Long lasting health conditions and illness harmonised standard

This harmonised standard is under development following the Inclusive Data Taskforce recommendations to review and update the harmonised standards every 5 years. This is in line with the GSS Harmonisation Workplan where disability has been identified as a priority topic.

You can find more information about this in the ‘Further information’ section of this guidance. If you would like to be involved with this work, please contact us at Harmonisation@statistics.gov.uk.

Policy details

What we mean by harmonisation

Harmonisation is the process of making statistics and data more comparable, consistent and coherent. This harmonised standard sets out how to collect and report statistics to ensure comparability across different data collections in the Government Statistical Service (GSS). This produces more useful statistics and gives users a greater level of understanding about the topic.

What we mean by long lasting health conditions and illness

Long lasting health conditions and illness is a topic of interest across the UK. All four countries of the UK collect data on long lasting health and illness within their respective censuses.

Together with the activity restriction standard, this standard measures disability for the Equality Act 2010. The Equality Act 2010 defines disability as a physical or mental impairment that impacts daily activities for at least 12 months. This standard does not refer to disability. The way individuals view disability varies and the term itself often makes people think about the most severe physical disabilities. Some individuals with impairments may not identify as being disabled.

Equality Act 2010

Disability is one of the nine protected characteristics identified in the 2010 Equality Act for Great Britain.

To determine whether someone is disabled under the 2010 Equality Act, this standard must be used with the activity restriction standard.

Questions and response options (inputs)

The harmonised question on this topic is designed to collect basic information, for use in the majority of surveys. It is not designed to replace questions used in specialist surveys where more detailed analysis is required.

The question 

Question	Response options
Do you have any physical or mental health conditions or illnesses lasting or expected to last for 12 months or more?	Yes No Spontaneous only: Don’t know Refusal

Using this standard

Guidance for data collection

This question is to be asked to respondents aged 16 and over.

This question can be asked by proxy for respondents aged under 16.

If respondents are too ill to respond on their own behalf, proxy responses from a family member or friend can be recorded. For those not able to speak English, a translator should assist with the data collection.

Spontaneous responses can be recorded but should not be presented as options to respondents.

Using this question in the Welsh language

This harmonised standard was designed in the English language. The England and Wales Census 2021 Welsh translation is:

Oes gennych chi gyflwr neu salwch corfforol neu feddyliol sydd wedi para neu sy’n debygol o bara 12 mis neu fwy?

1. Oes
2. Nac oes

Harmonised standards based on Census research have been tested in the Welsh language, which is why we are able to provide Welsh versions of them. If you are interested in using a Welsh language version of a harmonised standard that has not been translated, please contact us: Harmonisation@statistics.gov.uk.

Guidance on the coverage of conditions and illnesses

Interviewers should provide guidance about the coverage of conditions and illnesses if asked for clarification. For example, a respondent may state their mobility is impaired but is unsure whether this classifies as a long lasting condition or illness.

What is and is not covered

As a guide, this standard includes physical or mental health conditions:

• lasting or expected to last for 12 months or more
• that a person is likely to have for the rest of their life
• that are likely to need some level of supervision and treatment over a long period of time
• that are not curable, even if medication or treatment can control symptoms
• which flare up intermittently, but the exacerbation has a shorter duration than 12 months (for example, hayfever)
• which may not be perceived as serious and do not affect day-to-day activities but are nevertheless long lasting
• which are managed by treatment and lifestyle adjustments and do not affect day-to-day activities, but are nevertheless long lasting

This standard does not capture temporary conditions, however serious they might be.

What this question is designed for

The question is designed to include:

• sensory deficits
• non-temporary mobility problems including dyspraxia and cerebral palsy
• developmental conditions such as Autism Spectrum Disorder (ASD), which includes Asperger’s syndrome, and Attention Deficit Hyperactivity Disorder (ADHD)
• conditions associated with learning impairments such as Down’s syndrome or dyslexia
• common conditions and illnesses, such as asthma, diabetes, heart and other circulatory conditions, respiratory conditions, digestive conditions, anxiety and depression — if they have lasted or are expected to last 12 months or more
• seasonal conditions such as hay fever which recur and have lasted or are expected to recur in the future

This question is not designed to measure impact on an individual’s daily activities. The activity restriction standard measures that.

Types of data collection this standard is suitable for

This question measures any self-reported health conditions or illnesses lasting or expected to last a year or more. It is for use in social surveys.

The standard can be used for:

• interviewer led questionnaires
• Computer Assisted Personal interviewing (CAPI)
• Computer Assisted Telephone Interviewing (CATI)
• paper based and online self-completion forms

Presenting and reporting the data (outputs)

These tables show the output categories for long lasting physical or mental health conditions or illness. We are not prescribing a code but have given examples.

The coding used should comply with the coding conventions used in the specific survey source.

Suggested variable name: HealIll

Response	Example code
Has a long lasting health condition or illness	1
Does not have a long lasting health condition or illnesses	2
Don’t know	-8
Refusal	-9

Implications for classifications

Definition	Example code
EU-SILC: Long standing health problem or illness	1
EU-SILC: No long standing illness	2
EU-SILC: Not severely hampered in daily activities	2
EU-SILC: Not hampered in daily activities to some extent	2
Equality Act: Not core currently disabled	2

Use in the census

This standard, together with the activity restriction standard, was chosen for use in the 2021 Census in England and Wales.

More information on the comparability of census data on long lasting health conditions and illness is in the comparability section of this page.

Comparability

Outputs will be comparable if they have been produced from surveys using these standards. However, we would not recommend comparing levels of long lasting health conditions and illness from outputs using this standard with other outputs that use an alternative measure.

Comparability across the censuses

The 2011 Censuses for England and Wales, Scotland and Northern Ireland all used different questions on long lasting health conditions and illness. None of them produced comparable data on this topic.

The 2021 Census in England and Wales used this standard for long lasting health conditions and illness. However, as this will be different from the questions used in the 2011 Census for England and Wales, the data from these two censuses is not comparable.

The 2021 Census for Scotland used the same question on long lasting health conditions and illness as the 2011 Census for Scotland. This means the data from these two censuses is comparable.  However, the data is still not comparable with data from the 2021 Censuses for England and Wales or Northern Ireland.

Similarly, the 2021 Census for Northern Ireland used the same question on long lasting health conditions and illness as the 2011 Census for Northern Ireland. This means the data from these two censuses is comparable.  However, the data is still not comparable with data from the 2021 Censuses for England and Wales or Scotland.

Examples of when this standard has been used

Surveys that used this standard

• Labour Force Survey
• Family Resources Survey
• Health Survey for England
• Millennium Cohort Study
• National Travel Survey
• Scottish Household Survey
• Living Costs and Food Survey

Further information

Development of this standard

A topic group featuring various government departments, academics and external organisations designed the question.

Various proposals underwent cognitive testing. This testing looked at how respondents react to different versions of the question and checked that the questions correctly capture whether a respondent has a disability according to the Equality Act.

Further information on the development of this standard can be accessed in two Health Statistics Quarterly articles published in Issue 51 in August 2011.

Historical questions

Do you have any long standing illness, disability or infirmity? By long standing I mean anything that has troubled you over a period of at least 12 months or that is likely to affect you over a period of at least 12 months

1. Yes
2. No

Do you have any health problems or disabilities that you expect will last for more than a year?

1. Yes
2. No

Do you have any long standing illness, disability or infirmity by long standing I mean anything that has troubled you over a period of time or is likely to affect you over a period of time?

1. Yes
2. No

Do you have any long standing physical or mental impairment, illness or disability? By long standing I mean anything that has affected you over a period of at least 12 months or that is likely to affect you over a period of at least 12 months?

1. Yes
2. No

Social model of disability 

This standard uses the social model of disability. This model focuses on reducing barriers for disabled individuals whereas the medical model focuses on the specific symptoms, conditions or illnesses that impair them.

An individual with an impairment who lives and works in a suitably adjusted environment may not be considered as disabled under this model.

Inclusive Data Taskforce and GSS Harmonisation Workplan

In October 2020, the National Statistician established the Inclusive Data Taskforce. It was designed to improve the UK’s inclusive data holdings in a broad range of areas. This includes the nine protected characteristics of the Equality Act.

In September 2021 the Taskforce recommendations were published. Some of these recommendations specifically refer to harmonisation.

In response to the recommendations, the Office for National Statistics (ONS) oversaw the publication of an Implementation Plan in January 2022. This gives information about the current and planned initiatives across the UK statistical system. It refers to a GSS Harmonisation Workplan, which was published in February 2022. This workplan includes reviewing, refining, and updating harmonised standards.

The workplan sets out activities for this standard in relation to disability. This includes:

• reviewing the topic area
• working with stakeholders and user groups to make sure disability standards meet user needs
• testing possible improvements and changes to the question design for the disability standards

Timescales for this work will be guided by the feedback the team gets throughout the project. We have:

• run research and engagement activities throughout 2022
• published the first findings from our research and engagement work in our review of the disability harmonised standards

We are now working to:

• carry out further research and engagement activities throughout 2023
• design draft questions for updating the disability standards by winter 2023 — this will depend on our research findings and stakeholder engagement activities
• publish updated online self-completion questions, followed by telephone mode and face-to-face mode questions

You can find updates on timelines and project activities in the GSS Harmonisation Workplan.

Contact us

We are always interested in hearing from users so we can develop our work. If you would like to be involved in this work, or if you use or produce statistics based on this topic, contact us at Harmonisation@statistics.gov.uk.

Updates