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Healthy Life Expectancy in Developing Countries in Asia

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

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Healthy Life Expectancy in Developing Countries in Asia

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  1. Healthy Life Expectancy in Developing Countries in Asia Vicki L. Lamb Center for Demographic Studies Duke University

  2. 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

  3. Life expectancy at birth:Selected Asian countries, 1990-2002 World Bank Indicators, 2003

  4. 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

  5. Percent of total population aged 65 years and older, 1990-2002 World Bank Indicators, 2003

  6. 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?

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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) HLE estimates in Asia (year of study):

  12. What are the trends in life expectancy and healthy life expectancy in the developing countries in Asia?

  13. 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

  14. Similar trends in other Asian countries: Life Expectancy @ 65 Healthy Life Expectancy @ 65 Females Males Males

  15. 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

  16. Percent of Healthy Life @ 65 in selected Asian countries: Females Malaysia,1984 Thailand,1989 China,1992 Indonesia,1989 Thailand,1996 N.Korea,1989 Singapore,1995 Burma, 1989 Taiwan,1991 China,1987 S. Korea,1984 Sri Lanka,1989 Taiwan,1986 Thailand,1995 [SRH] Thailand,1986 [SRH] Males

  17. Trends in HLE • For several countries we have more than one estimate • These estimates can show us possible trends in HLE and percent HLE

  18. Trends in LE @ 65 for selected countries: Females Thailand 1986;1989;1996 China 1987;1992 Taiwan 1986;1991 Males

  19. Trends in HLE @ 65 for selected countries: Females Thailand 1989;1996 China 1987;1992 Taiwan 1986;1991 Thailand [SRH] 1986;1995 Males

  20. Results: • For all three countries: • Years of total life expectancy has increased • Years of healthy life expectancy has increased • What about percent HLE?

  21. Trends in % HLE for selected countries: Thailand 1989;1996 *Little change* China 1987;1992 Taiwan 1986;1991 Thailand [SRH] 1986;1995 *Little change*

  22. Results: • There has been an increase in the percent of HLE years for China and Taiwan • The Thailand rates show little change • More research is needed

  23. 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

  24. 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 • how long can persons work • how long can persons be self-sufficient • Policy concerns on the well-being and care of older persons in poor health

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