1. Main Points
Because of decreasing Annual Population Survey sample sizes, this release is designated as official statistics in development and uses a new method to estimate “good” health prevalence. See the section on ‘New methodology and Official Statistics in Development', below, for more information.
- in 2021-2023 healthy life expectancy at birth was 60.0 years for females, and 59.6 years for males
- healthy life expectancy at birth has been decreasing since 2014-2016 for females and males
- there is a wide gap in healthy life expectancy at birth between different council areas
- in 2021-2023, the Council Areas with the highest estimated healthy life expectancies at birth for both females and males were Orkney Islands, Shetland Islands, and Perth and Kinross
- also in 2021-2023, North Lanarkshire and North Ayrshire had the lowest estimated healthy life expectancy at birth for females and males
2. New methodology and Official Statistics in Development
Estimates of Healthy Life Expectancy (HLE) in this publication are based on how people rate their own health in the Annual Population Survey (APS). Due to issues around decreasing APS sample sizes, it is no longer possible to produce reliable estimates of HLE under the methodology used in our previous HLE publications (which calculated the prevalence of good health by age, sex and local area directly from survey responses).
Because of this, the estimates in this publication were produced by the Office for National Statistics (ONS) using a new methodology. This new methodology, which ONS first used in their December 2024 Healthy Life Expectancy in England and Wales publication (webpage), uses logistic regression modelling to reduce the effect of decreasing APS sample sizes by borrowing strength from the larger sample used in the model. More detailed information about this new methodology can be found in ONS' Estimating "good" health prevalence for use in healthy life expectancy outputs article (webpage), and in the Quality and Methodology Information report Health state life expectancies, UK QMI: 2021 to 2023 - Office for National Statistics (webpage).
Because the estimates in this publication have been produced using a different methodology than in our previous Healthy Life Expectancy publications, this means that they are not comparable to estimates in our previous publications. A back series of estimates from 2013-2015 has been produced using the new method to enable comparisons over time.
This publication is designated as Official Statistics in Development because the Accredited Official Statistics status of ONS outputs using APS data has been suspended. As set out above, ONS have produced the estimates in this publication using the same new methodology used for their most recent Healthy Life Expectancy publications. More information is available in our open letter to the Office for Statistics Regulation (OSR) (webpage).
3. Healthy life expectancy in Scotland
What is Healthy Life Expectancy (HLE)?
HLE is the average number of years of life that people are estimated to spend in good health. Good health is based on how people rate their own health in the Annual Population Survey (APS). Similar to life expectancy, healthy life expectancy is an average: some individuals may fall into ill health younger than the average, and others may remain in good health longer than the average.
Healthy Life Expectancy at birth
In 2021-2023, HLE at birth was 60.0 (±0.8*) years for females and 59.6 (±0.7) years for males.
In 2021-2023, HLE at birth is lower than in 2013-2015 for females and males.
Since the start of the time series in 2013-2015, HLE was highest for both sexes in 2014-2016, and has been decreasing since then. In 2021-2023, HLE is the lowest it has been for both sexes since the start of the time series in 2013-15.
Since 2013-2015, HLE at birth has been higher for females than for males. The gap has narrowed over time, and female and male HLE at birth has been more similar in recent years.
*Please see the Why do we report confidence intervals? section for more information on the confidence intervals presented in brackets alongside HLE estimates.
Figure 1: Healthy life expectancy at birth has been decreasing for females and males after 2014-2016
Healthy life expectancy at birth, Scotland, 2013-2015 to 2021-2023
Note: Please note that the y-axis starts at 40 years, rather than at 0 years. This is so that it is easier to see detail in the chart, however we would caution users that the scale may make small changes over time appear larger than they are.
Healthy Life Expectancy aged 65-69
In 2021-2023, HLE for females aged 65-69 was 10.7 (±0.3) years, and healthy life expectancy for males aged 65-69 was 9.6 (±0.3). Over the past decade, HLE for females and males aged 65-69 has remained stable, with some small variations from period to period. HLE for females aged 65-69 has been consistently higher than HLE for males in the same age group.
Figure 2: Healthy life expectancy at age 65-69 has remained stable over the past decade for females and males
Healthy life expectancy at age 65-69, Scotland, 2013-2015 to 2021-2023
It is interesting to note that healthy life expectancy at birth has generally fallen over the last decade, but HLE for those aged 65-69 has remained relatively stable.
Similar to life expectancy, healthy life expectancy is an average which is affected by people falling into ill health at younger ages as well as in old age.
If the proportion of people aged 65-69 reporting that they are in good health hasn’t changed very much, but the proportion of younger people reporting that they are in good health has decreased, we might expect to see HLE at birth fall but HLE at age 65-69 remain similar.
The stability in HLE for those aged 65-69 for both females and males suggests that decreasing HLE at birth may be driven by worsening health in younger age groups.
Can the impact of COVID-19 be seen in the figures?
These HLE figures are calculated for three-year periods. This means that years of the COVID-19 pandemic are included in several of the estimates.
Analysis of the effect of COVID-19 on life expectancy is available in the 2019-2021 edition of our report Life Expectancy in Scotland (webpage).
4. Change in healthy life expectancy compared with change in overall life expectancy
We compare healthy life expectancy (HLE) to overall life expectancy (LE) to see the proportion of life spent in good health. Please see our Life Expectancy in Scotland publication (webpage) for more information on overall life expectancy in Scotland.
Female LE has been consistently higher than male life expectancy across the time series. Female HLE has also been higher than male HLE, but by a much smaller margin. This means that females spend a greater proportion of their life in poor health than males.
As the proportion of LE which is spent in good health is created using two estimates (LE and HLE) which both have uncertainty around them, additional caution is required when interpreting these figures, particularly where differences between estimates are relatively small.
Figure 3: Females spend a greater proportion of their life in poor health than males
Healthy life expectancy at birth presented as a proportion of life expectancy at birth for females and males, 2021-2023
LE for females has not changed much from 2013-2015 to 2021-2023, although it has fallen slightly over the past three years. Female HLE has been falling since 2014-2016.
Figure 4a: Healthy life expectancy at birth has fallen at a faster rate than life expectancy at birth for females
Healthy life expectancy and life expectancy at birth, 2013-2015 to 2021-2023, females
Note: Please note that the y-axis starts at 40 years, rather than at 0 years. This is so that it is easier to see detail in the chart, however we would caution users that the scale may make small changes over time appear larger than they are.
Confidence intervals around estimated life expectancy are too narrow to be visible in the chart.
Although both LE and HLE for males have both decreased overall over the past decade, HLE has fallen at a faster rate than life expectancy. This means that a greater proportion of life is likely to be spent in poor health now than in previous years.
Figure 4b: Healthy life expectancy at birth has also fallen at a faster rate than life expectancy at birth for males
Healthy life expectancy and life expectancy at birth, 2013-2015 to 2021-2023, males
Note: Please note that the y-axis starts at 40 years, rather than at 0 years. This is so that it is easier to see detail in the chart, however we would caution users that the scale may make small changes over time appear larger than they are.
Confidence intervals around estimated life expectancy are too narrow to be visible in the chart.
As shown below in Figure 5, as age increases, LE and HLE both decrease, as expected.
The difference in the proportion of life in good health between males and females narrows as age increases.
Figure 5: As age increases, the proportion of remaining LE spent in good health decreases
Healthy life expectancy and life expectancy at all ages in Scotland, 2021-2023
5. Healthy life expectancy in Scotland, England, and Wales
This section compares estimates for Scotland with estimates for England and Wales for the same period, which were published by ONS in December 2024 (webpage). There are no comparable estimates for Northern Ireland, and thus the UK as a whole, available yet.
Compared to Scotland, healthy life expectancy (HLE) is higher in England for both females and males. HLE in Wales is more similar to Scotland, particularly for females. In each country, HLE has been falling in recent years.
Figure 6: Healthy Life Expectancy at birth has been falling in Scotland, England and Wales in recent years
Healthy Life Expectancy at birth in Scotland, England and Wales, 2013-2015 to 2021-2023
Note: Please note that the y-axis starts at 55 years, rather than at 0 years. This is so that it is easier to see detail in the chart, however we would caution users that the scale may make small changes over time appear larger than they are.
Source for England and Wales HLE estimates: Healthy life expectancy in England and Wales - Office for National Statistics
6. Healthy life expectancy in council areas
Caution: There is greater uncertainty around healthy life expectancy estimates for smaller populations
Some of the council areas and health boards with smaller populations have very wide confidence intervals, indicating a greater amount of uncertainty around the true value of the estimates. For example, in Shetland, healthy life expectancy (HLE) for males is estimated to be 67.2 years. The confidence interval is ±10.7 years, which means the true HLE could be anything from 56.5 years (a low HLE) to 77.9 years (a very high HLE).
This larger amount of uncertainty means that great care must be used when comparing the estimates of these small areas, which have wide confidence intervals.
For females in 2021-2023:
- there is a wide gap between HLE at birth in different council areas, as shown in Figure 7a below
- the councils with the highest HLE at birth were Orkney Islands (72.1 (±10.4) years), Shetland Islands (70.0 (±11.5) years) and Perth and Kinross (66.6 (±3.7) years)
- the councils with the lowest HLE at birth were North Lanarkshire (52.5 (±4.3) years) and North Ayrshire (52.5 (±5.1) years)
Figure 7a: There is a wide gap between the highest and lowest HLE by council area for females
Healthy life expectancy at birth in council areas with 95% confidence intervals, 2021-2023, females
Note: Please note that the y-axis starts at 40 years, rather than at 0 years. This is so that it is easier to see detail in the chart, however we would caution users that the scale may make small changes over time appear larger than they are.
For males in 2021-2023:
- there is a wide gap between HLE at birth in different council areas, as shown in Figure 7b below
- the councils with the highest HLE at birth were Orkney Islands (70.4 (±8.3) years), Shetland Islands (67.2 (±10.7) years) and Perth and Kinross (65.4 (±3.1) years)
- the councils with the lowest HLE at birth were North Ayrshire (52.6 (±4.7) years) and North Lanarkshire (53.2 (±4.1) years)
Figure 7b: There is also a wide gap between the highest and lowest HLE by council area for males
Healthy life expectancy at birth in council areas with 95% confidence intervals, 2021-2023, males
Note: Please note that the y-axis starts at 40 years, rather than at 0 years. This is so that it is easier to see detail in the chart, however we would caution users that the scale may make small changes over time appear larger than they are.
7. Healthy life expectancy in NHS health boards
Caution: There is greater uncertainty around healthy life expectancy estimates for smaller populations
Please see the note above in Section 6 for more information.
For female healthy life expectancy (HLE) at birth in 2021-2023:
- NHS Orkney, NHS Shetland and NHS Borders had the highest healthy life expectancy estimates of all the health boards (72.1 (±10.4), 70.0 (±11.5) and 64.6 (±4.3) years respectively).
- NHS Lanarkshire and NHS Ayrshire and Arran had the lowest healthy life expectancy estimates (55.3 (±2.9) and 55.3 (±3.1) years respectively).
Figure 8a: As by Council Area, HLE varies widely by Health Board for females
Healthy life expectancy at birth by health board with 95% confidence intervals, 2021-2023, females
For male HLE at birth in 2021-2023:
- NHS Orkney, NHS Shetland and NHS Borders had the highest healthy life expectancy estimates of all the health boards (70.4 (±8.3), 67.2 (±10.7) and 63.4 (±3.6) years respectively).
- NHS Lanarkshire and NHS Ayrshire and Arran, had the lowest healthy life expectancy estimates (55.4 (±2.7) and 55.7 (±2.7) years respectively).
Figure 8b: HLE also varies widely by Health Board for males
Healthy life expectancy at birth by health board with 95% confidence intervals, 2021-2023, males
8. In development: Healthy life expectancy by Area Deprivation and Urban and Rural areas
We are investigating how to produce estimates of healthy life expectancy by area deprivation and urban and rural areas under the new methodology. ONS published the first estimates for England and Wales by area deprivation using the new methodology on 4 July 2025. We are working with ONS to adapt the new method to work with Scottish data.
We plan to include estimates by area deprivation and urban and rural areas in our next Healthy Life Expectancy publication. This will include estimates for previous three-year periods using the new methodology, to allow comparisons over time.
9. Background
What is healthy life expectancy?
Healthy life expectancy (HLE) is an estimate of the number of years lived in ‘very good’ or ‘good’ general health, based on how individuals perceive their state of health.
How are the statistics calculated?
As set out in the New Methodology and Official Statistics in Development section above, estimates of HLE in this publication are based on how people rate their own health in the Annual Population Survey (APS). Due to issues around decreasing APS sample sizes, it is no longer possible to produce reliable estimates of Healthy Life Expectancy under the methodology used in our previous Healthy Life Expectancy publications (which calculated the prevalence of good health by age, sex and local area directly from survey responses).
HLE estimates for Scotland in this publication are based on data collected as part of the Annual Population Survey (APS). Data from the 2011 Census and 2022 Census were used to obtain health state prevalence rates. Survey data are not routinely collected for those aged under 16 years, and only sparsely for those aged 85 years and over, so data from the 2011 and 2022 Censuses were used to produce imputation adjustment factors and census-based health state prevalence.
More detailed information about this new methodology can be found in ONS' Estimating "good" health prevalence for use in healthy life expectancy outputs article (webpage), and in the Quality and Methodology Information report Health state life expectancies, UK QMI: 2021 to 2023 - Office for National Statistics (webpage).
More information on the life expectancy figures included in this publication is available in our Life Expectancy in Scotland (webpage) publication. More detailed information on methodology for our Life Expectancy statistics is available in the Life Expectancy for Scotland methodology document (PDF, 576KB), however please note that this document also contains information on our previous HLE methodology that is not relevant for this 2021-2023 publication.
Why is it useful to analyse healthy life expectancy?
Healthy life expectancy provides insight into the proportion of life expectancy spent in good health.
It is important to understand how healthy life expectancy and life expectancy are changing relative to each other, as this can determine the current and future health state of the population. For this reason, HLE is of particular use in monitoring and investigating the health inequalities across Scotland and directing public health targets.
These figures are also used to help deliver local and national services in addition to use for teaching and research purposes.
Why do we report confidence intervals?
95% confidence intervals are included to measure the uncertainty around the estimates. In this report, the confidence intervals are quoted in brackets beside the central estimate, for example 65 (±0.7) years. The plus-minus sign, ±, indicates that the upper limit of the confidence interval can be found by adding the figure in the bracket to the central estimate, and the lower limit can be found by subtracting the figure in the brackets from the central estimate. In this example, the upper limit would be 65.7 years, and the lower limit would be 64.3 years.
95% confidence intervals are calculated so that, if the analysis to produce an estimate was repeated many times, 95% of the time the true unknown value would lie between the lower and upper confidence limits.
Estimates from larger populations, such as Scotland as a nation, will have smaller confidence intervals than estimates for smaller populations, such as Council Areas and Health Boards. The larger amount of uncertainty around estimates for smaller geographies means that extra caution must be taken when making comparisons between estimates.
10. Related Statistics
ONS have produced healthy life expectancy estimates using the new methodology for England and Wales: Healthy life expectancy in England and Wales - Office for National Statistics (webpage). These estimates are comparable to the Scotland estimates in this report, and comparisons between these estimates are made in Section 5 above.
ONS have also published the statistics featured within this publication on their own website, as an ad-hoc release.
ONS have also produced statistics on healthy life expectancy by area deprivation for England and Wales: Healthy life expectancy by national area deprivation, England and Wales - Office for National Statistics (webpage). As mentioned in Section 8 above, we are investigating how to adapt the new methodology so that we can produce estimates of HLE by area deprivation for Scotland which can be compared to these ONS estimates for England and Wales.
11. Information about our statistics
Official Statistics in Development
These statistics are designated as Official Statistics in Development.
In previous years, our Healthy Life Expectancy publication has been designated as Accredited Official Statistics. The new methodology used in this publication was developed by ONS and first used in their latest Healthy Life Expectancy publication. Estimates produced using this methodology are based on results from the Annual Population Survey (APS).
Following an evaluation of the quality of statistics based on the APS, ONS requested suspension of Accredited Official Statistics status for their outputs based on the APS, which includes their HLE publications. Concerns centred around estimates for smaller geographies, which are particularly relevant to Scotland given its relatively smaller population compared to the UK, and having several Local Authorities and Health Boards with particularly small populations.
We have designated this publication as Official Statistics in Development to ensure statistical coherence, and to make the limitations of the results clear to users. More information is available in our open letter to the Office for Statistics Regulation (OSR) (webpage).
Information on background and source data
Further details on data source(s), timeframe of data and timeliness, continuity of data, accuracy, etc. can be found in the metadata that is published alongside this publication on the NRS website.
We also provide information about upcoming publications on our website.
If you would like receive updates on our statistics, you can register your interest on the Scottish Government ScotStat website.
