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Healthy Life Expectancy in Developing Countries in Asia. Vicki L. Lamb Center for Demographic Studies Duke University. Life Expectancy (LE). The expected number of years to be lived from age x (typically from birth) Measure of population health
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Healthy Life Expectancy in Developing Countries in Asia Vicki L. Lamb Center for Demographic Studies Duke University
Life Expectancy (LE) • The expected number of years to be lived from age x (typically from birth) • Measure of population health • LE is increasing over time in Asia and around the world
Life expectancy at birth:Selected Asian countries, 1990-2002 World Bank Indicators, 2003
Life Expectancy (LE) • The expected number of years to be lived from age x (typically from birth) • Measure of population health • LE is increasing over time in Asia and around the world • Result: an increase in Asian populations, particularly at older ages
Percent of total population aged 65 years and older, 1990-2002 World Bank Indicators, 2003
Major Question: • What is the state of health associated with longer life ? • More ill-health and disabilities, and greater suffering? • Longer period of life in good health? • Dynamic equilibrium between health and years of life?
Healthy life expectancy (HLE) • The expected number of years to be spent in good health from age x • “Health” usually refers to functional abilities or self-rated health • Advantage of HLE: ease in interpretation • LE @ 65 = 20.9 yrs*; HLE @ 65 = 18.3 yrs* • % of LE in good health: HLE/LE = .88 *Females in Japan, 1995
Estimating healthy life expectancy using the Sullivan (1971) method and life tables: DPR = Disability prevalence rate for age x from survey data • Lx(hs) = (1 - DPR) * Lx[person years spent in health] • Tx(hs) = x=t L [x(hs) + t][total person years lived in health] • ex(hs) = Tx(hs) / lx[healthy life expectancy] Note: hs=healthy state
REVES: Réseau Espérance de Vie en Santé • International Research Network on Health Expectancy • First meeting in Quebec in 1989 • Concern over the effects of increased life expectancy on population health • Goals are to collect, standardize, and improve national estimates of HLE
REVES research on developing countries • First estimates of HLE for developing countries were presented at the 3rd REVES meeting in 1991: • China (Grab, Dowd, and Michel), • Taiwan (Tu and Chen), and • Burma, Indonesia, Sri Lanka, and Thailand, (Lamb and Andrews) • Additional countries (e.g., Latin America) have been studied since that time
Burma (1989) China (1987, 1992, 1998-2000) Indonesia (1989) S. Korea (1984, 1989) N. Korea (1989) Malaysia (1984) Philippines (1984) Singapore (1995) Sri Lanka (1989) Taiwan (1986, 1991) Thailand (1986, 1989, 1995, 1996) Japan (1966, 1970, 1974-85, 1987, 1990, 1995) HLE estimates in Asia (year of study):
What are the trends in life expectancy and healthy life expectancy in the developing countries in Asia?
Life Expectancy (LE) and Healthy Life Expectancy (HLE), China, 1987 • Females are advantaged with more years of life and more years of healthy life. Grab et al., 1991
Similar trends in other Asian countries: Life Expectancy @ 65 Healthy Life Expectancy @ 65 Females Males Males
Percent of life to be spent in health @ 65, (HLE/LE) China, 1987 • Males have the advantage with a greater percent of healthy life years. Grab et al., 1991
Percent of Healthy Life @ 65 in selected Asian countries: Females Malaysia,1984 Thailand,1989 China,1992 Indonesia,1989 Thailand,1996 N.Korea,1989 Singapore,1995 Burma, 1989 Taiwan,1991 China,1987 S. Korea,1984 Sri Lanka,1989 Taiwan,1986 Thailand,1995 [SRH] Thailand,1986 [SRH] Males
Trends in HLE • For several countries we have more than one estimate • These estimates can show us possible trends in HLE and percent HLE
Trends in LE @ 65 for selected countries: Females Thailand 1986;1989;1996 China 1987;1992 Taiwan 1986;1991 Males
Trends in HLE @ 65 for selected countries: Females Thailand 1989;1996 China 1987;1992 Taiwan 1986;1991 Thailand [SRH] 1986;1995 Males
Results: • For all three countries: • Years of total life expectancy has increased • Years of healthy life expectancy has increased • What about percent HLE?
Trends in % HLE for selected countries: Thailand 1989;1996 *Little change* China 1987;1992 Taiwan 1986;1991 Thailand [SRH] 1986;1995 *Little change*
Results: • There has been an increase in the percent of HLE years for China and Taiwan • The Thailand rates show little change • More research is needed
Issues in measuring/studying HLE: • Accurate estimates of population health and disability via national health surveys: • representative samples • consistent measures of “health” • Valid life tables to estimate trends in mortality: • source of life table data • year of life table estimates VS. the year the health data are collected
Why study Healthy Life Expectancy? • Population aging and increased LE • Compare health of older persons in countries at different levels of development • “Elderly dependency load” reconsiderations • how long can persons work • how long can persons be self-sufficient • Policy concerns on the well-being and care of older persons in poor health