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

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.

Life Expectancy and Healthy Life Expectancy of Adults in Oman: Does Women’s Longer Life Expectancy than Men Mean Success or Burden for Women?

Objectives: The objective of this study was to examine the life expectancy (LE) and healthy life expectancy (HLE) of Omani adults with age and gender differentials, focusing on whether the higher LE of women than men is a gain or burden for women. Method: Data for the study come from multiple sources such as the 2010 population census, the 2008 World Health Survey in Oman, and secondary data published in the Statistical Yearbook of Oman. The life table and the modified life table proposed by Sullivan were used for estimating the LE and HLE of adult people of age 20 and above, respectively. Results: LE in Oman reached 76 years for both sexes in recent times. However, since 2010 LE has been stalled in the vicinity of 76 years in Oman. Women had higher LE than men (79 years versus 74 years). In terms of HLE, men outweighed women in Oman. At the age of 20, the gap between male-female LE was found to be 4.7 years in favor of females, whereas the gap between male-female HLE was found to be 5.8 years in favor of males. Females spent a relatively long time in poor health status than males (20.8 years versus 10.8 years) and the proportion of life spent in poor health was greater for females than males (35.0% vs. 19.3%). This revealed the paradox of less mortality but higher morbidity among women, supporting the “Failure of Success” hypothesis. Conclusion: Appropriate health policy and strategy need to be taken to reduce the gender gap in LE and HLE in Oman.

Direct Healthy Life Expectancy Estimates from Life Tables with a Sullivan Extension: The case of Brazil 2003

The Healthy Life Expectancy (HLE) in Brazil 2003 was estimated by Romero et al (2005) by using the Sullivan method and data from the World Health Survey carried out in Brazil in 2003. Here we use a Direct method to estimate the Healthy Life Years Lost (HLYL) and then the HLE. This is done after the analytic derivation of a more general model of survival-mortality and the estimation of a parameter bx related to the HLYL is followed by the formulation of a computer program providing results similar to those of the World Health Organization for the Healthy Life Expectancy (HALE) and the corresponding HLYL estimates. This program is an extension of classical life table including more columns to estimate the cumulative mortality, the average mortality, the person life years lost, and finally the HLYL parameter bx. Even more, a further extension of the Excel program based on the Sullivan method provides estimates of the Healthy Life Expectancy at every year of the lifespan.

Changes in Alienation in Physical Education Classes, School Happiness, and Future Healthy Life Expectancy After the COVID-19 Pandemic in Korean Adolescents

This study aims to investigate the changes in the structural relationship between alienation in physical education (PE) class, school happiness, and future healthy life expectancy in Korean adolescents after the COVID-19 pandemic. The data were collected from adolescents in the Republic of Korea using scales for these factors. The collected data were analyzed with frequency analysis, reliability analysis, validity analysis, independent t-test, and path analysis. The key results were as follows. First, there were partial changes in each of the parameters since the outbreak of COVID-19. Second, before the pandemic, alienation in PE class negatively affected school happiness, and school happiness positively affected future healthy life expectancy; however, alienation in PE class did not affect future healthy life expectancy showing a complete mediating effect. Third, during the pandemic, alienation in PE class negatively affected school happiness, and school happiness positively affected future healthy life expectancy; alienation in PE class negatively affected future healthy life expectancy, showing a partial mediating effect. These findings emphasize the importance and potential of school education, especially PE, in promoting happiness and healthy life in adolescents. We expect these findings to have practical implications for future research by presenting theoretical and empirical data.

Longitudinal Analysis of the Determinants of Life Expectancy and Healthy Life Expectancy: A Causal Approach

Understanding the determinants of health is essential to designing effective strategies to advance economic growth, reduce disease and disability, and enhance quality of life. We undertake a comprehensive outlook on public health by incorporating three metrics - life expectancy (LE), healthy life expectancy (HLE), and the discrepancy between the two. We investigate the effects of various health and socio-economic factors on these metrics and employ causal machine learning and statistical methods such as propensity score matching, X-learners, and causal forests to calculate treatment effects. An increase in basic water services and public health expenditure significantly increased average LE, whereas high HIV prevalence rates and poverty rates reduced average LE. High GNI per capita and moderate BMI increased HLE while high HIV prevalence rates decreased HLE. Moderate BMI and high GNI per capita expand the gap between HLE and LE, whereas high HIV prevalence rates diminish this gap. Results suggest that policymakers should utilize governmental resources to improve public health infrastructure rather than provide fiscal incentives to encourage private healthcare infrastructure. Additionally, more emphasis should be put on increasing educational levels of the general public by increasing educational expenditure and making educational institutions, public and private, more accountable.

Serum Level of Alkaline Phosphatase Correlates Negatively with Mini-Mental State Examination Score in the Very Elderly of Ashikaga City: Part of the Results of the Ashikaga Longevity Study

Objective: An important medical issue in both Japan and Ashikaga City is how to extend healthy life expectancy. To determine factors associated with healthy life expectancy, we established a joint study between Ashikaga City and the Ashikaga University Faculty of Nursing called the Ashikaga Longevity Study, using new biomarkers such as Diacron reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) tests as indicators of oxidative stress. In this study, factors related to cognitive function were clarified. Methods: Participants comprised 95 individuals (36 men; mean age, 91.0±5.1 years and 59 women; mean age, 92.2±5.9 years). Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). Results: MMSE score was ≤23 in 28 subjects (29.5%) and ≥24 in 67 subjects (70.5%). MMSE score showed significant negative correlations with age (p<0.0096), plasma alkaline phosphatase (p=0.0007), and peripheral leukocyte-to-lymphocyte ratio (p=0.0119), and positive correlations with plasma albumin (p=0.0096) and BAP-to-d-ROMs ratio (p=0.0427). Conclusions: These results suggest that cognitive decline may involve brain cell dysfunction due to inflammation based on a reduced ability to control oxidative stress. Not only anti-oxidative aerobic exercise but also anti-oxidative foods, may be necessary to maintain cognitive function.

213Traditional Japanese Diet Score and healthy life expectancy - a longitudinal global study

Background Traditional Japanese diets are considered to be health and longevity. We created a Traditional Japanese Diet Score (TJDS) and investigated the relationship between the TJDS and healthy life expectancy (HALE) longitudinally using global database. Methods Average food (g/day/capita) and energy supply (kcal/day/capita) by countries were identified by the Food and Agriculture Organization of the United Nations Statistics Division database. The sum of characterizing traditional Japanese foods supply (beneficial food components in Japanese diet; rice, fish, soybeans, vegetables, eggs, seaweeds, food components not use so much in Japanese diet; wheat, milk, and red meat) were divided as tertile (beneficial food components;-1, 0, 1, not use so much food components; 1, 0, -1). HALE values by country were derived from the Global Burden of Disease 2017 database. The longitudinal effects of TJDS on the rate of change in HALE from 1990 to 2013 were evaluated using a generalized mixed-effect model (GLMM), which takes into account the dependence of repeated observations within countries. The interaction between TJDS and survey year was applied to access the effects on HALE. This study covered 137 countries with populations of 1 million or greater. Results Longitudinal analysis controlled for covariates showed that smooth term of the interaction between TJDS and survey year was significant (p &lt; 0.001). The TJDS was negative associated with HALE in 1990, and in 1991, but positive associated after 2002. Conclusions The relationship between the TJDS as a healthy eating style and HALE is getting stronger since the 21st century. Key messages Well-balanced eating habits of traditional Japanese diets is supports healthy life expectancy.