Alzheimer’s disease and dementia are the biggest cause of death among women, according to a government report on the state of the nation’s health.

Public Health England (PHE)’s report, which uses population health data to produce a wide-ranging national report for the first time, suggests that while life expectancy has been steadily increasing – now 79.5 years for men and 83.1 years for women – more of those extra years are now spent in poor health.

Women can expect to live nearly a quarter of their lives in ill-health and men a fifth. The causes of death have shifted since the turn of the century, the analysis found, with the rise in deaths from dementia and Alzheimer’s the most significant features – alongside declines in other diseases.

“Since 2001, death rates from heart disease and stroke have halved for both males and females,” the report said. “Over the same time deaths from dementia and Alzheimer’s have increased by 60% in males and have doubled in females.”

In 2015, heart disease was the most common cause of death among men, but Alzheimer’s and dementia are now the most likely among women. These diseases are better diagnosed, while the prevention and treatment of heart disease have improved.

The report prompted warnings that investment in dementia research must not slow. Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “To achieve the same successes as we have with other health conditions like heart disease and cancer, we need dementia research to remain a national priority. We have been able to make promising steps forward, thanks to a renewed focus, but we are not there yet.”

The PHE report also sheds light on the ailments that afflict people in earlier years. Lower back and neck pain are the biggest cause of ill-health in England, while obesity is the biggest risk factor for becoming unwell.

Where you live and how you live make a big difference to the likely length of your life and chances of good or poor health. Men and women in the most deprived areas can expect to spend 20 years fewer in good health compared with those living in the least deprived areas.

The PHE director of health improvement, John Newton, said: “For both men and women, almost half the population live in areas where healthy life expectancy is slightly less than the current state pension [age]. It is a slightly larger proportion of men than women ... [but] a significant proportion of our population cannot expect to live in their pension age in good health.”

Diabetes, most of which is type 2 and linked to being overweight, has for the first time become one of the top 10 causes of ill-health and disability. The bill has been predicted to potentially cripple the NHS, which spends £14bn a year on testing and treatment.

But lower back pain and neck pain are ranked ahead of diabetes. Part of that is down to the ageing population, but excess weight and lack of activity are also factors.

Among men, skin disorders, such as acne and psoriasis, are the second most common cause of ill-health, although they are three times less common than lower back and neck pain. Third among men and second among women is depression.

Lifestyle, poverty and education all make a difference to health. Among the medical risks are being overweight or obese and having high cholesterol. High BMI (body mass index, a measurement of obesity) can lead to heart disease, stroke, osteoarthritis, back pain, chronic kidney disease, diabetes and some cancers.

“Behavioural risks include smoking, alcohol and unsafe sex, while environmental and occupational risks include air pollution, unclean water and other risks due to the working or living environment,” said the report.