Inequalities in healthy life expectancy between ethnic groups in England and Wales in 2001.

OBJECTIVES: We aim to develop robust estimates of disability-free life expectancy (DFLE) and healthy life expectancy (HLE) for ethnic groups in England and Wales in 2001 and to examine observed variations across ethnic groups. DESIGN: DFLE and HLE by age and gender for five-year age groups were computed for 16 ethnic groups by combining the 2001 Census data on ethnicity, self-reported limiting long-term illness and self-rated health using mortality by ethnic group estimated by two methods: the Standardised Illness Ratio (SIR) method and the Geographically Weighted Method (GWM). RESULTS: The SIR and GWM methods differed somewhat in their estimates of life expectancy (LE) at birth but produced very similar estimates of DFLE and HLE by ethnic group. For the more conservative method (GWM), the range in DFLE at birth was 10.5 years for men and 11.9 years for women, double that in LE. DFLE at birth was highest for Chinese men (64.7 years, 95% CI 64.0-65.3) and women (67.0 years, 95% CI 66.4-67.6). Over half of the ethnic minority groups (men: 10; women: 9) had significantly lower DFLE at birth than White British men (61.7 years, 95% CI 61.7-61.7) or women (64.1 years, 95% CI 64.1-64.2), mostly the Black, Asian and mixed ethnic groups. The lowest DFLE observed was for Bangladeshi men (54.3 years, 95% CI 53.7-54.8) and Pakistani women (55.1 years, 95% CI 54.8-55.4). Notable were Indian women whose LE was similar to White British women but who had 4.3 years less disability-free (95% CI 4.0-4.6). CONCLUSIONS: Inequalities in DFLE between ethnic groups are large and exceed those in LE. Moreover, certain ethnic groups have a larger burden of disability that does not seem to be associated with shorter LE. With the increasing population of the non-White British community, it is essential to be able to identify the ethnic groups at higher risk of disability, in order to target appropriate interventions.

Methods for Small Area Population Forecasts: State-of-the-Art and Research Needs.

Small area population forecasts are widely used by government and business for a variety of planning, research and policy purposes, and often influence major investment decisions. Yet, the toolbox of small area population forecasting methods and techniques is modest relative to that for national and large subnational regional forecasting. In this paper, we assess the current state of small area population forecasting, and suggest areas for further research. The paper provides a review of the literature on small area population forecasting methods published over the period 2001-2020. The key themes covered by the review are extrapolative and comparative methods, simplified cohort-component methods, model averaging and combining, incorporating socioeconomic variables and spatial relationships, 'downscaling' and disaggregation approaches, linking population with housing, estimating and projecting small area component input data, microsimulation, machine learning, and forecast uncertainty. Several avenues for further research are then suggested, including more work on model averaging and combining, developing new forecasting methods for situations which current models cannot handle, quantifying uncertainty, exploring methodologies such as machine learning and spatial statistics, creating user-friendly tools for practitioners, and understanding more about how forecasts are used. Supplementary Information: The online version contains supplementary material available at 10.1007/s11113-021-09671-6.

Estimates of internal migration flows for the UK, 2000-2007.

Statistics on migration flows year by year within the UK are produced by the Office for National Statistics, the General Register Office for Scotland and the Northern Ireland Statistics Research Agency for migration within England and Wales, within Scotland and within Northern Ireland respectively. However, these flow statistics are not integrated across the UK. As there was a need for such integrated flow statistics at a sub-national scale known as NUTS2 for an EU sponsored project, the authors developed a synthetic estimate of migration flows for the calendar years 2000 to 2007 and the mid-year to midyear intervals 1999-2000 to 2006-07. The estimates were controlled by the migration flows published at NUTS1 scale from the UK wide NHS Central Register to which country specific flows between NUTS2 regions from the various patient registers were fitted. The gaps, flows between regions in different devolved territories, were filled by adjusting comprehensive flow data from the 2001 Census to the published NHSCR flows. Age detail was added only to the total out-migration and in-migration flows from each region using a fixed national profile of migration rates by age from the 2001 Census. The resulting time series of flow data provide, therefore, the three matrix faces of an origin-destination-age array for each time period. The paper describes the details of the estimation process and reports on some of the trends that the time series show.

Introducing the area classification of output areas.

This article provides a brief introduction to the Area Classification of Output Areas. The classification uses data from the 2001 Census to group the 223,060 output areas into groups of similarity based on their census attributes. The classification is freely available as a 'National Statistic' via the National Statistics website.

Making an estimate of the number of people and households for Output Areas in the 2001 Census.

This article describes an investigation into the best way to estimate robust totals for people and households at Output Area level. We show that computing the average of people and household counts across the set of tables in which the same count appears is a good strategy. When we compare the mean or median person and household counts with those produced by summing from the postcode directory, the two sets of numbers are usually very close. Using averages in this way for other population bases in the sets of tables is therefore recommended. This technique can also be applied to larger areas.

The Hedgehog Inhibitor Cyclopamine Reduces ß-Catenin-Tcf Transcriptional Activity, Induces E-Cadherin Expression, and Reduces Invasion in Colorectal Cancer Cells.

Colorectal cancer is a major global health problem resulting in over 600,000 deaths world-wide every year with the majority of these due to metastatic disease. Wnt signalling, and more specifically ß-catenin-related transcription, has been shown to drive both tumorigenesis and the metastatic process in colorectal neoplasia, yet its complex interactions with other key signalling pathways, such as hedgehog, remain to be elucidated. We have previously shown that the Hedgehog (HH) signalling pathway is active in cells from colorectal tumours, and that inhibition of the pathway with cyclopamine induces apoptosis. We now show that cyclopamine treatment reduces ß-catenin related transcription in colorectal cancer cell lines, and that this effect can be reversed by addition of Sonic Hedgehog protein. We also show that cyclopamine concomitantly induces expression of the tumour suppressor and prognostic indicator E-cadherin. Consistent with a role for HH in regulating the invasive potential we show that cyclopamine reduces the expression of transcription factors (Slug, Snail and Twist) associated with the epithelial-mesenchymal transition and reduces the invasiveness of colorectal cancer cells in vitro. Taken together, Cancers 2015, 7 1886 these data show that pharmacological inhibition of the hedgehog pathway has therapeutic potential in the treatment of colorectal cancer.

Drivers of inequality in disability-free expectancy at birth and age 85 across space and time in Great Britain.

BACKGROUND: Although mortality and health inequalities at birth have increased both geographically and in socioeconomic terms, little is known about inequalities at age 85, the fastest growing sector of the population in Great Britain (GB). AIM: To determine whether trends and drivers of inequalities in life expectancy (LE) and disability-free life expectancy (DFLE) at age 85 between 1991 and 2001 are the same as those at birth. METHODS: DFLE at birth and age 85 for 1991 and 2001 by gender were calculated for each local authority in GB using the Sullivan method. Regression modelling was used to identify area characteristics (rurality, deprivation, social class composition, ethnicity, unemployment, retirement migration) that could explain inequalities in LE and DFLE. RESULTS: Similar to values at birth, LE and DFLE at age 85 both increased between 1991 and 2001 (though DFLE increased less than LE) and gaps across local areas widened (and more for DFLE than LE). The significantly greater increases in LE and DFLE at birth for less-deprived compared with more-deprived areas were still partly present at age 85. Considering all factors, inequalities in DFLE at birth were largely driven by social class composition and unemployment rate, but these associations appear to be less influential at age 85. CONCLUSIONS: Inequalities between areas in LE and DFLE at birth and age 85 have increased over time though factors explaining inequalities at birth (mainly social class and unemployment rates) appear less important for inequalities at age 85.