scholarly journals Income inequality in disability-free life expectancy in Denmark

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Brønnum-Hansen ◽  
E Foverskov ◽  
I Andersen
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Social Inequality ◽  
Socioeconomic Position ◽  
Life Tables ◽  
Register Data ◽  
Disposable Income ◽  
Inequality In Health ◽  
Disability Free Life Expectancy ◽  
The Difference

Abstract Background The state old-age pension in Denmark is adjusted in line with the projected increasing life expectancy without taking social inequality in health and life expectancy into account. The purpose of the study was to estimate income disparities in life expectancy and disability-free life expectancy (DFLE) at age 50. Methods By linking nationwide register data on income and mortality each individual at any age was divided into equivalised disposable income quartiles and life tables were constructed for each quartile. Data from the Danish Survey of Health, Ageing and Retirement in Europe (SHARE) was linked to register data providing access to information on respondents equivalised disposable income. Finally, data from the life tables were combined with prevalence on activity limitations by income quartiles from SHARE to estimate DFLE by Sullivan’s method. Differences in DFLE were investigated and decomposed into contributions from mortality and disability effects. Results A clear social gradient was seen for life expectancy as well as DFLE. Thus, life expectancy at age 50 differed between the highest and lowest income quartile by 8.0 years for men and 5.0 years for women. The difference in DFLE was 11.8 and 10.3 years for men and women, respectively. For men the mortality effect from the decomposition contributed by 4.1 years to the difference of 11.8 years in DFLE and 3.9 years to the difference in expected years with disability of 3.8 years while the disability effect contributed by 7.7 years. Conclusions The study quantifies social inequality in health in Denmark. Although income inequality in life expectancy and DFLE can partly be explained by loss of income due to chronic diseases, one would expect a welfare state to provide better financial security for citizens with health problems. Furthermore, the marked social disparity when approaching retirement age is questioning the fairness of implementing a pension scheme independently of socioeconomic position. Key messages Disability-free life expectancy differs between income quartiles by more than 10 years. Pension age follows the projected increasing life expectancy independently of socioeconomic position. This seems unfair.

Income inequality in life expectancy and disability-free life expectancy in Denmark

2020 ◽  
pp. jech-2020-214108
Author(s):  
Henrik Brønnum-Hansen ◽  
Else Foverskov ◽  
Ingelise Andersen
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Register Data ◽  
Income Quintile ◽  
Mortality Data ◽  
Activity Limitations ◽  
Important Indicator ◽  
Mortality Effect ◽  
Disability Free Life Expectancy ◽  
The Difference

BackgroundIncome has seldom been used to study social differences in disability-free life expectancy (DFLE). This study investigates income inequalities in life expectancy and DFLE at age 50 and 65 and estimates the contributions from the mortality and disability effects on the differences between income groups.MethodsLife tables by income quintile were constructed using Danish register data on equivalised disposable household income and mortality. Data on activity limitations from the Danish part of the Survey of Health, Ageing and Retirement in Europe (SHARE) was linked to register data on income. For each income quintile, life table data and prevalence data of no activity limitations from SHARE were combined to estimate DFLE. Differences between income quintiles in DFLE were decomposed into contributions from mortality and disability effects.ResultsA clear social gradient was seen for life expectancy as well as DFLE. Life expectancy at age 50 differed between the highest and lowest income quintiles by 8.6 years for men and 5.5 years for women. The difference in DFLE was 12.8 and 11.0 years for men and women, respectively. The mortality effect from the decomposition contributed equally for men and slightly more for women to the difference in expected lifetime without than with activity limitations. The disability effect contributed by 8.5 years for men and 8.0 years for women.ConclusionThe income inequality gradient was steeper for DFLE than life expectancy. Since income inequality increases, DFLE by income is an important indicator for monitoring social inequality in the growing share of elderly people.

scholarly journals Estimating social inequality in mortality and life expectancy in absence of register data in Germany

2017 ◽  
Vol 27 (suppl_3) ◽  
Author(s):  
LE Kroll ◽  
J Baumert ◽  
M Busch ◽  
C Scheidt-Nave ◽  
T Lampert ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Social Inequality ◽  
Register Data

Persistent social inequality in life expectancy and disability-free life expectancy: Outlook for a differential pension age in Denmark?

2016 ◽  
Vol 45 (4) ◽  
pp. 459-462 ◽  
Author(s):  
Henrik Brønnum-Hansen ◽  
Mette Lindholm Eriksen ◽  
Karen Andersen-Ranberg ◽  
Bernard Jeune
Keyword(s):  
Life Expectancy ◽  
Social Inequality ◽  
Educational Level ◽  
Average Life Expectancy ◽  
Men And Women ◽  
Level Of Education ◽  
Disability Free Life Expectancy ◽  
Low Levels ◽  
Pension Age ◽  
Old Men

Aims: The state old-age pension in Denmark increases to keep pace with the projected increase in average life expectancy (LE) without any regard to the social gap in LE and expected lifetime in good health. The purpose of this study was to compare changes in LE and disability-free life expectancy (DFLE) between groups of Danes with high, medium and low levels of education. Methods: Nationwide register data on education and mortality were combined with data from the Surveys of Health, Ageing and Retirement in Europe (SHARE) surveys in 2006–2007, 2010–2011 and 2013–2014 and the DFLE by educational level was estimated by Sullivan’s method for each of these three time points. Results: Between 2006–2007 and 2013–2014, LE among 65-year-old men and women with a low educational level increased by 1.3 and 1.0 years, respectively, and by 1.4 and 1.3 years for highly educated men and women. The gap in LE between people with high and low levels of education remained more than 2 years. In 2006–2007, 65-year-old men with a high level of education could expect 3.2 more years without disability than men of the same age with a low level of education. In 2013–2014, the difference was 2.9 years. For women, the results were 3.7 and 3.4 years, respectively. Conclusions: With the persistent social inequality in LE of more than 2 years and the continuous gap between high and low educational groups in DFLE of about 3 years, a differential pension age is recommended.

scholarly journals Disability-Free Life Expectancy among People Over 60 Years Old by Sex, Urban and Rural Areas in Jiangxi Province, China

2021 ◽  
Vol 18 (9) ◽  
pp. 4636
Author(s):  
Shengwei Wang ◽  
Songbo Hu ◽  
Pei Wang ◽  
Yuhang Wu ◽  
Zhitao Liu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Life Expectancy ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Rural Elderly ◽  
Jiangxi Province ◽  
Urban Rural ◽  
Disability Free Life Expectancy ◽  
The Difference

Objective: To estimate and compare age trends and the disability-free life expectancy (DFLE) of the population over 60 years old in 2018 in Jiangxi Province, China, by sex and urban–rural areas. Methods: The model life table was employed to estimate the age-specific mortality rate by sex and urban–rural areas, based on the Summary of Health Statistics of Jiangxi Province in 2018 and the Sixth National Health Service survey of Jiangxi Province. DFLE and its ratio to life expectancy (LE) were obtained by the Sullivan method. Results: In 2018, the DFLE among people over 60 is 17.157 years for men and is 19.055 years for women, accounting for 89.7% and 86.5% of their LE respectively. The DFLE/LE of men is higher than that of women at all ages. LE and DFLE are higher for the population in urban areas than in rural areas. For women, DFLE/LE is higher in urban areas than in rural areas (except at ages 75 and 80). Urban men have a higher DFLE/LE than rural men (except at age 85). The difference in DFLE between men and women over 60 years is 1.898 years, of which 2.260 years are attributable to the mortality rate, and 0.362 years are due to the disability-free prevalence. In addition, the difference in DFLE between urban–rural elderly over 60 years old is mostly attributed to the mortality rate by gender (male: 0.902/1.637; female: 0.893/1.454), but the impact of the disability-free rate cannot be ignored either (male: 0.735/1.637; female: 0.561/1.454). Conclusions: The increase in DFLE is accompanied by the increase in LE, but with increased age, DFLE/LE gradually decreases. With advancing age, the effect of disability on elderly people becomes more severe. The government administration must implement some preventive actions to improve health awareness and the life quality of the elderly. Rural elderly; rural women in particular, need to be paid more attention and acquire more health care.

scholarly journals Life expectancy among elderly Brazilians in 2003 according to different levels of functional disability

2008 ◽  
Vol 24 (4) ◽  
pp. 845-852 ◽  
Author(s):  
Mirela Castro Santos Camargos ◽  
Carla Jorge Machado ◽  
Roberto Nascimento Rodrigues
Keyword(s):  
Life Expectancy ◽  
Functional Disability ◽  
Household Survey ◽  
National Sample ◽  
Life Tables ◽  
Gender And Age ◽  
Disability Free Life Expectancy ◽  
Sullivan Method ◽  
Different Levels

The aim of the present study was to estimate disability-free life expectancy for the Brazilian elderly in 2003, by gender and age, based on different concepts of functional disability. The Sullivan method is used to combine the period life tables from the Brazilian Institute of Geography and Statistics (IBGE, 2003) and the prevalence of functional disability according to the 2003 National Sample Household Survey (PNAD 2003). The main results of the study indicate that at age 60, Brazilian men can expect to live 19 years, 39% with mild, 21% with moderate, and 14% with severe functional disability, respectively. At the same age, Brazilian women can expect to live 22 years: 56% with mild, 32% with moderate, and 18% with severe functional disability.

scholarly journals Why Are Inequalities in Disability-Free Life Expectancy by Socioeconomic Position Widening?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-640
Author(s):  
Carol Jagger
Keyword(s):  
Life Expectancy ◽  
Life Course ◽  
Socioeconomic Position ◽  
Occupational Status ◽  
Late Life ◽  
Healthy Life ◽  
Disability Free Life Expectancy ◽  
Life Education ◽  
The Uk ◽  
The Life Course

Abstract Life expectancy has increased over previous decades, but several countries are seeing widening inequalities in disability-free life expectancy (DFLE) by socioeconomic position (SEP). In this symposium we address three unanswered questions.1. Do DFLE trends differ for SEP groups, and which of the underlying transitions (incidence, recovery, death when disability-free, death when already disabled) explains the differences?2. Do DFLE trends by SEP depend on when in the life-course SEP is measured (early life - education, mid-life - occupational status or late-life - material disadvantage)?3. How much does multi-morbidity contribute to differing trends in DFLE by SEP, since multi-morbidity is more prevalent in low SEP groups? To answer these questions, we use unique longitudinal studies of older people across different generations in two countries: the UK (Cognitive Function and Ageing Studies – CFAS I and II) and Australia (Household, Income and Labour Dynamics in Australia – HILDA). The first presentation sets the scene with findings from a systematic review of worldwide trends in life and healthy life expectancy by SEP. Presentations two and three examine the first question using DFLE at age65 by SEP defined by late-life disadvantage in CFAS (1991-2011), followed by HILDA (2001-2017). The fourth presentation investigates the effect of different life-course measures of SEP using HILDA. The final presentation from CFAS examines the third question. This symposium increases our understanding of how and why inequalities in DFLE by SEP are changing with the goal of achieving healthy ageing for all.

scholarly journals Socioeconomic inequalities in life expectancy and disability-free life expectancy among Chilean older adults: evidence from a longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ximena Moreno ◽  
Lydia Lera ◽  
Francisco Moreno ◽  
Cecilia Albala
Keyword(s):  
Longitudinal Study ◽  
Life Expectancy ◽  
Older People ◽  
Social Protection ◽  
Socioeconomic Inequalities ◽  
Socioeconomic Differences ◽  
Basic Activity ◽  
Timely Access ◽  
Disability Free Life Expectancy ◽  
The Difference

Abstract Background Chile has one of the longest life expectancies of Latin America. The country is characterised by an important macroeconomic growth and persisting socioeconomic inequalities. This study analyses socioeconomic differences in life expectancy (LE) and disability-free life expectancy (DFLE) among Chilean older people. Methods The sample of the Social Protection Survey, a longitudinal study, was analysed. Five waves, from 2004 to 2016, were considered. The indicator was disability, defined as having difficulties to perform at least one basic activity of daily living. Type of health insurance was used to determine socioeconomic position (SEP). Total LE and DFLE were estimated with multistate life table models. Results At age 60, men in the higher SEP could expect to live 3.7 years longer (22.2; 95% CI 19.6–24.8) compared to men of the same age in the medium SEP (18.4; 95% CI 17.4–19.4), and 4.9 years longer than men of the same age in the lower SEP (17.3; 95% CI 16.4–18.2). They also had a DFLE (19.4; 95% CI 17.1–21.7) 4 (15.4; 95% CI 14.6–16.1) and 5.2 (14.2; 95% CI 13.4–14.9) years longer, compared to the same groups. Women aged 60 years in the higher SEP had a LE (27.2; 95% CI 23.7–30.8) 4.6 (22.7; 95% CI 21.9–23.5) and 5.6 (21.6; 20.6–22.6) years longer, compared to women in the medium and the lower SEP. The difference in DFLE, for the same age and groups was 4.9 and 6.1 years, respectively (high: 21.4; 95% CI 19.5–23.3; medium: 16.5; 95% CI 15.8–17.1; low: 15.3; 95% CI 14.6–16.0). Socioeconomic differences in LE and DFLE were observed among both sexes until advanced age. Discussion Socioeconomic inequalities in LE and DFLE were found among Chilean older men and women. Older people in the highest SEP live longer and healthier lives. Conclusion A reform to the Chilean health system should be considered, in order to guarantee timely access to care and benefits for older people who are not in the wealthiest group.

scholarly journals Area-Level Disadvantage and Changes in Disability-Free Life Expectancy for Older Australians

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-641
Author(s):  
Richard Tawiah ◽  
Kaarin Anstey ◽  
Carol Jagger ◽  
Kim Kiely
Keyword(s):  
Life Expectancy ◽  
Socioeconomic Position ◽  
Household Income ◽  
Activity Limitation ◽  
Disability Free Life Expectancy ◽  
Nationally Representative ◽  
Global Activity

Abstract We report the first analysis of inequalities in Disability-Free Life Expectancy (DFLE) trends for Australia, based on two cohorts of the nationally representative Household Income and Labour Dynamics in Australia survey. Each cohort was aged 45+ at baseline with 7-years of annual follow-up (Older cohort: 2001-2007, n=6363; Younger cohort: 2011-2017, n=8197). Disability was defined by a Global Activity Limitation Indicator, and socioeconomic position (SEP) by an area-level index of disadvantage. Compared to men in high advantage areas, men residing in low advantage areas experienced smaller gains in life expectancy (3.0 vs 4.6 years at age 65), DFLE (0.6 vs 1.8 years) and years with disability (2.4 vs 2.8 years). In contrast, for women in low advantage areas all years gained in life expectancy (2.6 years) were years with disability, whereas women in high advantage areas experienced gains in DFLE (1.7 years) and even more years with disability (2.7 years).

scholarly journals Trends in Health Expectancies by Late-Life Disadvantage: The Cognitive Function and Ageing Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 640-640
Author(s):  
Holly Bennett ◽  
Andrew Kingston ◽  
Gemma Spiers ◽  
Louise Robinson ◽  
Clare Bambra ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Expectancy ◽  
Longitudinal Data ◽  
Activities Of Daily Living ◽  
Socioeconomic Position ◽  
Daily Living ◽  
Late Life ◽  
Risk Of Death ◽  
Disability Free Life Expectancy

Abstract To understand how and why disability-free life expectancy (DFLE) trends differ by socioeconomic position (SEP) we use longitudinal data from the Cognitive Function and Ageing Studies (CFAS I: 1991; CFAS II: 2011), with two year follow up. Disability was defined as difficulty in activities of daily living, and SEP as area-level deprivation. Between 1991 and 2011, men aged 65 gained more in life expectancy (LE) than DFLE, with the greatest gain in DFLE for the most advantaged and in disability years for the most disadvantaged. The most advantaged men experienced a 60% reduction in the risk of death when disability-free, 30% reduction in incident disability, and 80% increase in recovery. The most disadvantaged experienced a 30% reduction of death but from disability. Women overall, and in the most advantaged groups, gained similar years of LE and DFLE to men but due to a 30% reduction in incident disability only.

scholarly journals The life table paradox: has Brazil already overcome it?

2021 ◽  
Vol 38 ◽  
pp. 1-23
Author(s):  
Filipe Costa de Souza
Keyword(s):  
Infant Mortality ◽  
Life Expectancy ◽  
Life Table ◽  
National Level ◽  
Decomposition Analysis ◽  
Life Tables ◽  
Total Change ◽  
Life Expectancy At Birth ◽  
The Difference ◽  
Over Time

Ideally, life expectancy should be a decreasing function of age. When this fact is not observed, this situation is known as the life table paradox. This paper investigated the timing (and health metrics at the time) in which Brazil and its Federation Units (FU) overcame (or are expected to overcome) this paradox. The data were gathered from the Brazilian Institute of Geography and Statistics and contained 3,416 sex-specific abridged life tables, from 2000 to 2060. At national level, females and males overcame the paradox in 2016 and 2018, respectively. However, when the FU were examined separately, much heterogeneity was observed. Through the decomposition analysis of the change over time in the difference between life expectancy at birth and at age one, we found that Brazil and most of its FU are expected to have both changes declining over time and the total change is expected to be decreasing and greater than zero. Nevertheless, for some Northeastern states the total change is expected to pass from a positive to a negative value; and for two Northern states the total change is expected to be neither decreasing nor increasing. In a public planning perspective, we understand that achieving balancing in the life tables is a goal to be pursued, especially because having an imbalanced table means that life expectancy at birth is still strongly influenced by high levels of infant mortality. Therefore, this knowledge could help planners to properly define strategies to accelerate the balancing process and revert unequal scenarios.

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