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Work package 8 Inequalities in summary measures of population health

Work package 8 Inequalities in summary measures of population health. Prof. Pekka Martikainen & Dr . Netta Mäki Population Research Unit / Faculty of Social Sciences University of Helsinki. Aims of work package 8. To quantify the magnitude of socioeconomic inequalities in

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Work package 8 Inequalities in summary measures of population health

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  1. Workpackage 8Inequalities in summarymeasuresof populationhealth Prof. Pekka Martikainen & Dr. Netta Mäki PopulationResearchUnit / Facultyof Social Sciences University of Helsinki

  2. Aims of workpackage 8 • To quantify the magnitude of socioeconomicinequalities in • Healthy Life Years and • Disability-adjustedLife-Yearslost in selectedEuropeancountries (measures) • To assess the contribution of specific diseases and risk factors to inequalities (outcome) • To estimate the potential for reduction in these inequalities under “counterfactual” distributions of socioeconomic determinants and risk factors (counterfactuals)

  3. Summarymeasures of populationhealth • Healthy Life Years • Sullivanmethod • Based on SES-specificlife-tables and prevalencesof disease • Disability-adjustedLife-YearslostDALYs • GlobalBurden of Diseasemethod • Years of Life Lost (YLL) + YearsLivedwithDisability (YLD) • High requirements for data in terms of comparability: feasibleonly for a limitednumber of countries

  4. Outcome • Manypreviousstudiesbased on the Sullivanmethodrely on selfreportedhealth • Comparabilitybetweencountriesmaybecompromised • Alternatives: • Chronicdisease • Diabetes • Dementia • Functionaldisabilites

  5. Outcome / Example Source: Health 2000 -survey

  6. Measures / Example 1/2 Healthy Life Years: Disability-free life expectancy in Finlandthoseaged 30–64 years Source: Finbalt –surveys in 1994, 1998, 2000, 2002 & 2004

  7. Measures / Example 2/2 DALYsBrazil in 1998, allagegroupsincluded YLL=Years of Life Lost YLD=YearsLivedwithDisability Source: Oliveira AF et al. 2009

  8. Counterfactualscenarios / For example • What would be the SES differentials in Healthy Life Years if all SES groups experienced the morbidity level of the highestsocioeconomicgroup • What would be the SES differentials in Health Life Years if smoking rates were 20% lower in the higher SES groups and 35% lower in the lower SES group • Resultswillbecomparedbetweencountries to identify the lowestobservedinequalities

  9. Openissues • HLY or DALYs or both? • Selection of morbidity outcomes and their sources? • Counterfactuals used?

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