Statistics

Wellbeing of Wales, 2024 - A healthier Wales

The report helps us assess whether we are making progress against the 7 national wellbeing goals.

First published: 26 September 2024

Last updated: 26 September 2024

Current page (5 of 11)

Download document: File size 651 KB, File type PDF

This file may not be fully accessible.

In this page

The goal for a healthier Wales

Author: Dr William Perks

A healthier Wales: a society in which people’s physical and mental wellbeing is maximised and in which choices and behaviours that benefit future health are understood.

What have we learnt from the data in the last year?

Life expectancy fell for the second period in a row, which includes the period of the coronavirus (COVID-19) pandemic
Life expectancy continues to be higher for females than males.
Healthy life expectancy fell compared to the previous period.
Healthy life expectancy was higher in males than females in the latest period.
Deaths from all causes increased in the last year compared to the previous, but was lower than the high number of deaths seen during the COVID-19 pandemic.
Age-standardised mortality rates improved in the last year compared to the previous.
The gap in life expectancy between the most and least deprived areas was similar to the previous period for both females and males.
There has been a slight upward trend in the number of low birth weight babies, with 2022 being the highest on record. This figure remained unchanged in 2023.
Breastfeeding rates were the highest on record.
Pregnant women’s healthy lifestyle behaviours at initial assessment were mixed, with a lower percentage of women reported as smokers, but a higher percentage recorded as obese or with a mental health condition than the previous year.
Life satisfaction and anxiety levels for adults deteriorated compared to the previous year.

What is the longer term progress towards the goal?

Limited progress appears to have been made towards achieving the goal, with many of the healthier Wales national indicators remaining relatively stable and not showing significant change over the periods in which they are available. The pandemic has also had a dominant effect on many of the trends, and the implications for longer term trends is unclear.

Life expectancy had been rising since the Second World War, although at a slower pace in the past decade. However, it has fallen for the second period in a row, which includes the period of the COVID-19 pandemic.

The national milestone on healthy life expectancy is to increase the healthy life expectancy of adults and narrow the gap in healthy life expectancy between the least and the most deprived by at least 15% by 2050. The data shows healthy life expectancy at birth for females and males has fallen between 2011-13 and 2020-22. Whereas the gap in healthy life expectancy between most and least deprived areas appears to have improved slightly for males but deteriorated slightly for females, although these are not significantly different.

Over the long-term, age-standardised mortality rates, which allow for better comparisons over time and area because they account for the population size and age structure, have been improving.

The proportion of babies born with a low birth weight has remained relatively steady over the course of the time series, typically fluctuating between 5% and 6%, but more recent years have seen increases in the percentage of babies with a low birth weight.

The national milestone is to increase the percentage of adults with two or more healthy behaviours to 97% by 2050. Between 2016-17 and 2019-20 there was a deterioration in the proportion of adults who reported two or more healthy lifestyle behaviours and is short of the national milestone. The trend since 2020-21 has been stable but this is not comparable with previous years, due to the change in the mode of the National Survey for Wales.

The national milestone is to increase the percentage of children with two or more healthy behaviours to 94% by 2035 and more than 99% by 2050. The percentage of young people meeting the national milestone has improved and in 2021/22 was 89.8% higher than the 87.7% reported in 2017/18.

The national milestone on mental wellbeing is to improve adult and children’s mean mental wellbeing and eliminate the gap in adult and children’s mean mental wellbeing between the most deprived and least deprived areas in Wales by 2050.

Adult average mental wellbeing was similar compared to the year prior. The gap in the average wellbeing score between those from the most and least deprived areas appears to have widened since 2020-21. However, due to the difference in collection mode, it is difficult to draw longer term comparisons for this indicator.

When measuring young people’s mental wellbeing using the new measure for the national indicator, the average score for young people was lower in 2021/22 compared to 2017/18, indicating a fall in mental wellbeing. The gap in the average score between those from low and high family affluence has narrowed, but only due to a deterioration in the score of those from high family affluence.

Housing conditions have improved. The most recent Welsh Housing Conditions Survey showed that 82% of dwellings were free from the most serious (category 1) hazards in 2017-18, compared with 71% in 2008. There were improvements in all tenures.

Life expectancy

Life expectancy had been rising since the Second World War, although at a slower pace in the past decade.

Analysis shows that for both males and females, people aged around 60 to 84 years were the main contributors to increasing life expectancy, but these improvements have slowed down considerably.

Life expectancy fell in the most recent period available (2020-22), which includes the period of the COVID-19 pandemic.

Life expectancy at birth was 81.8 years for females and 77.9 years for males for 2020-22. This was a slight reduction for both males and females, following higher death rates during the COVID-19 pandemic.

In the most recent period for healthy life expectancy (2020-22), healthy life expectancy was 61.1 years for males and 60.3 years for females, a decrease for both males and females compared with 2011-13, when the time series began. Healthy life expectancy for females also fell below that of males for the first time.

Figure 3.1: Life expectancy and healthy life expectancy at birth, by sex, 2001-03 to 2020-22 [Note 1]

Description of Figure 3.1: A line chart showing increases in life expectancy for males and females have stalled in recent years and in the most recent period fallen. Healthy life expectancy has also decreased, especially for females compared with 2011-13 when the time series began.

Source: Life expectancy and Health state life expectancies in England, Northern Ireland and Wales, Office for National Statistics (ONS)

[Note 1] Y axis does not start at zero

Causes of deaths

In 2023, there were 36,054 deaths from all causes. This was an increase on 2022 but lower than the high number of deaths seen in 2020 and 2021. This was also still higher than historical numbers recorded prior to the pandemic.

The leading causes of death in 2022 were from Ischaemic heart diseases (3,922), followed by Dementia and Alzheimer’s disease (3,833), both with almost double the number of deaths than any other cause of death. These have historically been the highest causes of death.

Age-standardised mortality rates (ASMRs) allow for better comparisons over time and area because they account for the population size and age structure.

Based on data up to 2022, over the long-term ASMRs have been improving, falling from 1,406 deaths per 100,000 people in 1994 to 1,056 deaths per 100,000 people in 2022.

In 2022, the ASMRs were significantly higher for males, 1,217 deaths per 100,000, than for females, 924 deaths per 100,000 females.

In 2022, 22.7% of all deaths were considered avoidable (8,114 of 35,694 deaths) lower than in 2021. Over the long-term ASMRs for avoidable deaths have been improving, falling from 376.1 deaths per 100,000 people in 2001 to 273.8 deaths per 100,000 people in 2022.

Neoplasms (cancers) remain the leading cause of avoidable mortality, but the avoidable mortality rates for neoplasms have continued to decline. In 2022, the ASMR for neoplasms was 84.1 per 100,000 people, compared with 115.0 in 2001.

The mortality rate for avoidable alcohol-related and drug-related deaths has continued to increase. The ASMR for alcohol-related and drug-related deaths was 30.2 per 100,000 people in 2022, compared with 21.2 in 2001.

Figure 3.2: Age-standardised mortality rates, 1994 to 2022

Description of Figure 3.2: A line chart showing improvemnts in age-standardised mortality rates over the long-term

Source: Deaths registered in England and Wales, ONS

Inequalities in life expectancy and mortality

Inequalities in life expectancy and mortality remain wide.

Analysis based on 2018-20 data shows that the overall gap in healthy life expectancy between the most and least deprived areas has remained relatively stable between 2011-13 and 2018-20. In the most recent time period, this gap seems to have reduced slightly for males (13.3 years) and increased slightly for females (16.9 years).

The life expectancy gap is much narrower at 7.6 years for males and 6.4 years for females. But it has been generally increasing in recent years for males and females, suggestive of growing inequality.

Males also spend more of their life in good health compared to females.

The most recent data on socioeconomic inequalities in avoidable mortality is from 2020 where the proportion of total deaths that were avoidable continued to be substantially larger in the most deprived areas compared with the least deprived areas.

Avoidable deaths accounted for 37.0% of all male deaths in the most deprived areas compared with 18.9% in the least deprived areas. For females the equivalent figures were 25.7% in the most deprived areas and 14.1% in the least deprived areas.

In 2020, the absolute gap in avoidable mortality between the most and least deprived areas widened to the highest level since 2003 for males and since the data time series began for females.

Figure 3.3: Absolute gap in life expectancy and healthy life expectancy between most and least deprived areas, males and females, 2011-13 to 2020-22 [Note 1] [Note 2]

Description of Figure 3.3: A line chart showing absolute gap in life expectancy between 2011-13 to 2020-22 and healthy life expectancy for males and females between 2011-13 to 2018-20. Females have a higher life expectancy but males have a higher healthy life expectancy.

Source: Public Health Outcomes Framework for Wales reporting tool, Public Health Wales (PHW)

[Note 1] The gap in health expectancies is calculated as the absolute difference between the least and most deprived fifths. This is a change of method since previous health expectancies releases, to improve the stability of the measure at local authority level. The gap was previously calculated using the Slope Index of Inequality (SII). ONS continue to publish the SII at national level as part of their Health state life expectancies release.

[Note 2] The gap in healthy life expectancy between most and least deprived areas for 2020-22 is not currently available.

Healthy babies

The percentage of low birth weight babies has remained relatively steady over the course of the time series, typically fluctuating between 5% and 6%.

The lowest figures on record were recorded in 2014 and 2015. Since then there has been a slight upward trend in the number of low birth weight babies, with 2022 being the highest on record. This figure remained unchanged in 2023.

In 2023, a slightly higher percentage of female babies had low birth weight (6.7%) compared to male babies (5.5%). This is broadly consistent with the longer-term trend.

In the last decade breastfeeding rates at all points of time have been increasing, with rates in 2023 becoming the highest on record. The latest annual data in 2023 showed the percentage of babies breastfed at birth was 65.5%. This was 3.6 percentage points higher than five years ago.

Figure 3.4: Percentage of singleton births with a birth weight of under 2,500g, 2005 to 2023

Description of Figure 3.4: A line chart showing the percentage of live singleton births with a birth weight of under 2,500g. The rate has typically fluctuated between 5% and 6% over the course of the time series, with a slight upward trend since 2014.

Source: Maternity and birth statistics, Welsh Government

Maternal health

In 2023, the data continues to show mixed results for healthy lifestyle behaviours of pregnant women at initial assessment, with a lower percentage of women reporting as smokers, but a higher percentage recorded as obese or as having a mental health condition than in the previous year.

In 2023, 13.8% of pregnant women were recorded as smokers at their initial assessment. This continues the downward trend since data was first collected in 2016 and is slightly lower than in the previous year. However, between 2021 and 2022 nearly all data has been self-reported to reduce the risks of spreading COVID-19, rather than being carbon monoxide monitored and may impact direct comparisons prior to this. CO monitoring resumed in 2023 and the percentage of women CO monitored at initial assessment rose to 17%.

Just over three out of ten (32%) pregnant women had a body mass index (BMI) of 30 or greater at their initial assessment. The longer-term upward trend continued as the percentage in 2023 was 1 percentage point higher than in the previous year and six percentage points higher than in 2016 (the first year of comparable data).

Just over three out of ten (32%) pregnant women reported a mental health condition at their initial assessment. This also continued a longer-term upward trend, with the latest data 2 percentage point higher than in the previous year, and 13 percentage points higher than in 2016.

The number of live births fell to its lowest number in 2023 since broadly comparable data was collected in 1929. For the 30 years prior to 2018, the number of live births in Wales ranged between 30,000 and 37,000 per year but has been below 30,000 in every year since. The number of live births has decreased by 23.2% compared with 10 years ago.

Healthy lifestyle behaviours

The national milestones on adult and children’s healthy lifestyle behaviours are:

to increase the percentage with two or more healthy behaviours to more than 97% for adults by 2050.
to increase the percentage with two or more healthy behaviours to 94% for children by 2035, and to more 99% by 2050.

The National Survey for Wales was adapted due to the pandemic, with a change in the mode of the survey (telephone interviews replacing face-to-face interviews) and changes to some questions compared with previous years. As these topics can be sensitive to such changes it is not possible to compare the results directly with data from years prior to 2020-21.

Prior to the pandemic, between 2016-18 and 2019-20 the percentage of adults with two or more healthy behaviours has deteriorated and is short of the national milestone. The trend since 2020-21 has been stable but is not comparable with previous years.

The most recent data presented here is for April 2022 to March 2023. Where the majority (92.3%) of adults reported following two or more of the five healthy lifestyle behaviours. This includes not currently smoking, drinking within weekly guidelines, eating five or more portions of fruit or vegetables the previous day, being active for 150 minutes or more the previous week and being a healthy weight.

In 2022-23, the percentage of adults with two or more healthy lifestyle behaviours was lower for males (compared with females), people aged between 45 to 64 (compared to those from younger or older age groups) and people from a more deprived area (compared with those from a less deprived area).

Due to the sample size of the National Survey for Wales, breakdowns by other protected characteristics are limited, therefore the below analysis combines 4 years of data (from 2016-17 to 2019-20) to be able to analyse these. In addition, this analysis is based on age-standardised results to take account of differences in the age profile in different groups.

Adults identifying as bisexual were more likely to report having two or more healthy lifestyle behaviours (compared with those in other sexual orientation groups) as were adults who were not disabled (compared with those who were disabled).

Adults reporting no religion were less likely to report having two or more healthy lifestyle behaviours than those in other religious groups; those identifying as Muslim were most likely to do so (although the difference compared with the Other religion group was not statistically significant) and adults who were married or in a civil partnership were more likely to report having two or more healthy lifestyle behaviours than those who were single or those who were separated or divorced.

Figure 3.5: Percentage of adults with two or more healthy lifestyle behaviours, 2016-17 to 2022-23 [Note 1] [Note 2] [Note 3]

Description of Figure 3.5: A line chart showing the percentage of adults with two or more healthy behaviours deteriorated between 2016-17 and 2019-20. The trend since 2020-21 has been stable but is not comparable with previous years.

Source: National Survey for Wales, Welsh Government

[Note 1] Results from 2020-21 are not comparable with previous years due to changes in the survey

[Note 2] Results from 2020-21 are for quarter 4 only and not annual data

[Note 3] Y axis does not start at zero

The School Health Research Network Student Health and Wellbeing survey showed the percentage of young people (11 to 16 year olds) meeting the national milestone in 2021/22 academic year was 89.8%, higher than the 87.7% reported in 2019/20 and 2017/18 academic years.

These healthy lifestyle behaviours include not smoking, never or rarely drinking alcohol, eating fruit or vegetables every day and being physically active for an hour or more per day, over the past seven days. For these underlying behaviours in 2021/22 academic year:

95% of young people reported that they did not smoke
83% of young people reported that they never or rarely drank alcohol
45% of young people reported that they ate fruit or vegetables every day
16% of young people reported that they had been physically active for an hour or more per day, over the past seven days

Between 2017/18 and 2021/22 academic years, young people reporting that they did not smoke and that they never or rarely drank alcohol has shown slight improvements. Whereas those reporting that they ate fruit or vegetables every day or had been physically active for an hour or more per day over the past seven days have shown a slight decline.

In 2021/22 academic year, those who were younger, male (91%) and in the high family affluence group (90%) had the highest percentage of young people with two or more healthy lifestyle behaviours, compared to those who identified as neither a boy nor a girl (84%), were in the low family affluence group (89%) or were older, who had the lowest.

Reported physical activity levels declined with age in secondary school, and boys (rather than girls or young people who identified as neither a boy nor a girl) and those in the high family affluence group (rather than medium or low family affluence) were more likely to report being physically active for an hour or more per day, over the past seven days.

The percentage of young people who reported that they eat fruit or vegetables every day also declined with age in secondary school, with girls (rather than boys or young people who identified as neither a boy nor a girl) and those in the high family affluence group (rather than medium or low family affluence) more likely to report that they eat fruit or vegetables every day.

The percentage of young people who reported that they did not smoke declined with age during secondary school. Both girls and boys (compared with young people who identified as neither a boy nor a girl) and those in the high and medium family affluence group (compared with low family affluence) were more likely to report they did not smoke.

The percentage of young people who reported that they never or rarely drank alcohol fell with age during secondary school. Both girls and boys (compared with young people who identified as neither a boy nor a girl) and those in the low family affluence group (compared with high and medium family affluence) were more likely to report that they never or rarely drank alcohol.

Figure 3.6: Percentage of young people aged 11 to 16 with two or more healthy behaviours, 2017/18 (academic year) to 2021/22

Description of Figure 3.6: A line chart showing the percentage of young people aged 11 to 16 with two or more healthy behaviours has improved between 2017/18 and 2021/22.

Source: School Health Research Network Student Health and Wellbeing Survey

[Note 1] Y axis does not start at zero

Mental health and wellbeing in adults

The national milestone on mental wellbeing is to improve adults’ and children’s mean mental wellbeing and eliminate the gap in adults’ and children’s mean mental wellbeing between the most deprived and least deprived areas in Wales by 2050

Adults were asked about their mental wellbeing and results were scored using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). A higher score (58 to 70) suggests high mental wellbeing, while scoring 44 or lower suggests having a low mental wellbeing. Scoring between 45 and 57 suggests the person has medium mental wellbeing.

The overall average WEMWBS score in latest available data from the National survey (2022-23) was 48.2, meaning on average responders had medium mental wellbeing. This is a similar average WEMWEBS score to that in 2021-22.

The gap in the average WEMWEBS score between those from the most and least deprived WIMD quintiles appears to have widened in the latest period compared to 2020-21.

When looking at the breakdowns of responder scores, 32% of adults scores corresponded to a low mental wellbeing, 55% to a medium mental wellbeing and 13% to a high mental wellbeing.

On average younger adults have lower mental wellbeing (with those aged 16 to 24 having a WEMWBS score of 47.4) than those aged 65 and over (WEMWBS score of 51.3).

Adults in better general health also had better mental wellbeing. As general health declined, so did the average mental wellbeing score. Those with good general health had an average mental wellbeing score of 50.4, whilst those with bad general health had an average mental wellbeing score of 39.1.

Adults who say they are lonely also have lower mental wellbeing on average (WEMWBS score of 39.0) than those who are sometimes lonely (WEMWBS score of 47.4) or never lonely (WEMWBS score of 52.0).

These interactions with age and health show the same trend as previous years, but the change in mode should also be considered when comparing the results.

Average life satisfaction had been increasing for almost a decade since 2011-12, accompanied with slight reductions in average anxiety levels. However, in 2020-21 life satisfaction and anxiety levels deteriorated to levels worse than those seen in 2011-12, likely due to impacts from the pandemic and, although scores in 2021-22 scores improved slightly, 2022-23 returned to those similar in 2020-21.

Figure 3.7: Average Warwick-Edinburgh Mental Wellbeing Scale score for adults, 2016-17 to 2022-23 [Note 1] [Note 2]

Description of Figure 3.7: A line chart showing the average Warwick-Edinburgh Mental Wellbeing Scale (WEMWEBS) score for adults did not show any significant change between 2016-17 and 2019-20 or since 2020-21. The gap in the average WEMWEBS score between those from the most and least deprived areas appears to have widened since 2020-21. However understanding a longer-term trend for this milestone is not possible due to changes in the data collection.

Source: National Survey for Wales, Welsh Government

[Note 1] Results from 2020-21 are not comparable with previous years due to changes in the survey

[Note 2] Y axis does not start at zero

Mental health and wellbeing in children

The underlying measure used to calculate the national indicator for children’s mental wellbeing has changed compared to previous updates of the Wellbeing of Wales report. This indicator is now calculated using the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS) using the School Health Research Network (SHRN) Student Health and Wellbeing Survey. The indicator was previously measured using the Strength and Difficulties Questionnaire (SDQ). This change has been made as SWEMWBS, which captures both a person’s happiness and the extent to which a person is fully functional, is better aligned to the national indicator compared to the SDQ, which is a screening questionnaire for measuring psychological strengths and difficulties. The new measure also aligns better with the measure used for adults’ mental wellbeing (WEMWBS).

A higher overall SWEMWBS score is indicative of more positive mental wellbeing. Scores from the SWEMWBS is based on a shorter set of questions to the adult WEMWBS and so scores are not directly equivalent.

When measuring children’s mental wellbeing using the new measure (SWEMWBS) for the national indicator, the average SWEMWBS score for young people (11 to 16 year olds) was lower in the 2021/22 academic year (23.0), compared to 2017/18 (23.9) indicating a fall in mental wellbeing.

The gap in the average SWEMWEBS score between those from low and high family affluence has narrowed, but only due to a deterioration in the score of those from high family affluence.

Breakdowns by gender, showed those self-identifying as neither a boy nor a girl reported the lowest mental wellbeing, and girls reported lower mental wellbeing than boys. Mental wellbeing scores also declined with age.

78% of young people rated their life satisfaction as 6 or above on the Cantril Ladder (where scores range from 0 to 10, and a score of 6 or above was defined as high life satisfaction) in the 2021/22 academic year, showing a declining trend from the 2017/18 academic year when 85% of young people rated their life satisfaction as 6 or above.

Boys (85%) were more likely than girls (74%) to be satisfied with their life, while life satisfaction was markedly lower among young people who identified as neither a boy nor a girl (43%).

Life satisfaction also declined with age and was lowest in the low family affluence group.

Further data on health behaviour in school-aged children is available from the School Health Research Network Student Health and Wellbeing Survey.

Figure 3.8: Average Short Warwick-Edinburgh Mental Wellbeing Scale score for young people aged 11 to 16, 2017/18 (academic year) to 2021/22

Description of Figure 3.8: A line chart showing the average Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWEBS) score for young people aged 11 to 16 has declined between 2017/18 and 2021/22. The gap in the average SWEMWEBS score between those from low and high family affluence has narrowed, but only due to a deterioration in the score of those from high family affluence

Source: School Health Research Network Student Health and Wellbeing Survey

[Note 1] Y axis does not start at zero

Hazardous housing

A range of factors are important to everyone's health. For example employment, air pollution and housing all impact on overall health outcomes.

Housing conditions in Wales have improved over the 10 years to 2017-18, reducing the potential risk to the health of occupants.

The most recent Welsh Housing Conditions Survey showed that 82% of dwellings were free from the most serious (category 1) hazards in 2017-18, compared with 71% in 2008. There were improvements in all tenures.

The Welsh Government also collects data on Housing Health and Safety Rating System (HHSRS) assessments carried out by local authorities. The latest data shows that in 2022-23, 70% of local authority HHSRS assessments were free from category 1 hazards, consistent with the previous year and the years observed prior to the pandemic. Local authority HHSRS assessments are generally carried out in the private rented sector and only under particular circumstances (for example, when a complaint is received about a dwelling). For this reason, data on local authority HHSRS assessments is not directly comparable with the results of the WHCS.