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Comparing the differences in three measures of healthy life expectancy among prefectures in Japan.

ABSTRACT: OBJECTIVE:An ecological study using secondary open data from Japanese government statistics was conducted. The study aimed to verify differences in three measures of healthy life expectancy (HLE); namely, disability-free life expectancy without activity limitation (DFLE-AL), life expectancy with self-perceived health (LE-SH), and disability-free life expectancy without care need (DFLE-CN). RESULTS:Each HLE from 47 prefectures in 2010, 2013, and 2016 was extended over time. There were strong Cronbach's coefficient alpha (?) between DFLE-AL and LE-SH (Minimum ?; 0.80, Maximum ?; 0.90) as well as between LE and DFLE-CN (Minimum ?; 0.92, Maximum ?; 0.99) in both sexes in every data year. However, the other pairs had weaker associations. In regression analysis with each HLE as a dependent variable and aging rate, mortality, the proportion of unhealthy people as independent variables, the subjective unhealthy rate had significant standardized partial regression coefficients (?) in models with DFLE-AL and LE-SH as dependent variables (Minimum ?; -?0.56, Maximum ?; -?0.34). Therefore, DFLE-CN tended to differ from the other HLEs. The subjective unhealthy rate had a significant influence on DFLE-AL and LE-SH.

SUBMITTER: Taira K

PROVIDER: S-EPMC7404923 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Comparing the differences in three measures of healthy life expectancy among prefectures in Japan.

Taira Kazuya K Ogata Soshiro S Kamide Kei K

BMC research notes 20200805 1

<h4>Objective</h4>An ecological study using secondary open data from Japanese government statistics was conducted. The study aimed to verify differences in three measures of healthy life expectancy (HLE); namely, disability-free life expectancy without activity limitation (DFLE-AL), life expectancy with self-perceived health (LE-SH), and disability-free life expectancy without care need (DFLE-CN).<h4>Results</h4>Each HLE from 47 prefectures in 2010, 2013, and 2016 was extended over time. There w ...[more]

PMID: 32758291

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Project description:BackgroundFew studies have investigated the change in life expectancy (LE) and the healthy lifespan among patients with advanced schistosomiasis. This study was to evaluate the LE and healthy life expectancy (HLE) for patients and assess the mechanism responsible for the LE inequality.MethodsWe utilized data from a dynamic advanced schistosomiasis cohort (10,362 patients) for the period from January 2008 to December 2019 in Hunan Province, China, to calculate the LEs of patients, and made a comparison with that of general population (19,642 schistosomiasis-free individuals) in the schistosomiasis endemic areas. LEs were estimated from 15 years of age by constructing period life tables. Arriaga's decomposition method was applied to quantify the influence of the age structure on the difference in LE. HLE for advanced schistosomiasis patients was calculated by using Sullivan method with age-specific disability weight. The LE and HLE were calculated for both males and females to perform further analyses on gender gap.ResultsThe estimated LE for advanced schistosomiasis patients aged 15-19 was 49.51 years (48.86 years for males and 51.07 years for females), which was 20.14 years lower compared with general population (69.65 years), and the LE gap between patients and general population decreased with age. The largest age-specific mortality contribution to the gap (32.06%) occurred at age 80-84 years. Women had a lower LE and HLE than men at age ≥ 60 years (both gender gaps in LE and HLE < 0). For advanced schistosomiasis patients, the gender gap in LE was largely attributed to the difference in mortality among those under the age of 55; the age-specific mortality in women exerted positive influence on the gap at age 25-64 and 75-79 years, with the contribution rate ranging from 0.59% to 57.02%, and made the negative contribution at other age groups.ConclusionsThe LE of advanced schistosomiasis patients was still much lower compared with general population. Strengthened prevention strategies and targeted treatments are needed to reduce morbidity and mortality due to advanced schistosomiasis, especially for younger population and elderly female patients.

Project description:BackgroundHealthy life expectancy (HLE) is becoming an important indicator of population health. While actuarial estimates of HLE are frequently studied, there is scarcity of research on the subjective expectations of people about their HLE. The objective of this study is to compare actuarial and subjective HLE (sHLE) estimates in the ≥50-year-old Hungarian general population. Furthermore, we assessed subjective life expectancy (sLE) and explored determinants of the individual variance of sHLE and sLE.MethodsWe conducted a cross-sectional online survey in 2019. Subjective health expectations were measured at 60, 70, 80 and 90 years of age via the Global Activity Limitation Indicator (GALI). Point-estimates of sLE and background variables were also recorded. sHLE was estimated from GALI and sLE responses. Actuarial estimates of life expectancy (LE) and HLE for 2019 were provided by the Central Statistical Office of Hungary.ResultsFive hundred and four respondents (female 51.6%) were included. Mean (±SD) age was 63 (±7.5) years. Median LE (81.5 years, 95%CI 81.1-81.7) and sLE (82 years, 95%CI 80-85) were similar (p = 0.142), while median sHLE (66.8 years, 95%CI 65.5-68.3) was lower than HLE (72.7 years, 95%CI 82.4-82.9) by 5.9 years (p<0.001). Despite the greater median actuarial LE of women compared to men (p<0.001), we found no gender differences between the median sLE (p = 0.930), HLE (p = 0.417) and sHLE (p = 0.403) values. With less apparent gender differences among the predictors when compared to sLE, sHLE was mainly determined by self-perceived health, age and place of residence, while self-perceived health, close relatives' longevity, social conditions, happiness and perceived lifestyle influenced sLE.ConclusionsAlong subjective life expectancy, subjective healthy life expectancy may be a feasible indicator and provide insights to individuals' subjective expectations underlying the demographic estimates of the healthy life expectancy of the population.

Project description:BackgroundWhile many studies have examined differences between body mass index (BMI) categories in terms of mortality risk and health-related quality of life (HRQL), little is known about the effect of body weight on health expectancy. We examined life expectancy (LE), health-adjusted life expectancy (HALE), and proportion of LE spent in nonoptimal (or poor) health by BMI category for the Canadian adult population (age ? 20).MethodsRespondents to the National Population Health Survey (NPHS) were followed for mortality outcomes from 1994 to 2009. Our study population at baseline (n=12,478) was 20 to 100 years old with an average age of 47. LE was produced by building abridged life tables by sex and BMI category using data from the NPHS and the Canadian Chronic Disease Surveillance System. HALE was estimated using the Health Utilities Index from the Canadian Community Health Survey as a measure of HRQL. The contribution of HRQL to loss of healthy life years for each BMI category was also assessed using two methods: by calculating differences between LE and HALE proportional to LE and by using a decomposition technique to separate out mortality and HRQL contributions to loss of HALE.ResultsAt age 20, for both sexes, LE is significantly lower in the underweight and obesity class 2+ categories, but significantly higher in the overweight category when compared to normal weight (obesity class 1 was nonsignificant). HALE at age 20 follows these same associations and is significantly lower for class 1 obesity in women. Proportion of life spent in nonoptimal health and decomposition of HALE demonstrate progressively higher losses of healthy life associated with lowered HRQL for BMI categories in excess of normal weight.ConclusionsAlthough being in the overweight category for adults may be associated with a gain in life expectancy as compared to normal weight adults, overweight individuals also experience a higher proportion of these years of life in poorer health. Due to the descriptive nature of this study, further research is needed to explore the causal mechanisms which explain these results, including the important differences we observed between sexes and within obesity subcategories.

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Comparing the differences in three measures of healthy life expectancy among prefectures in Japan.

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Comparing the differences in three measures of healthy life expectancy among prefectures in Japan.

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