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Comparison of HLY according to different health surveys

Comparison of HLY according to different health surveys. 4th Meeting of the Task Force on Health Expectancies Luxembourg, 4 th June 2007 Bianca Cox. Introduction. EHEMU Information System : Health expectancies for 25 European countries Demographic data

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Comparison of HLY according to different health surveys

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  1. Comparison of HLY according to different health surveys 4th Meeting of the Task Force on Health Expectancies Luxembourg, 4th June 2007 Bianca Cox

  2. Introduction • EHEMU Information System : Health expectancies for 25 European countries • Demographic data Eurostat + national statistical centers • Health data Eurostat, DG SANCO, Mannheim University  from different European surveys

  3. Introduction

  4. Introduction • Are the health expectancies for a given country comparable between the surveys? • Surveys carried out in the same year (2004): ESS, SHARE, SILC  Common health indicators : • Self-Percieved Health (SPH) • Activity Limitation (AL)

  5. Data • Health expectancies comparison WITHIN country : same demographic data • Raw health data (prevalences) • Self-Percieved Health : good, fair, bad  • Activity Limitation : without, moderate, severe • Average over 5-year age groups: 50-54, 55-59,…, 85+

  6. Analyses • Health expectancies : graphical exploration • Prevalences : logistic regression  Separate model for each health state and gender • Overall models : • Main effects : survey, agegr, country • Interactions : survey*agegr, survey*country, agegr*country • Country-specific models : • Main effects : survey, agegr • Interactions : survey*agegr  Odds ratio estimates of one survey vs the other for agegroups 50, 65 and 85+

  7. Results : Graphical exploration SPH health expectancies

  8. Results : Graphical exploration AL health expectancies

  9. Results : Graphical exploration health expectancies • Common trend in some countries : • Self-Perceived Health : • Good : SHARE > ESS > SILC • Bad : SHARE < ESS < SILC • Activity Limitation : • Without : ESS > SILC > SHARE • Severe : ESS < SHARE < SILC • Confidence intervals of health expectancies : SILC << SHARE < ESS

  10. Results : Logistic models on prevalences • Overall models : • Survey*agegr, survey*country, agegr*country • SPH: sign. in all 6 models • AL: sign. in 4 models (not in ♀models for “without” & “severe”) •  Effect of survey different for different age groups and countries • Country-specific models : • Odds ratio estimates of one survey vs the other for age groups 50, 65 and 85+

  11. Results : Logistic models on SPH prevalences + or - odds ratio > 1 or odds ratio < 1 A & B number of models with a significant odds ratio C number of models with a odds ratio > 1

  12. Results : Distribution of odds ratio estimates for SPH Good SPH males SH > ES > SI Good SPH females Bad SPH males SH (<) ES < SI Bad SPH females

  13. Results : Logistic models on AL prevalences + or - odds ratio > 1or odds ratio < 1 A & B number of models with a significant odds ratio C number of models with a odds ratio > 1

  14. Results : Distribution of odds ratio estimates for AL Without AL males ES > SI > SH Without AL females Severe AL males ES < SH < SI Severe AL females

  15. Discussion • Significant effect of survey, different for different age groups and countries • Still : odds ratios show common trend across age groups and countries • Good SPH : SH > ES > SI • Bad SPH : SH (<) ES < SI • Without AL : ES > SI > SH • Severe AL : ES < SH < SI • Significance of odds ratios increases with age but also the variability in the distribution of the odds ratio estimates  chance effects due to smaller sample sizes

  16. Discussion • Possible reasons for differences between surveys : • Different sampling designs : Sr = Simple random sampling Systrs = Systematic random sampling Stratrs = Stratified random sampling Ms = Multi-stage sampling Final sampling units: P = Persons H = Households A = Addresses T = Telephone numbers D = Dwellings But : Sampling design depends more on country than on survey  Survey design often constrained by what is available in the country

  17. Discussion • Possible reasons for differences between surveys : • Different selection bias : e.g. participation / item response • Different sample sizes : SILC > SHARE > ESS • Different position in questionnaire • Differences in wording: • SPH : “ How is your health in general ? ” ESS & SILC general questionnaires : “health” further specified (f.e. including mental health) in footnote or between brackets  Also in country-specific questionnaires or spoken out by interviewer ??

  18. Discussion • AL : - ESS : “ Are you hampered in your daily activities in any way by any longstanding illness, or disability, infirmity or mental health problem ? ” - SHARE & SILC : “ For the past six months at least, to what extent have you been limited because of a health problem in activities people usually do ? ”

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