Increasing inequalities in disability-free life expectancy among older adults in Sweden 2002–2014

2021 ◽  
pp. 140349482110623
Author(s):  
Louise Sundberg ◽  
Neda Agahi ◽  
Jonas W. Wastesson ◽  
Johan Fritzell ◽  
Stefan Fors
Keyword(s):  
Life Expectancy ◽  
Daily Living ◽  
Educational Inequalities ◽  
Swedish Population ◽  
Educational Differences ◽  
Total Life Expectancy ◽  
Disability Free Life Expectancy ◽  
Lower Education ◽  
Sullivan Method ◽  
Total Life

Background: In an aging society with increasing old age life expectancy, it has become increasingly important to monitor the health development in the population. This paper combines information on mortality and disability and explores educational inequalities in disability-free life expectancy in the aging population in Sweden, and to what extent these inequalities have increased or decreased over time. Methods: A random sample of the Swedish population aged 77 years and above ( n=2895) provided information about disability in the population in the years 2002, 2004, 2011 and 2014. The prevalence of disability was assessed by five items of personal activities of daily living and incorporated in period life tables for the corresponding years, using the Sullivan method. The analyses were stratified by sex and educational attainment. Estimates at ages 77 and 85 years are presented. Results: Disability-free life expectancy at age 77 years increased more than total life expectancy for all except men with lower education. Women with higher education had a 2.7-year increase and women with lower education a 1.6-year increase. The corresponding numbers for men were 2.0 and 0.8 years. The educational gap in disability-free life expectancy increased by 1.2 years at age 77 years for both men and women. Conclusions: While most of the increase in life expectancy was years free from disability, men with lower education had an increase of years with disability. The educational differences prevailed and increased over the period as the gains in disability-free life expectancy were smaller among those with lower education.

US State Disparities in Life Expectancy, Disability-Free Life Expectancy, and Disabled Life Expectancy Among Adults Aged 25 to 89 Years

2021 ◽  
Vol 111 (4) ◽  
pp. 708-717
Author(s):  
Mateo P. Farina ◽  
Anna Zajacova ◽  
Jennifer Karas Montez ◽  
Mark D. Hayward
Keyword(s):  
Life Expectancy ◽  
Well Being ◽  
The United States ◽  
Community Survey ◽  
Us States ◽  
Southern States ◽  
Total Life Expectancy ◽  
Similar Range ◽  
Disability Free Life Expectancy ◽  
Total Life

Objectives. To estimate total life expectancy (TLE), disability-free life expectancy (DFLE), and disabled life expectancy (DLE) by US state for women and men aged 25 to 89 years and examine the cross-state patterns. Methods. We used data from the 2013–2017 American Community Survey and the 2017 US Mortality Database to calculate state-specific TLE, DFLE, and DLE by gender for US adults and hypothetical worst- and best-case scenarios. Results. For men and women, DFLEs and DLEs varied widely by state. Among women, DFLE ranged from 45.8 years in West Virginia to 52.5 years in Hawaii, a 6.7-year gap. Men had a similar range. The gap in DLEs across states was 2.4 years for women and 1.6 years for men. The correlation among DFLE, DLE, and TLE was particularly strong in southern states. The South is doubly disadvantaged: residents have shorter lives and spend a greater proportion of those lives with disability. Conclusions. The stark variation in DFLE and DLE across states highlights the large health inequalities present today across the United States, which have significant implications for individuals’ well-being and US states’ financial costs and medical care burden.

scholarly journals Changes in total and disability-free life ex-pectancy among older adults in China: Do they portend a compression of morbidity?

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Zachary Zimmer ◽  
Mira Hidajat ◽  
Yasuhiko Saito
Keyword(s):  
Life Expectancy ◽  
Population Aging ◽  
Compression Of Morbidity ◽  
Urban Residence ◽  
Healthy Longevity ◽  
Total Life Expectancy ◽  
Disability Free Life Expectancy ◽  
Older Chinese ◽  
Sullivan Method

The purpose of this research is to determine whether disability-free life expectancy (DFLE) in China has been increasing more rapidly than total life expectancy (TLE). Such a scenario would be consistent with a compression of morbidity, a situation that is especially desirable in a country experiencing rapid population aging and gains in old-age longevity. Us-ing the Chinese Longitudinal Healthy Longevity Study, an exponential survival regression is used to calculate TLE. The Sullivan method is then employed for computing DFLE. Results for a 65 and older sample are compared across data collected during two periods, the first with a 2002 baseline and a 2005 follow-up (N=15,641) and the second with a 2008 baseline and a 2011 follow-up (N=15,622). The first comparison is by age and sex. The second comparison divides the sample further by rural/urban residence and education. The ratio of DFLE/TLE across periods provides evidence of whether older Chinese are living both longer and healthier lives. The findings are favorable for the total population aged 65+, but improvements are only statistically significant for females. Results also suggest heterogeneous compression occurring across residential status with the urban population experiencing more favorable changes than their rural counterparts. Results both portend a compression of morbidity and continuing dis-advantage for rural residents who may not be participating in population-wide improvements in health.

scholarly journals Trends in Disability-Free Life Expectancy (DFLE) from 1995 to 2017 in the older Norwegian population by sex and education: The HUNT Study

2021 ◽  
pp. 140349482110117
Author(s):  
Siri H. Storeng ◽  
Simon Øverland ◽  
Vegard Skirbekk Erstatt ◽  
Laila Arnesdatter Hopstock ◽  
Erik R. Sund ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Activities Of Daily Living ◽  
Functional Ability ◽  
Daily Living ◽  
Severe Disability ◽  
Educational Inequalities ◽  
Norwegian Population ◽  
Mild Disability ◽  
Disability Free Life Expectancy ◽  
High Educational

Aim: Understanding whether increasing Life Expectancy (LE) translates to improved health and function among older adults is essential, but results are inconclusive. We aimed to estimate trends in Disability-Free Life Expectancy (DFLE) in the older Norwegian population by sex and education from 1995 to 2017. Method: National life table data were combined with cross-sectional data on functional ability for 70+ year-olds from the population-based Trøndelag Health Surveys 2-4 (1995–1997, 2006–2008 and 2017–2019) ( n=24,733). Self-reported functional ability was assessed on a graded scale by a combination of Instrumental Activities of Daily Living (IADL) such as paying bills, going out or shopping (mild disability) and Personal Activities of Daily Living (PADL) such as washing, dressing or eating (severe disability). LE, DFLE, Mild-Disability LE and Severe-Disability LE at age 70 were estimated by the Sullivan method. Results: From 1995 to 2017 DFLE at age 70 increased from 8.4 to 13.0 years in women, and from 8.0 to 12.1 years in men. DFLE increased in the basic and high educational groups, but more so in the high educational group among men. Educational inequalities in years spent with disability however, remained low. Conclusions: From the mid-1990s and over the past three decades both LE and DFLE at 70 years increased in the older Norwegian population, for both men and women, and across basic and high educational levels. Educational inequalities in DFLE increased, especially in men, but years spent with disability were similar across the three decades.

scholarly journals Multimorbidity, Disadvantage, and Trends in Disability-Free Life Expectancy: The CFAS Studies

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 641-641
Author(s):  
Andrew Kingston ◽  
Holly Bennett ◽  
Louise Robinson ◽  
Lynne Corner ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Life Expectancy ◽  
Longitudinal Data ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Health Conditions ◽  
Disadvantaged Groups ◽  
Disability Free Life Expectancy ◽  
Reported Health

Abstract The combined contribution of multi-morbidity and socio-economic position (SEP) to trends in disability free life expectancy (DFLE) is unknown. 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. Multi-morbidity was constructed from nine self-reported health conditions and categorised as 0-1, 2-3, 4+ diseases. In 1991 and 2011, shorter total and disability-free years were associated with greater multi-morbidity. Between 1991 and 2011, gains in life expectancy and DFLE were observed at all levels of multi-morbidity, the greatest gain in DFLE being 4 years for men with 0-1 diseases. As multi-morbidity is more prevalent in more disadvantaged groups, further analyses will investigate whether SEP differences remain at all levels of multi-morbidity.

scholarly journals Neighborhood Disadvantage and Active, Disabled and Total Life Expectancy Among Community-living Older Persons

2021 ◽  
Author(s):  
Thomas M. Gill ◽  
Emma X. Zang ◽  
Terrence E. Murphy ◽  
Linda Leo-Summers ◽  
Evelyne A. Gahbauer ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Life Expectancy ◽  
Older Persons ◽  
Neighborhood Disadvantage ◽  
Community Living ◽  
Remaining Life ◽  
Disadvantaged Group ◽  
Individual Level ◽  
Total Life Expectancy ◽  
Total Life

AbstractBackgroundNeighborhood disadvantage is a novel social determinant of health that could adversely affect the functional well-being and longevity of older persons. We evaluated whether estimates of active, disabled and total life expectancy differ on the basis of neighborhood disadvantage after accounting for individual-level socioeconomic characteristics and other prognostic factors.MethodsWe used data on 754 community-living older persons from South Central Connecticut, who completed monthly assessments of disability from 1998 to 2020. Scores on the area deprivation index were dichotomized at the 80th state percentile to distinguish neighborhoods that were disadvantaged (81-100) from those that were not (1-80).ResultsWithin 5-year age increments from 70 to 90, active and total life expectancy were consistently lower in participants from neighborhoods that were disadvantaged versus not disadvantaged, and these differences persisted and remained statistically significant after adjustment for individual-level race/ethnicity, education, income, and other prognostic factors. At age 70, adjusted estimates (95% CI) for active and total life expectancy (in years) were 12.3 (11.5-13.1) and 15.0 (13.8-16.1) in the disadvantaged group and 14.2 (13.5-14.7) and 16.7 (15.9-17.5) in the non-disadvantaged group. At each age, participants from disadvantaged neighborhoods spent a greater percentage of their projected remaining life disabled, relative to those from non-disadvantaged neighborhoods, with adjusted values (SE) ranging from 17.7 (0.8) vs. 15.3 (0.5) at age 70 to 55.0 (1.7) vs. 48.1 (1.3) at age 90.ConclusionsLiving in a disadvantaged neighborhood is associated with lower active and total life expectancy and a greater percentage of projected remaining life disabled.

Trends in Partial Disability-Free Life Expectancy between the Ages of 45 and 70 in Canada, 2000–2014

2022 ◽  
pp. 1-7
Author(s):  
Judith Lefebvre ◽  
Yves Carrière
Keyword(s):  
Life Expectancy ◽  
Health Utility Index ◽  
Health Utility ◽  
Canadian Community Health Survey ◽  
Retirement Age ◽  
Utility Index ◽  
Community Health Survey ◽  
Recent Trends ◽  
Disability Free Life Expectancy ◽  
Sullivan Method

Abstract To better evaluate the benefits of a possible increase in the normal retirement age, this article proposes to examine recent trends in the health status of Canadians between 45 and 70 years of age. Using the Sullivan method, trends from 2000 to 2014 in partial disability-free life expectancy (PDFLE) between the ages of 45 and 70 years are computed. Disability is estimated using attributes of the Health Utility Index correlated with the capacity to work, and is looked at by level of severity. Data from the Canadian Community Health Survey were used to estimate the prevalence of disability. Results reveal a slight increase in partial life expectancy between the ages of 45 and 70, and a larger number of those years spent in poor health since the beginning of the 2000s. Hence, this study brings no evidence in support of the postponement of the normal retirement age if this policy were solely based on gains in life expectancy.

Disability-free life expectancy at old ages in Egypt

2020 ◽  
pp. 1-15
Author(s):  
Soha Metwally
Keyword(s):  
Life Expectancy ◽  
Decision Makers ◽  
Sample Population ◽  
Functional Difficulties ◽  
Disability Prevalence ◽  
Disability Free Life Expectancy ◽  
The Common ◽  
Nationally Representative ◽  
Type Data ◽  
Sullivan Method

Abstract This study aimed to estimate among the older population in Egypt (aged 60 years and over): 1) disability prevalence rates, their levels of severity and the common types and 2) disability-free life expectancy (DFLE) by sex, age and disability type. Data were from the nationally representative 2016 Household Observatory Survey (HOS-2016), with 4658 persons aged 60+ constituting the study sample population. To identify individuals with disabilities, the HOS asked respondents a short set of questions on functional difficulties, as suggested by the United Nations Washington Group on Disability Statistics. The DFLE was estimated using the Sullivan method. Older (60+) women reported a higher prevalence of disability than older men. Women had longer DFLEs and longer disabled life expectancies (DLEs) than men but had lower proportions of DFLE to their total lifetime. The findings suggest that, at age 60, around 30% of life expectancy in Egypt can be expected to be with limitations in mobility and vision. Men, although they live for fewer years than women, can expect to have a greater proportion of their life expectancy free of disability. The findings of the study suggest that the contextual differences in how the process of ageing is experienced need to be considered by decision-makers when designing gender-responsive health policies.

Poverty, Income, and Unemployment as Determinants of Life Expectancy: Empirical Evidence from Panel Data of Thirteen Malaysian States

2020 ◽  
Author(s):  
Khaled TAFRAN ◽  
Makmor TUMIN ◽  
Ahmad Farid OSMAN
Keyword(s):  
Panel Data ◽  
Life Expectancy ◽  
Cross Sections ◽  
Health Spending ◽  
Secondary Data ◽  
Socioeconomic Variables ◽  
Life Expectancy At Birth ◽  
Total Life Expectancy ◽  
Official Sources ◽  
Total Life

Background: The primary indicator of public health, which all nations aim to prolong, is life expectancy at birth. Uncovering its socioeconomic determinants is key to extending life expectancy. This study examined the determinants of life expectancy in Malaysia. Methods: This observational study employs secondary data from various official sources of 12 states and one federal territory in Malaysia (2002-2014). Panel data of 78 observations (13 cross-sections at six points in time) were used in multivariate, fixed-effect, regressions to estimate the effects of socioeconomic variables on life expectancy at birth for male, female and both-gender. Results: Poverty and income significantly determine female, male, and total life expectancies. Unemployment significantly determines female and total life expectancies, but not male. Income inequality and public spending on health (as a percentage of total health spending) do not significantly determine life expectancy. The coefficients of the multivariate regressions suggest that a 1% reduction in poverty, 1% reduction in unemployment, and around USD 23.20 increase in household monthly income prolong total life expectancy at birth by 17.9, 72.0, and 16.3 d, respectively. The magnitudes of the effects of the socioeconomic variables on life expectancy vary somewhat by gender. Conclusion: Life expectancy in Malaysia is higher than the world average and higher than that in some developing countries in the region. However, it is far lower than the advanced world. Reducing poverty and unemployment and increasing income are three effective channels to enhance longevity.

scholarly journals Trends of Healthy Life Expectancy of the Elderly in China in 1994–2015: Revisiting From the Perspective of Morbidity Transition

2022 ◽  
Vol 9 ◽  
Author(s):  
Zhen Zhang ◽  
Junhan Dong ◽  
Chenyuan Zhao ◽  
Qiang Li
Keyword(s):  
Life Expectancy ◽  
Dynamic Equilibrium ◽  
The Elderly ◽  
Underlying Mechanism ◽  
Healthy Life Expectancy ◽  
Health Improvement ◽  
Healthy Life ◽  
Disability Free Life Expectancy ◽  
Sullivan Method

Research on healthy life expectancy (HLE) in China has been fueled by a spate of new data sources and studies, yet no consensus is reached on the pattern of HLE changes and the underlying mechanism. This study examined the change of HLE in China over 20 years with long term national data. Health status, measured by activities of daily living, is combined with mortality to calculate the disability-free life expectancy by the Sullivan method. The results show that the HLE rose slower than life expectancy (LE) in 1994–2004, indicating morbidity expansion. However, in 2010–2015, the proportion of HLE to LE increased, manifesting morbidity compression. A counterfactual analysis further shows that health improvement has been increasingly important in increasing HLE in 2010–2015, despite the dominance of mortality decline. The findings suggest that morbidity can transition between compression, expansion and dynamic equilibrium over a long period due to different combinations of mortality and health improvements. Given the limited data in this study, whether and how morbidity transitions unfold in the future remains open and requires further research.

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