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Has working-age morbidity been declining? Changes over time in survey measures of general health, chronic diseases, symptoms and biomarkers in England 1994-2014

Baumberg Geiger, Ben (2020) Has working-age morbidity been declining? Changes over time in survey measures of general health, chronic diseases, symptoms and biomarkers in England 1994-2014. BMJ Open, 10 (e03237). E-ISSN 2044-6055. (doi:10.1136/bmjopen-2019-032378) (KAR id:79925)

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Abstract

Objectives: As life expectancy has increased in high-income countries, there has been a global debate about whether additional years of life are free from ill-health/disability. However, little attention has been given to changes over time in morbidity in the working-age population, particularly outside the US, despite its importance for health monitoring and social policy. This study therefore asks: what are the changes over time in working-age morbidity in England over two decades? Design, setting and participants: We use a high-quality annual cross-sectional survey, the Health Survey for England (‘HSE’) 1994-2014. HSE uses a random sample of the English household population, with a combined sample size of over 140,000 people. We produce a newly-harmonised version of HSE that maximises comparability over time, including new non-response weights. While HSE is used for monitoring population health, it has hitherto not used for investigating morbidity as a whole. Outcome measures: We analyse all 39 measures that are fully comparable over time – including chronic disease diagnoses, symptomatology and a number of biomarkers – adjusting for gender and age. Results: We find a mixed picture: we see improving cardiovascular and respiratory health, but deteriorations in obesity, diabetes, some biomarkers, and feelings of extreme anxiety/depression, alongside stability in moderate mental ill-health and musculoskeletal-related health. In several domains we also see stable or rising chronic disease diagnoses even where symptomatology has declined. While data limitations make it challenging to combine these measures into a single morbidity index, there is little systematic trend for declining morbidity to be seen in the measures that predict self-reported health most strongly. Conclusions: Despite considerable falls in working-age mortality – and the assumptions of many policymakers that morbidity will follow mortality – there is no systematic improvement in overall working-age morbidity in England from 1994 to 2014.

Item Type: Article
DOI/Identification number: 10.1136/bmjopen-2019-032378
Uncontrolled keywords: Morbidity; Population Health; Biomarkers; Cross-Sectional Studies; Trends; England
Subjects: H Social Sciences
R Medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research
Depositing User: Benjamin Geiger
Date Deposited: 03 Feb 2020 10:10 UTC
Last Modified: 06 Apr 2020 14:45 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/79925 (The current URI for this page, for reference purposes)
Baumberg Geiger, Ben: https://orcid.org/0000-0003-0341-3532
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