Decennial trends and inequalities in healthy life expectancy: The HUNT Study, Norway

2017 ◽  
Vol 46 (1) ◽  
pp. 124-131 ◽  
Author(s):  
Siri H. Storeng ◽  
Steinar Krokstad ◽  
Steinar Westin ◽  
Erik R. Sund

Aims: Norway is experiencing a rising life expectancy combined with an increasing dependency ratio – the ratio of those outside over those within the working force. To provide data relevant for future health policy we wanted to study trends in total and healthy life expectancy in a Norwegian population over three decades (1980s, 1990s and 2000s), both overall and across gender and educational groups. Methods: Data were obtained from the HUNT Study, and the Norwegian Educational Database. We calculated total life expectancy and used the Sullivan method to calculate healthy life expectancies based on self-rated health and self-reported longstanding limiting illness. The change in health expectancies was decomposed into mortality and disability effects. Results: During three consecutive decades we found an increase in life expectancy for 30-year-olds (~7 years) and expected lifetime in self-rated good health (~6 years), but time without longstanding limiting illness increased less (1.5 years). Women could expect to live longer than men, but the extra life years for females were spent in poor self-rated health and with longstanding limiting illness. Differences in total life expectancy between educational groups decreased, whereas differences in expected lifetime in self-rated good health and lifetime without longstanding limiting illness increased. Conclusions: The increase in total life expectancy was accompanied by an increasing number of years spent in good self-rated health but more years with longstanding limiting illness. This suggests increasing health care needs for people with chronic diseases, given an increasing number of elderly. Socioeconomic health inequalities remain a challenge for increasing pensioning age.

Author(s):  
Befikadu L Wubishet ◽  
Julie E Byles ◽  
Melissa L Harris ◽  
Carol Jagger

Abstract Background Diabetes is a major chronic condition with ever-increasing health and economic burden. This study aimed to measure the impact of diabetes on total life expectancy (TLE) and healthy life expectancy (HLE) at ages 70 and 80 and to assess how educational level, obesity, and comorbidity affected the expectancies. Methods The study involved 9849 population-representative women born between 1921 and 1926 from the Australian Longitudinal Study on Women’s Health (ALSWH). Self-rated health was obtained from the ALSWH surveys. Diabetes diagnosis was ascertained using survey and health care administrative data. Total life expectancy and HLE were estimated for women with and without diabetes using multistate modeling. Results Diabetes was associated with an increased risk of poor health (adjusted risk ratio: 1.63, 95% confidence interval: 1.49–1.79). Diabetes was also associated with a reduction of 0.9 years in HLE and 2.6 years in TLE at age 70 and 0.4 years in HLE and 1.3 years in TLE at age 80. If a woman had low education, obesity, and more than 2 comorbidities in addition to diabetes, these reductions increased to 3.0 years in TLE and 7.9 years in HLE at age 70 and 1.5 years in TLE and 3.8 years in HLE at age 80. Conclusions Diabetes substantially reduced older women’s quantity and quality of life, with further reductions for those with lower education, obesity, and comorbidities. These findings underscore the importance of optimally managing diabetes by maintaining a healthy weight and delaying the onset of comorbidities, to promote healthy aging for older women with diabetes.


2014 ◽  
Vol 35 (5) ◽  
pp. 1075-1094 ◽  
Author(s):  
MD. ISMAIL TAREQUE ◽  
TOWFIQUA MAHFUZA ISLAM ◽  
KAZUO KAWAHARA ◽  
MAKIKO SUGAWA ◽  
YASUHIKO SAITO

ABSTRACTAgeing is going to be a major problem in Bangladesh given its population size, scarce resources, existing poverty, insufficient health facilities and lack of a social security system. This paper examines how many years older people expect to be in good health, and what are the correlates of self-rated health (SRH). The data used in this study come from 896 older people aged 60 years and above from Rajshahi district in Bangladesh and from United Nations’ projected population figures. Results show that individuals at age 60 expected about 41 per cent of their remaining life to be in good health, while individuals at age 80 expected only 21 per cent of their remaining life to be in good health. Having exercised during the six months prior to the survey was the single most important correlate of SRH (odds ratio=5.49; confidence interval 4.03–7.47; without any adjustment). While rural–urban differentials and some health decline in old age are inevitable, four factors (exercise behaviour, sufficiency of income, physical limitations and facing abusive behaviour) are to a certain extent modifiable and therefore provide the potential for improving SRH and healthy life expectancy in Rajshahi district, Bangladesh.


2016 ◽  
Vol 116 (4) ◽  
pp. 692-699 ◽  
Author(s):  
L. Leigh ◽  
J. E. Byles ◽  
C. Jagger

AbstractThere is conflicting evidence for the effect of BMI on mortality at older ages, and little information on its effect on healthy life expectancy (HLE). Longitudinal data were from the 1921–1926 cohort of the Australian Longitudinal Study on Women’s Health (n 11 119), over 18 years of follow-up. Self-rated health status was measured at each survey, and BMI was measured at baseline. Multi-state models were fitted to estimate the effect of BMI on total life expectancy (TLE) and HLE. Compared with women of normal weight, overweight women at the age of 75 years had similar TLE but fewer years healthy (−0·79; 95 % CI −1·21, −0·37) and more years unhealthy (0·99; 95 % CI 0·56, 1·42). Obese women at the age of 75 years lived fewer years in total than normal-weight women (−1·09; 95 % CI −1·77, −0·41), and had more unhealthy years (1·46; 95 % CI 0·97, 1·95 years). Underweight women had the lowest TLE and the fewest years of healthy life. Women should aim to enter old age at a normal weight and in good health, as the slight benefit on mortality of being overweight is offset by spending fewer years healthy. All outcomes were better for those who began in good health. The relationship between weight and HLE has important implications for nutrition for older people, particularly maintenance of lean body mass and prevention of obesity. The benefit of weight loss in obese older women remains unclear, but we support the recommendation that weight-loss advice be individualised, as any benefits may not outweigh the risks in healthy obese older adults.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 505-505
Author(s):  
Matthew Farina ◽  
Phillip Cantu ◽  
Mark Hayward

Abstract Recent research has documented increasing education inequality in life expectancy among U.S. adults; however, much is unknown about other health status changes. The objective of study is to assess how healthy and unhealthy life expectancies, as classified by common chronic diseases, has changed for older adults across education groups. Data come from the Health and Retirement Study and National Vital Statistics. We created prevalence-based life tables using the Sullivan method to assess sex-specific life expectancies for stroke, heart disease, cancer, and arthritis by education group. In general, unhealthy life expectancy increased with each condition across education groups. However, the increases in unhealthy life expectancy varied greatly. While stroke increased by half a year across education groups, life expectancy with diabetes increased by 3 to 4 years. In contrast, the evidence for healthy life expectancy provides mixed results. Across chronic diseases, healthy life expectancy decreased by 1 to 3 years for respondents without a 4-year degree. Conversely, healthy life expectancy increased for the college educated by .5 to 3 years. While previous research shows increases in life expectancy for the most educated, trends in life expectancy with chronic conditions is less positive: not all additional years are in lived in good health. In addition to documenting life expectancy changes across education groups, research assessing health of older adults should consider the changing inequality across a variety of health conditions, which will have broad implications for population aging and policy intervention.


2005 ◽  
Vol 21 (suppl 1) ◽  
pp. S7-S18 ◽  
Author(s):  
Dalia Elena Romero ◽  
Iúri da Costa Leite ◽  
Célia Landmann Szwarcwald

The objective of this study is to present the method proposed by Sullivan and to estimate the healthy life expectancy using different measures of state of health, based on information from the World Health Survey carried out in Brazil in 2003. By combining information on mortality and morbidity into a unique indicator, simple to calculate and easy to interpret, the Sullivan method is currently the one most commonly used for estimating healthy life expectancy. The results show higher number of healthy years lost if there is a long-term disease or disability that limits daily activities, regardless of the difficulty in performing such activities or the severity of the functional limitations. The two measures of healthy life expectancy adjusted by the severity of functional limitation show results very similar to estimates based on the perception of state of health, especially in advanced age. It was also observed, for all measures used, that the proportion of healthy years lost increases significantly with age and that, although females have higher life expectancy than males, they live proportionally less years in good health.


2016 ◽  
Vol 2 (4) ◽  
pp. 126
Author(s):  
Mariana Mourgova

This article examines the health status of the population in Bulgaria at age 65 by gender during the period 2006-2014. The health status is examined by some of the most frequently used demographic indicators, namely life expectancy, based on mortality data and healthy life years and healthy life expectancy, based on mortality, life expectancy and self-perceived health. The main results show that despite of the observed increase in life expectancy at age 65 in Bulgaria during the period it is the lowest compared to other European countries. The share for both men and women reported their health status as without limitations in respect to daily activities decline, while those reported their health status as good increase. These contradictory facts reflect on the measures of health status. Thus, the trend in healthy life years for both sexes decline over the period, whereas the trend in healthy life expectancy increases. Compared with the other European countries, the expected number of years without limitations in Bulgaria is among the largest, while the healthy life expectancy is the lowest. These differences could be explained by the different levels in mortality and the nature of the measures of health status themselves.


2016 ◽  
Vol 6 (1) ◽  
pp. 126
Author(s):  
Mariana Mourgova

This article examines the health status of the population in Bulgaria at age 65 by gender during the period 2006-2014. The health status is examined by some of the most frequently used demographic indicators, namely life expectancy, based on mortality data and healthy life years and healthy life expectancy, based on mortality, life expectancy and self-perceived health. The main results show that despite of the observed increase in life expectancy at age 65 in Bulgaria during the period it is the lowest compared to other European countries. The share for both men and women reported their health status as without limitations in respect to daily activities decline, while those reported their health status as good increase. These contradictory facts reflect on the measures of health status. Thus, the trend in healthy life years for both sexes decline over the period, whereas the trend in healthy life expectancy increases. Compared with the other European countries, the expected number of years without limitations in Bulgaria is among the largest, while the healthy life expectancy is the lowest. These differences could be explained by the different levels in mortality and the nature of the measures of health status themselves.


2008 ◽  
Vol 28 (1) ◽  
pp. 35-48 ◽  
Author(s):  
MIRELA CASTRO SANTOS CAMARGOS ◽  
CARLA JORGE MACHADO ◽  
ROBERTO NASCIMENTO RODRIGUES

ABSTRACTWhether life is spent in good health or disability has a critical influence on the use of health-care services. It is also known that average healthy life expectancy differs by sex. This paper reports estimations of healthy and unhealthy life expectancy in old age using self-reported health assessments for the City of São Paulo, Brazil in 2000–01. The data derived from the Health, Well-being and Aging in Latin America and the Caribbean Project (SABE), and from population censuses and mortality statistics. Sullivan's estimation method was used. It combines the age-specific schedule of the current probabilities of death with the prevalence of self-perceived ‘poor’ and ‘good’ health. The paper also reports multivariate analyses of the factors associated with variations by age group and sex in self-perceived health. The findings revealed that, at all ages, women live longer than men and for more years in a healthy state. Among men, those aged 60, 65 and 70 years were expected to live a higher percentage of their remaining life than women in a healthy state, but among those aged 75, 80 and 85 years, the opposite held. Among women, the percentage of remaining years that were unhealthy did not increase as age increased, which differs from previous findings. The multivariate analyses showed that with increasing age, for women the number of chronic diseases decreased but dependency increased, and for men the opposite held. This finding indicated that the percentage of life spent in poor self-perceived health more accurately predicts mortality in men than women.


2019 ◽  
Vol 4 (2) ◽  
pp. 12 ◽  
Author(s):  
Witness Chirinda ◽  
Yasuhiko Saito ◽  
Danan Gu ◽  
Nompumelelo Zungu

Data characterizing older people’s life expectancy by good or poor health isimportant for policy and fiscal planning. This study aims to examine trends and investigategender differences in healthy life expectancy (HLE) for older people in South Africa for theperiod 2005–2012. Using data from three repeated cross-sectional surveys conducted in 2005,2008, and 2012, we applied a self-rated health measure to estimating HLE. The Sullivanmethod was used in the calculations. We found that unhealthy life expectancy decreased overthe period, while HLE and the proportion of life spent in good health increased more thantotal life expectancy in the same period. Gender disparities were evident: Women had higherlife expectancy than men, yet they spent a greater proportion of their lifetime in poor health.We concluded that HLE of older people in South Africa has improved over the period underinvestigation.


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