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Research into an indicator on health expectancy without limitations in daily activities (HEALTHYLIFE-EXP)

Research project AG/KK/155 (Research action AG)

Persons :

Description :

The Healthy Life Years indicator (HLY) measures the number of remaining years that a person of a certain age is still supposed to live without disability. Healthy Life Years introduces the concept of quality of life. It is used to distinguish between years of life free of any activity limitation and years experienced with at least one activity limitation. The emphasis is not exclusively on the length of life, as is the case for life expectancy, but also on the quality of life.

Because the Healthy Life Years is a solid indicator to monitor health as a productivity/economic factor, the "Healthy Life Years" indicator is now in the core set of the European Structural Indicators designed to support the Lisbon Strategy. In the framework of the “social protection and social inclusion” plan of the European Commission, the Member States need to estimate this indicator according to the socioeconomic status. That is why having accurate and reliable estimates for HLY by socioeconomic status is of prime importance.

Currently, in Belgium, the estimation of HLY by socioeconomic status is based on mortality rates generated from the follow-up of the censuses of 1991 and 2001. Given that there is no planned national population census in the near future, alternative methods must be explored.

Two alternative methods are possible. In the first method, HLY by educational level can be estimated based on mortality rates generated from the follow up of a number of surveys such as the Health Interview Survey or the EU-SILC that include information on the participants’ socioeconomic status, health and functional limitations. The duration of such mortality follow up depends on the size of the survey sample, but must not be less than 2 to 3 years.

The second method involves the use of mortality rates by educational level generated from two different cross-sectional datasets: one providing the number of death by educational level and the other the distribution of the population by educational level. This second method is sensible to the numerator denominator bias.

In this project, both methods will be explored by undertaking the following tasks:

- Estimate the size of the numerator/denominator bias.
- Evaluate a number of surveys as an alternative source of mortality and disability data by socioeconomic status.
- Review the methods used in other EU states to estimate HLY by socioeconomic status.
- Present the HLY estimates and the uncertainties around each estimate using the data source identified in this project.
- Provide recommendations for the monitoring of HLY by socioeconomic status in Belgium.

Documentation :

Social inequalities in Healthy Life Expectancy : final report    Brussels : Federal Science Policy, 2011 (SP2361)
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