On the measurement of healthy lifespan inequality
Permanyer, Iñaki, (Centre d'Estudis Demogràfics)
Spijker, Jeroen (Centre d'Estudis Demogràfics)
Blanes, Amand (Centre d'Estudis Demogràfics)

Data:	2022
Resum:	Background. - Current measures to monitor population health include indicators of (i) average length-of-life (life expectancy), (ii) average length-of-life spent in good health (health expectancy), and (iii) variability in length-of-life (lifespan inequality). What is lacking is an indicator measuring the extent to which healthy lifespans are unequally distributed across individuals (the so-called 'healthy lifespan inequality' indicators). Methods. - We combine information on age-specific survival with the prevalence of functional limitation or disability in Spain (2014-2017) by sex and level of education to estimate age-at-disability onset distributions. Age-, sex- and education-specific prevalence rates of adult individuals' daily activities limitations were based on the GALI index derived from Spanish National Health Surveys held in 2014 and 2017. We measured inequality using the Gini index. Results. - In contemporary Spain, education differences in health expectancy are substantial and greatly exceed differences in life expectancy. The female advantage in life expectancy disappears when considering health expectancy indicators, both overall and across education groups. The highly educated exhibit lower levels of lifespan inequality, and lifespan inequality is systematically higher among men. Our new healthy lifespan inequality indicators suggest that the variability in the ages at which physical daily activity limitations start are substantially larger than the variability in the ages at which individuals die. Healthy lifespan inequality tends to decrease with increasing educational attainment, both for women and for men. The variability in ages at which physical limitations start is slightly higher for women than for men. Conclusions. - The suggested indicators uncover new layers of health inequality that are not traceable with currently existing approaches. Low-educated individuals tend to not only die earlier and spend a shorter portion of their lives in good health than their highly educated counterparts, but also face greater variation in the eventual time of death and in the age at which they cease enjoying good health-a multiple burden of inequality that should be taken into consideration when evaluating the performance of public health systems and in the elaboration of realistic working-life extension plans and the design of equitable pension reforms.
Ajuts:	European Research Council 2019/CoG-864616 Ministerio de Economía y Competitividad RYC-2013-14196 Ministerio de Economía y Competitividad RYC-2013-14851
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Population health measures ; Life expectancy ; Health expectancy ; Lifespan inequality ; Socio-economic inequality ; Spain ; Education
Publicat a:	Population Health Metrics, Vol. 20 Núm. 1 (2022) , p. 1-9, ISSN 1478-7954

DOI: 10.1186/s12963-021-00279-8
PMID: 34983576

9 p, 1.6 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències socials i jurídiques > Centre d’Estudis Demogràfics (CED-CERCA)
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