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Healthy life expectancy in the EU 15

Healthy life expectancy in the EU 15. Carol Jagger EHEMU team. Europe Blanche XXVI Living Longer but Healthier lives Budapest November 2005. Monitoring population ageing. Most countries are seeing year on year increase in life expectancy at birth and at older ages

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Healthy life expectancy in the EU 15

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  1. Healthy life expectancy in the EU 15 Carol Jagger EHEMU team Europe Blanche XXVI Living Longer but Healthier lives Budapest November 2005

  2. Monitoring population ageing • Most countries are seeing year on year increase in life expectancy at birth and at older ages • Are we exchanging longer life for poorer health (expansion of morbidity scenario) or are the extra years spent in good health (compression of morbidity)? • Do these trends hold for all countries, all social groups, men and women? • Health expectancies provide the answer as they extend the notion of life expectancy to different health dimensions, thus adding quality to quantity of life lived

  3. Purpose • To explore compression or expansion of healthy life and gender differences through cross-national comparisons of healthy life expectancy at birth and age 65 among EU countries between 1995 and 2003 • In preparation for the new EU structural indicator Healthy Life Years • Using disability-free life expectancy (DFLE) as a measure of healthy life expectancy

  4. Data and methods Estimation of DFLE and 95% CI, using Sullivan method • age specific probability of death: Eurostat life tables • age specific disability prevalence: European Community Household Panel 1995-2001 question ‘Are you hampered in your daily activities by any physical or mental health problem, illness or disability? ‘ • Some interpolation for odd missing values and extrapolation of trends for 2002-3

  5. DFLE calculation Age specific disability prevalence from ECHP Eurostat Life table Life expectancy LE free of disability (DFLE) LE with disability

  6. Distribution of LE and DFLE at birth EU(14), 1995-2003 Women Men LE

  7. Distribution of LE and DFLE at birth EU(14), 1995-2003 Women Men LE DFLE

  8. Distribution of LE and DFLE at birth EU(14), 1995-2003 • By 2003 LE at birth in the EU14 ranged from 74.2 (Portugal) to 78 (Sweden) years for men and 80.1 (Denmark) to 83.2 years (France) for women, following a steady increase from 1995. • Compared to LE, trends in DFLE were more variable although gender differences were smaller • Between 1995-2003 the gain in total years for men exceeded the gain in years free of disability • In women there was only a slight improvement, on average, in life expectancy with a similar gain in disability-free life years.

  9. Trends in LE and DFLE at age 65 in EU (14), 1995-2003 Men

  10. Trends in proportion of life spent disability-free at age 65 Men = gain of 5% + between 1995 and 2001 = gain or loss of less than 5% between 1995 and 2001 = loss of 5% + between 1995 and 2001

  11. Trends in proportion of life spent disability-free at age 65 Women = gain of 5% + between 1995 and 2001 = gain or loss of less than 5% between 1995 and 2001 = loss of 5% + between 1995 and 2001

  12. Men Austria, Belgium, Italy, Finland, Germany France, Greece, Ireland, Spain Denmark, Portugal,Netherlands, Sweden, UK Women Belgium,Italy, Sweden Austria, Denmark, UK, Finland, France, Spain, UK Germany, Greece, Ireland, Netherlands, Portugal Trends in the proportion of life spent disability-free at age 65

  13. Trends in DFLE using the ECHP • Life expectancy: • Small variation in LE between these 14 MS • Increase between 1995-2003 • Disability Free Life Expectancy and %DFLE/LE • Large variation in DFLE between these 14 MS • Diverging trends over 1995-2003: reduction / stagnation / increase in the proportion of life with reported disability at age 65 while LE increases • Gender differences in trends

  14. Real or artefact? May be an artefact due to • Data problems • Sampling • Omission of institutionalised population • Not harmonised disability question • Cultural differences in reporting of disability • Confounding factors – socio-economic But trends less sensitive to these If real what is ‘cause’

  15. Conclusions • Population aging has a different impact in the 14 Member States in Europe: - different levels of reported disability (larger dispersion than LE) - variation in the magnitude of the gender difference - different trends over time • Need to improve cross-national comparisons in self-reported disability to ensure differences are not an artefact: - improved harmonisation of the instruments - using different levels of severity - documenting differences in reporting - documenting differences in selection in the panel

  16. Healthy life expectancy in the EU 15 Carol Jagger EHEMU team Europe Blanche XXVI Living Longer but Healthier lives Budapest November 2005

  17. Data and Methods • Problems in both • mortality and the panel data • 1) Data base • Probable data errors • Replacement with other sources • Missing • 2) Interruption of data collection • No data for 2002 and 2003 • Solutions • 1) Data base • Linear imputation of age pecific probabilities (death and disability) • Shift of the prevalence trend to the ECHP level • Imputation of data according to observed trends • 2) Interruption of data collection • Linear extrapolation of the disability prevalence

  18. Trends in LE and DFLE at age 65 in EU (14), 1995-2003 Women

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