Published: 27/03/2003, Volume II3, No. 5848 Page 25
Why do the Welsh feel so ill, Norwich dwellers so atheist and 5.2 million people so underpaid?
John Appleby reports on the results of the 2001 census
The recent release of statistics from the 2001 census reveals that Norwich is, in the words of the Eastern Daily Press, 'a godless city', with nearly 28 per cent of the population describing themselves as having no religion. There is no information yet on what proportion of the England and Wales population (around 390,000) who are members of that new religion, 'Jedi Knight', reside in Norwich.
Along with the new departure into the matter of faith, the 2001 census asked some new questions about health. Among these was whether, over the previous 12 months, a person's health had in general been good, fairly good or not good.
This is about as unsophisticated as one could get - on a par with Florence Nightingale's outcome measures, 'relieved', 'not relieved' and 'dead'. An opportunity has been missed to include a set of more sophisticated health status questions, such as the EQ5D developed by the Euroqol group, which could have provided useful connections with - and data for - other health surveys both here and abroad.
Nevertheless, the 2001 census health questions are an advance and should yield some interesting information.
What is perhaps most immediately striking from the results of the general health question is the national variation in health. Overall, across England and Wales, just over one in 11 people (9 per cent) described their health as not good. But this masks a four-fold variation across local authorities; in Merthyr Tydfil, over 18 per cent of the population rated their health as not good compared with just over 4 per cent in Wokingham. In fact, of the 10 authorities with the highest proportion of people in this group, seven are Welsh.
As this is the first time that the general health question has been asked, there are obviously no trends to which to refer. Another question concerns people's limiting long-standing illnesses, which has appeared in a previous census. In 1991, 13.3 per cent of the population stated that they had an LLI.
A decade later, this had risen by over a third to 18.2 per cent - just under one in five of the population.
A significant part of this growth in LLI will be due to changing demographics rather than the population as a whole being less healthy. For example, between 1991 and 2001, the numbers of people aged over 65 has increased by nearly 1.2 million, to over 9.4 million - an increase of 14 per cent. Similarly, the proportion of the total population aged over 65 has also grown, from 15.9 per cent to 18.1 per cent.
A further new question for the census concerned the provision of unpaid care. Again, there are no trends to report, but the scale (and value) of unpaid care and the variations across the country are striking. With 5.2 million people providing unpaid care for various hours a week, a back-of-the-envelope calculation suggests that, using the current minimum adult wage of£4.20 per hour, the value of this unpaid care amounts to over£24bn a year in England and Wales - getting on for nearly half the total NHS spend.
Meanwhile, back in Norwich, it is possible to say that, although the associations are statistically weak, a 10 per cent rise in 'godlessness' across the country would imply a 2.3 per cent fall in the proportion of people with LLI, a 2 per cent rise in those describing their health as 'good', a 1.2 per cent fall in those describing their health as 'not good', but a 1.2 per cent fall in the proportion of the population providing unpaid care.
John Appleby is chief economist, the King's Fund.