7 8.3 5.3 21.6 7.8 8.6 Group Chinese 3.8 2.3 19.8 15.8 6.1 4.3 7.4 4.4 4.6 2.3 20.3 15.0 6.9 3.9 8.3 4.4 Other Ethnic Group 7.3 24.6 9.6 9.4 6.0 22.8 8.5 8.9 Mixed+Other Ethnic 9.9 5.5 28.6 21.7 12.0 7.7 10.0 6.7 8.7 5.8 27.5 22.8 10.9 7.8 9.4 6.8 Group (Other) Note: Due to changes in the ethnic classification used in 2001, comparable ethnic categories for 1991 are included in parentheses where appropriate. 25

%

Age Group 50-64 Yrs Age Group 16-64 Yrs 0. 0

10 . 0

20 . 0

30 . 0

40 . 0

50 . 0

60 . 0 2001 1991

e s e n i h C ) e t i h W ( h s i t i r B s p u o r G

c i n h t E ll A ) r e h t O ( r e h t O + d e x i M

n a c i r f A k c a l B h s i r I n a i s A r e h t O k c a l B r e h t O n a e b b i r a C k c a l B n a i d n I i n a t s i k a P i h s e d a l g n a B

e s e n i h C ) e t i h W ( h s i t i r B s p u o r G

c i n h t E ll A ) r e h t O ( r e h t O + d e x i M

n a c i r f A k c a l B h s i r I n a i s A r e h t O k c a l B r e h t O n a e b b i r a C k c a l B n a i d n I i n a t s i k a P i h s e d a l g n a B

Figure 2.1 Limiting long -t e rm illnes s rate by ethnic g r o u p f or ages 16-64 an d 5 0-64, 1991 and 200 1 , E n gland a n d Wa le s 26

1.600

ng long-term illness rates relat ve to Eng and and Wales value = 1 2001

ng long-term illness rates relat ve to Eng and and Wales value = 1 Figure 2.2b Lim

by ethnicity – aged 50-64 years

i l )

Figure 2.2c Lim ng long-term illness rates relat ve to Eng and and Wales ( by ethnicity – males aged 50-64 years

)

Figure 2.2d Lim ng long-term illness rates relative to England and Wales ( by ethnicity – females aged 50-64 years i

ti

i ti

Black Africans (and Other Asians in 1991) also report lower levels of LLI. Overall, Bangladeshi and Pakistani men and women in this age group report consistently higher levels of limiting long-term illness, as do Indian women aged 50-64; the disparity also appears to have widened over time for the Bangladeshi and Pakistani older working age population groups.

Analysis of the additional question included in the 2001 Census enquiring about each person's general health over the previous twelve months (good, fairly good, not good) indicates that around 8% of males and females of working age (16-64) and 15% in the age group 50-64 years report that their health had been 'not good' (see Table 2.2). Once again, this figure varies depending on the ethnic group, particularly for the 50-64 age cohort. In the latter case, approximately one in four Asians report their health as 'not good', in comparison to one in five Black or Black British, one in seven British (White), and one in ten Chinese. In this same age cohort, reported rates were higher for men in the Irish and British (White) groups, whereas a higher proportion of women than men reported 'not good' health in the Indian, Pakistani and Black or Black British population groups.

Table 2.2 Percentage of people reporting 'not good' health and those with limiting long-term illness for ages 50-64 and 16-64 by sex and ethnicity, England & Wales, 2001

Not Good Health With Limiting Long-term Illness Reporting Not Good Health Ethnic Group 50-64 Years 16-64 Years 50-64 Years 16-64 Years

Male Female Male Female Male Female Male Female All Ethnic Groups 15.5 14.7 8.0 8.3 50.6 48.5 45.2 45.9 Note: The Census question asked individuals to classify their general health over the last 12 months as 'good',, 'fairly good' or 'not good'.

As might be expected, there was a strong association between responses to the question on health and that on limiting long-term illness. About four-fifths of working age people who reported their health as 'not good' also had a limiting long-term illness. Conversely, under half

(46%) of those with LLI of working age (16-64) and 50% in the 50-64 age group also reported that their health had been 'not good' (see Table 2.2). It is likely that individuals who report both have a more persistent disability ('chronic impairment') that may limit their continued participation in full-time employment. Table 2.2 shows that ethnic differences in prevalence of chronic impairment are particularly evident in the 50-64 age group. For this age group, levels for males vary from 42.6% for Chinese to 58.1% for Irish, and for females from 40.8% for Chinese to 61.4% for Pakistani women.

Bangladeshi Pakistani Black Caribbean

Indian White and Black Caribbean

Other Black White and Black African

Irish Other Mixed Other Asian White and Asian All Ethnic Groups British (White)

Black African Other Ethnic Group

Other White Chinese

l Mal Persons Fema es

es

0 5 % ^{10 15 20 25 30}

Figure 2.3 Chronic impaired health population (aged 50-64) by ethnicity, 2001 In conclusion, the analyses above indicate that specific ethnic minority groups report a higher level of LLI in the working age population compared to the national average, especially for the 50-64 age group. Furthermore, the proportion of the workforce aged 50-64 years with ‘chronic impaired health’ is particularly high for the Bangladeshi and Pakistani populations (see Figure 2.3). The existence of this vulnerable group must raise serious concerns for policy makers in terms of the health of the UK older working population.

35

2.2 ETHNICITY AND DISABILITY AND EFFECTS ON EMPLOYMENT & WAGES