ObjectiveOur aim was to compare the effect of central obesity (measured by waist-to-height ratio, WHtR) and total obesity (measured by body mass index, BMI) on life expectancy expressed as years of life lost (YLL), using data on British adults.MethodsA Cox proportional hazards model was applied to data from the prospective Health and Lifestyle Survey (HALS) and the cross sectional Health Survey for England (HSE). The number of years of life lost (YLL) at three ages (30, 50, 70 years) was found by comparing the life expectancies of obese lives with those of lives at optimum levels of BMI and WHtR.ResultsMortality risk associated with BMI in the British HALS survey was similar to that found in US studies. However, WHtR was a better predictor of mortality risk. For the first time, YLL have been quantified for different values of WHtR. This has been done for both sexes separately and for three representative ages.ConclusionThis study supports the simple message “Keep your waist circumference to less than half your height”. The use of WHtR in public health screening, with appropriate action, could help add years to life.

This paper develops a multiple state model to project the number of people with disabilities in the United Kingdom over the next 35 years, thereby identifying implications for demand for long-term care for the elderly in the future.The model requires three types of data: prevalence rate data, transition rate data and trends data. Recent trends in healthy life expectancy data are used to frame the assumptions made regarding changes in the disability rates of the U.K. population in the future.Although there will be a large increase in the number of elderly people in the U.K. over the next 35 years, the projections suggest that the implications for the number of elderly people requiring long-term care could be ameliorated by a reduction in the proportion of older people who are severely disabled.

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