Socioeconomic inequalities in disability-free life expectancy: new research highlights the urgent need for action

People in England’s most deprived areas spend over a decade longer living with disability compared to those in the least deprived areas, according to new research using ELSA data.

The study, published in The Lancet Healthy Longevity, reveals significant inequalities in disability-free life expectancy (DFLE) across England. It finds that those in the most socioeconomically deprived areas develop serious disabilities 11 to 12 years earlier than their wealthier counterparts, meaning they spend a far greater proportion of their lives in poor health and in need of greater support.

The research, which combines data from ELSA with two other major longitudinal studies, shows that people in the most disadvantaged areas not only develop disabilities at a younger age but also live with them for longer. On average, men in the most deprived areas spend about a year longer with serious disabilities compared to those in the least deprived areas, while for women the difference is closer to 18 months.

At a national level, this adds up to tens of thousands of extra years spent with disability across the population. The findings also show that women are disproportionately affected, with those in the most deprived areas reaching the point where they spend half of their remaining life with a disability by the age of 71.5. In contrast, women in the least deprived areas do not reach this threshold until age 83.5.

The gap for men is similarly stark, with the most disadvantaged spending half their remaining life with a disability from age 78.5, compared to 89.5 for those in the least deprived areas.

The study highlights the urgent need for targeted policies to tackle health inequalities in older age. The researchers argue that reducing disparities in access to healthcare and social care, improving rehabilitation services, and addressing wider social determinants of health such as education, employment, and housing are essential.

The UK government has pledged to halve the gap in healthy life expectancy between the richest and poorest areas. This research provides the evidence needed to shape effective policies that will not only improve quality of life for those in disadvantaged communities but also reduce the financial burden on the NHS and social care services.

Reference: Davies, L. E., Sinclair, D. R., Todd, C., Hanratty, B., Matthews, F. E., & Kingston, A. (2025). Area-level socioeconomic inequalities in activities of daily living disability-free life expectancy in England: A modelling study. The Lancet Healthy Longevity. https://doi.org/10.1016/j.lanhl.2025.100700