Healthy Life Expectancy in Developing Countries in Asia



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Healthy Life Expectancy in Developing Countries in Asia

  • Vicki L. Lamb
  • Center for Demographic Studies
  • Duke University

Life Expectancy (LE)

  • The expected number of years to be lived from age x (typically from birth)
  • Measure of population health
  • LE is increasing over time in Asia and around the world

Life expectancy at birth: Selected Asian countries, 1990-2002

Life Expectancy (LE)

  • The expected number of years to be lived from age x (typically from birth)
  • Measure of population health
  • LE is increasing over time in Asia and around the world
  • Result: an increase in Asian populations, particularly at older ages

Percent of total population aged 65 years and older, 1990-2002

  • World Bank Indicators, 2003

Major Question:

  • What is the state of health associated with longer life ?
    • More ill-health and disabilities, and greater suffering?
    • Longer period of life in good health?
    • Dynamic equilibrium between health and years of life?

Healthy life expectancy (HLE)

  • The expected number of years to be spent in good health from age x
  • “Health” usually refers to functional abilities or self-rated health
  • Advantage of HLE: ease in interpretation
    • LE @ 65 = 20.9 yrs*; HLE @ 65 = 18.3 yrs*
    • % of LE in good health: HLE/LE = .88
    • *Females in Japan, 1995

Estimating healthy life expectancy using the Sullivan (1971) method and life tables:

  • DPR = Disability prevalence rate for age x from survey data
  • Lx(hs) = (1 - DPR) * Lx [person years spent in health]
  • Tx(hs) = x=t L [x(hs) + t] [total person years lived in health]
  • ex(hs) = Tx(hs) / lx [healthy life expectancy]
  • Note: hs=healthy state

REVES: Réseau Espérance de Vie en Santé

  • International Research Network on Health Expectancy
  • First meeting in Quebec in 1989
  • Concern over the effects of increased life expectancy on population health
  • Goals are to collect, standardize, and improve national estimates of HLE

REVES research on developing countries

  • First estimates of HLE for developing countries were presented at the 3rd REVES meeting in 1991:
    • China (Grab, Dowd, and Michel),
    • Taiwan (Tu and Chen), and
    • Burma, Indonesia, Sri Lanka, and Thailand, (Lamb and Andrews)
  • Additional countries (e.g., Latin America) have been studied since that time

HLE estimates in Asia (year of study):

  • Burma (1989)
  • China (1987, 1992, 1998-2000)
  • Indonesia (1989)
  • S. Korea (1984, 1989)
  • N. Korea (1989)
  • Malaysia (1984)
  • Philippines (1984)
  • Singapore (1995)
  • Sri Lanka (1989)
  • Taiwan (1986, 1991)
  • Thailand (1986, 1989, 1995, 1996)
  • Japan (1966, 1970, 1974-85, 1987, 1990, 1995)
  • What are the trends in life expectancy and healthy life expectancy in the developing countries in Asia?

Life Expectancy (LE) and Healthy Life Expectancy (HLE), China, 1987

  • Females are advantaged with more years of life and more years of healthy life.
  • Grab et al., 1991

Similar trends in other Asian countries:

  • Life Expectancy @ 65
  • Healthy Life Expectancy @ 65
  • Males
  • Males
  • Females

Percent of life to be spent in health @ 65, (HLE/LE) China, 1987

  • Males have the advantage with a greater percent of healthy life years.
  • Grab et al., 1991
  • Males
  • Females
  • Percent of Healthy Life @ 65 in selected Asian countries:
  • Taiwan,1986
  • Burma, 1989
  • China,1992
  • Taiwan,1991
  • China,1987
  • Malaysia,1984
  • S. Korea,1984
  • Indonesia,1989
  • N.Korea,1989
  • Sri Lanka,1989
  • Thailand,1989
  • Thailand,1986 [SRH]
  • Thailand,1995 [SRH]
  • Thailand,1996
  • Singapore,1995

Trends in HLE

Trends in LE @ 65 for selected countries:

  • Males
  • Females
  • Taiwan
  • 1986;1991
  • China
  • 1987;1992
  • Thailand
  • 1986;1989;1996

Trends in HLE @ 65 for selected countries:

  • Males
  • Females
  • Thailand [SRH]
  • 1986;1995
  • Taiwan
  • 1986;1991
  • China
  • 1987;1992
  • Thailand
  • 1989;1996

Results:

Trends in % HLE for selected countries:

  • Thailand [SRH]
  • 1986;1995
  • *Little change*
  • Taiwan
  • 1986;1991
  • China
  • 1987;1992
  • Thailand
  • 1989;1996
  • *Little change*

Results:

Issues in measuring/studying HLE:

  • Accurate estimates of population health and disability via national health surveys:
    • representative samples
    • consistent measures of “health”
  • Valid life tables to estimate trends in mortality:
    • source of life table data
    • year of life table estimates VS. the year the health data are collected

Why study Healthy Life Expectancy?

  • Population aging and increased LE
  • Compare health of older persons in countries at different levels of development
  • “Elderly dependency load” reconsiderations
  • Policy concerns on the well-being and care of older persons in poor health


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