Europa...The EHEMU/EHLEIS team comprises: Jean-Marie Robine, Health and Demography, University of Montpellier, France, [email protected] Carol Jagger, University of Leicester,

EHEMU Technical report 2009_4.5 April 2009

EHEMU Country Reports Issue 2 – April 2009

The EHEMU/EHLEIS team comprises:

Jean-Marie Robine, Health and Demography, University of Montpellier, France, [email protected]

Carol Jagger, University of Leicester, United-Kingdom, [email protected]

Herman Van Oyen Scientific Institute of Public Health, Brussels, Belgium, [email protected]

Emmanuelle Cambois, INED (Institut National d’Etudes Démographiques), Paris, France, [email protected]

Gabriele Doblhammer, Rostock Center for Demographic Change, Germany, [email protected]

Wilma J. Nusselder, Erasmus University, Rotterdam, [email protected]

Jitka Rychtarikova, University Charles, Prague, Czech Republic, [email protected]

Bianca Cox, Scientific Institute of Public Health, Brussels, Belgium, [email protected]

Clare Gillies, University of Leicester, United-Kingdom, [email protected]

Anne Kruse, Rostock Center for Demographic Change, Germany, [email protected]

Isabelle Beluche, Health and Demography, University of Montpellier, France, [email protected]

Renaud Counienc, Health and Demography, University of Montpellier, France, [email protected]

Isabelle Romieu, Health and Demography, University of Montpellier, France, [email protected]

Christine Perrier, Health and Demography, University of Montpellier, France, [email protected]

Contact EHEMU: Isabelle Romieu Equipe Démographie et Santé, Centre Val d'Aurelle, Parc Euromédecine, 34298 Montpellier cedex 5, France. Tel: +33 (0) 467 61 30 27 Fax: +33 (0) 467 61 37 87 Email: [email protected]

EHLEIS project co-funded by DG SANCO (Agreement number 2006109).

Introduction

This report by the European Health Expectancy Monitoring Unit (EHEMU) comprises the second issue of Country Reports on life and health expectancies for the 25 Member States (MS) in 2006. In particular Country Reports present analysis of the EU structural indicator Healthy Life Years (HLY) for each country in the wider European context. The joint analysis of health and life expectancies adds a quality dimension to the quantity of life lived by the European populations and can provide evidence of inequalities between MS in terms of health gaps and highlight potential targets for public health strategies both nationally and at a pan-European level.

Country Reports by EHEMU aim to:

• improve the understanding and dissemination of the HLY indicator at national level

• improve the measurement of the HLY indicator by providing standardized definitions and to stimulate the use of national estimates

In particular, the design of the Country Reports as a standardized 4 page newsletter is an important asset to the MS and the EU in the realization of their health policies since the format is suitable for non-technical readers and key-points and benchmarking of the MS against the EU average (without ranking of the MS) is provided. The main objective of the Country Reports is to give a simple interpretation of the values and trends of health expectancies. More specifically:

• Page 1 provides a background to HLY and describes the contents of the report.

• Page 2 shows the series of life expectancy and HLY for 1995-2001 in the MS, based on the European Community Household Panel (ECHP) and then from 2005 and 2006, based on the European Statistics on Income and Living Conditions (SILC), together with EU average values.

• Page 3 describes the most recent (2006) health expectancies in the MS. Three health expectancy indicators are presented based on the Minimal European Health Module (MEHM): HLY, life expectancy free of chronic morbidity, and life expectancy in good perceived health.

• Page 4 uses the latest available data to show the absolute years and proportion of healthy life at ages 25, 50 and 65 by gender for the EU 25 and for the EU 10 (countries joining in 2004) and EU 15.

This document assembles the Country Reports in alphabetical order of the countries. Care should be taken when reading the reports since the health data collected through SILC is not yet completed harmonized across all the MS. Thus it is as yet too early to compare countries in terms of health expectancies and indeed it will be safer to compare trends rather than annual values though emerging trends will not be evident until at least three annual values have been collected. Cultural differences may impact on the self-reporting of health and may explain some of the inequalities between MS. Trends in the HLY over time will provide the opportunity to quantify these. Theoretically cultural differences may have less of an impact on severe activity limitation but such a severity level addresses a very specific type of disability linked to the need for daily assistance and most common in the elderly whilst less severe activity limitation may be more policy relevant to the wider population. Through its analysis of other European data sets, EHEMU will undertake wider validation of the activity limitation data used in the HLY against other measures of health and functioning.

* Nevertheless, before 2008, the translations of the module used in some countries were not optimum (See Eurostat-EU Task Force on Health Expectancies common statement about the SILC data quality); ** Computed with the Eurostat method.

EHEMU Country Reports Issue 2 - April 2009

HEALTH EXPECTANCY IN AUSTRIA

What is health expectancy?

Health expectancies were first developed to address whether or not longer life is being accompanied by an increase in the time lived in good health (the compression of morbidity scenario) or in bad health (expansion of morbidity). So health expectancies divide life expectancy into life spent in different states of health, from say good to bad health. In this way they add a dimension of quality to the quantity of life lived.

How is the effect of longer life measured?

The general model of health transitions (WHO, 1984) shows the differences between life spent in different states: total survival, disability-free survival and survival without chronic disease. This leads naturally to life expectancy (the area under the 'mortality' curve), disability-free life expectancy (the area under the 'disability' curve) and life expectancy without chronic disease (the area under the 'morbidity' curve).

The general model of health transition (WHO, 1984): observed mortality and hypothetical morbidity and disability survival curves for females, USA, 1980.

There are in fact as many health expectancies as concepts of health. The commonest health expectancies are those based on self-perceived health, activities of daily living and on chronic morbidity.

How do we compare health expectancies?

Health expectancies are independent of the size of populations and of their age structure and so they allow direct comparison of different population sub-groups: e.g. sexes, socio-professional categories, as well as countries within Europe (Robine et al., 2003).

Health expectancies are most often calculated by the Sullivan method (Sullivan, 1971). However to make valid comparisons, the underlying health measure should be truly comparable.

To address this, the European Union has decided to include a small set of health expectancies among its European Community Health Indicators (ECHI) to provide synthetic measures of disability, chronic morbidity and perceived health. Therefore the Minimum European Health Module (MEHM), composed of 3 general questions covering these dimensions, has been introduced into the Statistics on Income and Living Conditions (SILC) to improve the comparability of health expectancies between countries.* In addition life expectancy without long term activity limitation, based on the disability question, was selected in 2004 to be one of the structural indicators for assessing the EU strategic goals (Lisbon strategy) under the name of “Healthy Life Years” (HLY).

What is in this report?

This report is produced by the European Health Expectancy Monitoring Unit (EHEMU) as part of a country series. In each report we present:

• Life expectancies** and health expectancies based on activity limitation (HLY) for the country of interest and for the overall 25 European Union member states (EU25), using the SILC question on long term activity limitation for 2005 and 2006. As the SILC has been only recently initiated, to document trends we provide previous HLY series based on the disability question of the 1995-2001 European Community Household Panel (ECHP)

• health expectancies based on the two additional dimensions of health (chronic morbidity and self-perceived health) for the country of interest, based on SILC 2006

• a global analysis of health expectancies of European countries, based on the SILC 2006

References

Jagger C, Gillies C, Moscone F, Cambois E, Van Oyen H, Nusselder W, Robine J-M, EHLEIS Team. Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis. The Lancet. 2008;372(9656) 2124-2131 (doi:10.1016/S0140-6736(08)61594-9)

Robine JM, Jagger C, Mathers CD, Crimmins EM Suzman RM, Eds. Determining health expectancies. Chichester UK: Wiley, 2003.

Sullivan DF (1971) A single index of mortality and morbidity. HSMHA Health Reports 86:347-354.

World Health Organization. The uses of epidemiology in the study of the elderly: Report of a WHO Scientific Group on the Epidemiology of Aging. Geneva: WHO, 1984 (Technical Report Series 706).

Further details on the MEHM, the European surveys and health expectancy calculation and interpretation can be found on www.ehemu.eu

Life expectancy (LE) and Healthy Life Years (HLY) at age 65 for Austria and the European Union (EU15 and EU25) based on ECHP (1995-2001) and SILC (2005-2006)

0

2

4

6

8

10

12

14

16

18

20

22

1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Exp

ecte

d ye

ars

Women : life expectancy (LE)

Women : healthy life years (HLY)

EU15Austria

Austria

EU15

Austria

Austria

EU25

EU25

based on ECHP data based on SILC data Austria 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Women : LE 18.8 18.9 19.1 19.4 19.4 19.6 20.0 20.4 20.7

Women : HLY 10.0 10.3 10.0 10.0 10.0 11.1 11.5 6.6 7.5

% HLY/LE 53% 54% 52% 52% 51% 57% 57% 33% 36%

0

2

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6

8

10

12

14

16

18

20

22

1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Expe

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yea

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Men : life expectancy (LE)

Men : healthy life years (HLY)

Austria

Austria

Austria

based on ECHP data based on SILC data

EU15

Austria

EU25

EU25

EU15

Austria 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Men : LE 15.0 15.1 15.2 15.4 15.7 16.0 16.3 17.0 17.3

Men : HLY 8.0 9.0 8.8 9.1 8.9 10.1 9.6 6.7 7.0

% HLY/LE 54% 60% 58% 59% 57% 63% 59% 40% 40%

Key points:

� Austrian life expectancy (LE) at age 65 has increased by 1.8 years for women and 2,2 years for men over the 1996-2006 period: it was in the EU15 average in 2001 but by 2006 was higher than the EU25 average.

� Over the 1995-2001 period, health expectancy based on activity limitation (HLY) at age 65 from the ECHP data steadily increased. Therefore the proportion of HLY (or years without self-reported limitations due to a health condition or disability), within the total expected years, increased for both sexes to 57% for women and 59% for men by 2001. Between 1995 and 2001 HLY in Austria was above the average for the EU15.

� The new HLY series, initiated in 2005 with the SILC data, shows values for Austria in 2006 of 1.4 and 1.7 years below the EU25 average for women and men respectively. In 2006 women and men at age 65 could expect to spend 36% and 40% of their life without self-reported long-term activity limitations respectively. Compared to earlier trends, the SILC question may result in people reporting limitations of different severity. Between 2005 and 2006 HLY slightly increased in Austria.

European Health Expectancy Monitoring Unit – EHEMU – website: www.ehemu.eu Contact Isabelle Romieu, Equipe INSERM Démographie et Santé – CRLC Val d'Aurelle - Parc Euromédecine -

34298 Montpellier cedex 5 – France Tel: +33 (0) 467 61 30 27 - e-mail: [email protected]

Life and health expectancies at age 65 based on activity limitation (Healthy Life Years), chronic morbidity and perceived health for Austria (Health data from SILC 2006) Life Expectancy at age 65 and expected years Without activity limitation With moderate activity limitation With severe activity limitation Life Expectancy at age 65 and expected years Without chronic morbidity With chronic morbidity Life Expectancy at age 65 and expected years In very good or good perceived health In fair perceived health In bad or very bad perceived health 6.9

7.0

10.0

10.8

7.0

7.5

6.8

8.2

6.5

6.9

3.6

5.5

7.3

9.9

3.8

6.3

0 2 4 6 8 10 12 14 16 18 20 22

Expected Years

Published results and other reports of health expectancies for Austria

C. Jagger, C. Gillies, F. Moscone, E. Cambois, H. Van Oyen, W. Nusselder, J-M. Robine, EHLEIS Team. Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis. The Lancet 2008;372(9656) 2124-2131 (doi:10.1016/S0140-6736(08)61594-9)

C. Jagger, J.-M. Robine, H. Van Oyen, E. Cambois. Life expectancy with chronic morbidity. In: European Commission, editor. Major and chronic diseases - report 2007. Luxembourg: European Communities; 2008. p. 291-304.

A. Lievre, F. Jusot, T. Barnay, C. Sermet, N. Brouard, J.-M. Robine, A.-M. Brieu, F. Forette. Healthy working life expectancies at age 50 in Europe: a new indicator. J Nutr Health Aging. 2007;11(6):508-514.

C. Jagger, EHEMU team. Healthy life expectancy in the EU 15. In: Institut des Sciences de la Santé, editor. Living longer but healthier lives: how to achieve health gains in the elderly in the European Union Europe Blanche XXVI, Budapest, 25-26 November 2005. Paris: ISS; 2006. p. 49-62.

G. Doblhammer, J. Kytir. Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998. Soc Sci Med. 2001;52:385-391.

G. Doblhammer, J. Kytir. Social Inequalities in Disability-free and healthy life expectancy in Austria. Wien Klin Wochenschr. 1998;110(11):393-396.

Key points:

• In 2006, LE at age 65 in Austria was 20.7 years for women and 17.3 years for men.

• Based on the SILC 2006, at age 65, women spent 7.5 years (36% of their remaining life) without activity limitation (corresponding to Healthy Life Years (HLY)), 6.9 years (33%) with moderate activity limitation and 6.3 years (30%) with severe activity limitation.*

• Men of the same age spent 7.0 years (40% of remaining life) without activity limitation compared to 6.5 years (38%) with moderate activity limitation and 3.8 years (22%) with severe activity limitation.*

• Although the total years lived by men were less than those for women, the numbers of years lived in very good or good perceived health were very similar. However the numbers of years lived without chronic morbidity and the years lived without activity limitation were greater for women than men.

• Compared to men, women spent a larger proportion of their life in ill health and these years of ill health were more likely to be years with severe health problems.

These results should be interpreted cautiously given the lack of the institutional population and in some countries the small sample size. The sample size for Austria comprised 1321 women and 1010 men aged 65+ years. * These may not sum to Life Expectancy due to rounding.

Women Men

Women Men

Women Men

European Health Expectancy Monitoring Unit – EHEMU – website: www.ehemu.eu Contact Isabelle Romieu, Equipe INSERM Démographie et Santé – CRLC Val d'Aurelle - Parc Euromédecine -


Healthy Life Years in Europe at ages 25, 50 and 65 in 2006

The top two graphs in the figure below show for men and women separately Healthy Life Years (HLY) and life expectancy at different ages for the newly joined EU10 countries, the established EU15 countries and the EU25 as a whole. The two lower graphs show HLY as a proportion of life expectancy for each of the ages and country groupings. The key points are:

• LE at age 25 is less in the EU10 countries than the EU15, by 6.5 years in men and 3.8 years in women. Differences between the EU10 and EU15 in LE reduce with age and by age 65 are 3.3 years for men and 2.7 for women.

• Differences in HLY between the EU10 and EU15 are smaller than differences in LE at all ages; at age 25 men in the EU10 have 5.5 years fewer free of activity limitation than men in the EU15 and women have 2.6 years fewer. Differences reduce with age for men but are relatively static for women; by age 65 differences are 2.6 years for men and 2.3 years for women.

• The proportion of remaining life spent free of activity limitation reduces with age but values are very similar in the EU10 and EU15.

Men Women

Age 65

Age 50

Age 25

Age 65

Age 50

Age 25

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Proportion of remaining life

0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


HLY

Years limited

0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

HLY

Years limited

About EHEMU

The European Health Expectancy Monitoring Unit (EHEMU) and its current project European Health and Life Expectancy Information System (EHLEIS) are funded by the European Public Health Programme (2004-2008) and is a collaboration between: the French national institute on health and medical research (INSERM) and CRLC (Montpellier, France), the University of Leicester (UK), the Scientific Institute of Public Health (ISP Belgium), the French National Institute of Demography (INED), University Charles (Czech Republic), Erasmus University Medical centre (The Netherlands) and University of Rostock (Germany). EHEMU aims to provide a central facility for the co-ordinated analysis, interpretation and dissemination of life and health expectancies to add the quality dimension to the quantity of life lived by the European populations. Further details about EHEMU can be found on the websites: www.ehemu.eu and www.healthy-life-years.eu



HEALTH EXPECTANCY IN BELGIUM
















References





Further details on the MEHM, the European surveys and health expectancy calculation and interpretation can be found on www.ehemu.eu.

Life expectancy (LE) and Healthy Life Years (HLY) at age 65 for Belgium and the European Union (EU15 and EU25) based on ECHP (1995-2001) and SILC (2005-2006)

0

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1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Expe

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yea

rsWomen : life expectancy (LE)


EU15Belgium

Belgium

EU15

Belgium

Belgium

EU25

EU25


Belgium 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Women : LE 19.3 19.4 19.5 19.6 19.6 19.7 19.9 20.2 20.6

Women : HLY 11.8 12.2 12.2 10.9 12.6 12.6 12.9 9.5 9.8

% HLY/LE 61% 63% 62% 56% 64% 64% 65% 47% 47%

0

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1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

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EU15

Belgium

Belgium

EU15

Belgium

EU25

Belgium


EU25

Belgium 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Men : LE 14.8 15.0 15.2 15.3 15.5 15.6 15.9 16.6 17.0

Men : HLY 9.8 9.5 10.8 9.5 11.1 11.1 11.2 9.1 9.5

% HLY/LE 66% 63% 71% 62% 72% 71% 70% 55% 56%

Key points:

� Belgian life expectancy (LE) at age 65 has increased by 1.2 years for women and 2.0 years for men over the 1996-2006 period: LE for both sexes between 1995-2001 was slightly below the EU15 average. By 2006 LE for both sexes was close to the EU25 average.

� Over the 1995-2001 period, health expectancy based on activity limitation (HLY) at age 65 from the ECHP data increased in Belgium. The proportion of HLY (or years without self-reported limitations due to health condition or disability), within the total expected years, slightly increased for both sexes between 1995 and 2001, being 65% for women and 70% for men in 2001. Between 1995 and 2001 HLY in Belgium was above the EU15 average.

� The new HLY series, initiated in 2005 with the SILC data, shows values for Belgium in 2006 of around 1 year above the EU25 average. In 2006 women and men at age 65 could expect to spend 47% and 56% of their life without self-reported long-term activity limitations respectively. Between 2005 and 2006 HLY slightly increased for men and women in Belgium.

European Health Expectancy Monitoring Unit – EHEMU – website: http://www.ehemu.eu Contact Isabelle Romieu, Equipe INSERM Démographie et Santé – CRLC Val d'Aurelle - Parc Euromédecine -


Life and health expectancies at age 65 based on activity limitation (Healthy Life Years), chronic morbidity and perceived health for Belgium (Health data from SILC 2006) Life Expectancy at age 65 and expected years Without activity limitation With moderate activity limitation With severe activity limitation Life Expectancy at age 65 and expected years Without chronic morbidity With chronic morbidity Life Expectancy at age 65 and expected years In very good or good perceived health In fair perceived health In bad or very bad perceived health 9.1

9.0

9.8

11.0

9.5

9.8

5.2

7.3

7.2

9.7

4.8

6.8

2.7

4.3

2.7

4.1

0 2 4 6 8 10 12 14 16 18 20 22

Expected Years

Published results and other reports of health expectancies for Belgium


H. Van Oyen, B. Cox, S. Demarest, P. Deboosere, V. Lorant. Trends in health expectancy indicators in the older adult population in Belgium between 1997 and 2004. Eur J Ageing. 2008 Jun;5(2):137-146.


H. Van Oyen, P. Deboosere. Tendances dans la sante de la population en Belgique entre 1997 et 2004 / Tendensen in de volksgezondheid in België tussen 1997 en 2004. Revue Belge de Securite Sociale / Belgisch Tijdschrift voor Sociale Zekerheid. 2008:245-283 / 249-287.



H. Van Oyen, N. Bossuyt, P. Deboosere, S. Gadeyne, E. Abatih, S. Demarest. Differential inequity in health expectancy by region in Belgium. Sozial- und Präventivmedizin. 2005;50(5):301-310.

W.J. Nusselder, C.W.N. Looman, J.P. Mackenbach, M. Huisman, H. Van Oyen, P. Deboosere, S. Gadeyne, A.E. Kunst. The Contribution of Specific Diseases to Educational Disparities in Disability-Free Life Expectancy. Am J Public Health. 2005;95(11):2035-2041.

N. Bossuyt, S. Gadeyne, P. Deboosere, H. Van Oyen. Socio-economic inequalities in health expectancy in Belgium. Public Health. 2004;118:3-10.

Key points:

• In 2006, LE at age 65 in Belgium was 20.6 years for women and 17.0 years for men.

• Based on the SILC 2006, at age 65, women spent 9.8 years (47% of their remaining life) without activity limitation (corresponding to Healthy Life Years (HLY)), 6.8 years (33%) with moderate activity limitation and 4.1 years (20%) with severe activity limitation.*


• Although the total years lived by men were less than those for women, the numbers of years lived in very good or good perceived health and the years lived without activity limitation were very similar. However the number of years lived without chronic morbidity was greater for women than men.


These results should be interpreted cautiously given the lack of the institutional population and in some countries the small sample size. The sample size for Belgium comprised 1079 women and 938 men aged 65+ years. * These may not sum to Life Expectancy due to rounding.

Women Men

Women Men

Women Men







Men Women

Age 65

Age 50

Age 25

Age 65

Age 50

Age 25

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


HLY

Years limited

0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

HLY

Years limited

About EHEMU




HEALTH EXPECTANCY IN CYPRUS
















References






Life expectancy (LE) and Healthy Life Years (HLY) at age 65 for Cyprus and the European Union (EU15 and EU25) based on ECHP (1995-2001) and SILC (2005-2006)

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EU15

Cyprus

EU15

Cyprus

Cyprus

EU25

EU25


Cyprus 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Women : LE 18.5 18.6 18.2 17.9 18.3 18.4 19.4 19.1 19.7

Women : HLY 4.8 7.2

% HLY/LE 25% 36%

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Cyprus

EU15

EU15

Cyprus

Cyprus

EU25

EU25



Cyprus 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Men : LE 15.8 15.7 15.7 15.2 16.5 15.8 17.0 16.8 17.7

Men : HLY 6.7 9.4

% HLY/LE 40% 53%

Key points:

� Cypriot life expectancy (LE) at age 65 has increased by 1.1 years for women and 2.0 years for men over the 1996-2006 period: LE for men between 1995-2001 was close to the EU15 average while LE for women was below. By 2006 LE for men was above the EU25 average while LE for women remained below.

� Because Cyprus joined the European Union in 2004, health expectancy based on activity limitation (HLY) over the 1995-2001 period is not available.

� The new HLY series, initiated in 2005 with the SILC data, shows that in 2006 women and men at age 65 could expect to spend 36% and 53% of their life without self-reported long-term activity limitations respectively. The HLY values for Cyprus are 1.7 years below the EU25 average for women in 2006 and 0.7 years above for men. Between 2005 and 2006 HLY increased considerably in Cyprus.



Life and health expectancies at age 65 based on activity limitation (Healthy Life Years), chronic morbidity and perceived health for Cyprus (Health data from SILC 2006) Life Expectancy at age 65 and expected years Without activity limitation With moderate activity limitation With severe activity limitation Life Expectancy at age 65 and expected years Without chronic morbidity With chronic morbidity Life Expectancy at age 65 and expected years In very good or good perceived health In fair perceived health In bad or very bad perceived health

6.4

3.9

5.6

4.5

9.4

7.2

6.2

7.0

3.8

5.9

5.1

8.9

12.2

15.3

4.5

6.7

0 2 4 6 8 10 12 14 16 18 20 22

Expected Years

Published results and other reports of health expectancies for Cyprus



Key points:

• In 2006, LE at age 65 in Cyprus was 19,7 years for women and 17.7 years for men. • Based on the SILC 2006, at age 65, women spent 36% of their remaining life (7.2 years) without activity limitation

(corresponding to Healthy Life Years (HLY)), 30% (5.9 years) with moderate activity limitation and 34% (6.7 years) with severe activity limitation.*

• Men of the same age spent 53% (9.4 years) of remaining life without activity limitation compared to 22% (3.8 year) with moderate activity limitation and 25% (4.5 years) with severe activity limitation.*

• Although the total years lived by men were less than those for women, for all the health expectancies the years of life spent in positive health were greater for men than women.


These results should be interpreted cautiously given the lack of the institutional population and in some countries the small sample size. The sample size for Cyprus comprised 818 women and 686 men aged 65+ years. * These may not sum to Life Expectancy due to rounding.

Women Men

Women Men

Women Men








Men Women

Age 65

Age 50

Age 25

Age 65

Age 50

Age 25

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


HLY

Years limited

0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

HLY

Years limited

About EHEMU




HEALTH EXPECTANCY IN THE CZECH REPUBLIC
















References






Life expectancy (LE) and Healthy Life Years (HLY) at age 65 for the Czech Republic and the European Union (EU15 and EU25) based on ECHP (1995-2001) and SILC (2005-2006)

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EU15

Czech Republic

EU15

CzechRepublic

CzechRepublic

EU25

EU25


Czech Republic 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Women : LE 16.2 16.6 16.7 17.0 17.0 17.3 17.3 17.7 18.3

Women : HLY 6.9 7.1

% HLY/LE 39% 39%

0

2

4

6

8

10

12

14

16

18

20

22

1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Exp

ecte

d y

ears

Men : life expectancy(LE)


EU15

Czech Republic

EU15

Czech Republic

CzechRepublic

EU25

EU25


Czech Republic 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Men : LE 12.7 13.1 13.2 13.5 13.7 13.8 14.0 14.4 14.8

Men : HLY 6.5 6.7

% HLY/LE 45% 45%

Key points:

� Czech life expectancy (LE) at age 65 has increased by 1.7 years for both sexes over the 1996-2006 period. LE for both sexes between 1995-2001 was below the EU15 average and remained below the EU25 (1.9 years for men and 2.0 years for women) in 2006.

� Because the Czech Republic joined the European Union in 2004, health expectancy based on activity limitation (HLY) over the 1995-2001 period is not available.

� The new HLY series, initiated in 2005 with the SILC data, shows that in 2006 women and men at age 65 could expect to spend 39% and 45% of their life without self-reported long-term activity limitations respectively. The HLY values for the Czech Republic are 1.8 years and 2.0 years below the EU25 average in 2006 for women and men respectively. Between 2005 and 2006 HLY slightly increased in the Czech Republic.



Life and health expectancies at age 65 based on activity limitation (Healthy Life Years), chronic morbidity and perceived health for the Czech Republic (Health data from SILC 2006) Life Expectancy at age 65 and expected years Without activity limitation With moderate activity limitation With severe activity limitation Life Expectancy at age 65 and expected years Without chronic morbidity With chronic morbidity Life Expectancy at age 65 and expected years In very good or good perceived health In fair perceived health In bad or very bad perceived health 2.7

2.3

6.2

6.6

6.7

7.1

7.3

8.8

5.7

7.4

4.8

7.2

8.7

11.7

2.5

3.8

0 2 4 6 8 10 12 14 16 18 20 22

Expected Years

Published results and other reports of health expectancies for the Czech Republic



J. Rychtaříková. Healthy life expectancy in the current Czech population. Czech Demography. 2007;1:61-74.

J. Rychtaříková. Zdravá délka života v současné české populaci [Healthy Life Expectancy in the Czech population ]. Demografie. 2006;48(3):166-178.

J. Hrkal, Š. Kasalová Daňková. Zdravá délka života u obyvatel EU [Healthy Life Expectancy in the population of the EU]. Demografické informační centrum 2005(10.07.2005).

J. Rychtaříková. Naděje dožití ve zdraví [Disability free life expectancy]. Demografie. 2000;42(1):41-48.

Key points:

• In 2006, LE at age 65 in the Czech Republic was 18.3 years for women and 14.8 years for men. • Based on the SILC 2006, at age 65, women spent 7.1 years (39% of their remaining life) without activity limitation

(corresponding to Healthy Life Years (HLY)), 7.4 years (40%) with moderate activity limitation and 3.8 years (21%) with severe activity limitation.*


• Although total years lived by men were less than those for women, for all the health expectancies the years of life spent in positive health were similar for men and women.


These results should be interpreted cautiously given the lack of the institutional population and in some countries the small sample size. The sample size for the Czech Republic comprised 1831 women and 1221 men aged 65+ years. * These may not sum to Life Expectancy due to rounding.

Women Men

Women Men

Women Men








Men Women

Age 65

Age 50

Age 25

Age 65

Age 50

Age 25

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


HLY

Years limited

0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

HLY

Years limited

About EHEMU




HEALTH EXPECTANCY IN DENMARK
















References






Life expectancy (LE) and Healthy Life Years (HLY) at age 65 for Denmark and the European Union (EU15 and EU25) based on ECHP (1995-2001) and SILC (2005-2006)

0

2

4

6

8

10

12

14

16

18

20

22

1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Exp

ecte

d y

ears



EU15

Denmark

Denmark

EU15

Denmark

Denmark

EU25

EU25


Denmark 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Women : LE 17.6 17.9 18.0 18.3 18.1 18.3 18.3 19.1 19.2

Women : HLY 9.3 9.5 9.0 9.9 9.5 9.9 10.3 14.1 14.1

% HLY/LE 53% 53% 50% 54% 52% 54% 56% 74% 73%

0

2

4

6

8

10

12

14

16

18

20

22

1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Exp

ecte

d y

ea

rs



EU15

Denmark

EU15

Denmark

Denmark

Denmark

EU25

EU25


Denmark 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Men : LE 14.1 14.4 14.6 14.9 15.0 15.2 15.2 16.1 16.2

Men : HLY 9.0 8.6 8.6 9.0 9.0 7.7 9.0 13.1 12.6

% HLY/LE 64% 60% 59% 61% 60% 51% 59% 81% 78%

Key points:

� Danish life expectancy (LE) at age 65 has increased by 1.3 years for women and 1.8 years for men over the 1996-2006 period: LE for both sexes between 1995-2001 was below the EU15 average. In 2006 LE for both sexes was below the EU25.

� Over the 1995-2001 period, health expectancy based on activity limitation (HLY) at age 65 from the ECHP data increased for women and was relatively stable for men. The proportion of HLY (or years without self-reported limitations due to health condition or disability), within the total expected years, slightly increased for women and decreased for men, being 56% and 59% respectively in 2001. Between 1995 and 2001, HLY in Denmark was close to the EU15 average.

� The new HLY series, initiated in 2005 with the SILC data, shows values for Denmark in 2006 of 5.2 and 3.9 years above the EU25 average for women and men respectively. In 2006 women and men at age 65 could expect to spend 73% and 78% of their life without self-reported long-term activity limitations respectively. Between 2005 and 2006 HLY did not change for women and decreased for men.

� Results for Denmark should be interpreted cautiously given the difference in response categories for activity limitation compared to other EU countries.



Life and health expectancies at age 65 based on activity limitation (Healthy Life Years), chronic morbidity and perceived health for Denmark (Health data from SILC 2006) Life Expectancy at age 65 and expected years Without activity limitation With moderate activity limitation Life Expectancy at age 65 and expected years Without chronic morbidity With chronic morbidity Life Expectancy at age 65 and expected years In very good or good perceived health In fair perceived health In bad or very bad perceived health 9.6

10.4

9.8

10.0

12.6

14.1

4.3

6.0

3.6

5.1

2.3

2.8

6.5

9.2

0 2 4 6 8 10 12 14 16 18 20 22

Expected Years

Published results and other reports of health expectancies for Denmark


B. Jeune, H. Bronnum-Hansen. Trends in health expectancy at age 65 for various health indicators, 1987-2005, Denmark. Eur J Ageing. 2008;5(4): 279-285.

H. Brønnum -Hansen, I. Petersen, B. Jeune, K. Christensen. Lifetime according to health status among the oldest olds in Denmark. Age Ageing. 2008 Advance Access published on November 18, 2008; doi:10.1093.

H. Bronnum-Hansen, M. Baadsgaard. Increase in social inequality in health expectancy in Denmark. Scand J Public Health. 2008;36:44-51.


H. Bronnum-Hansen, K. Juel, M. Davidsen, J. Sorensen. Impact of selected risk factors on expected lifetime without long-standing, limiting illness in Denmark. Preventive Medicine. 2007 Mar 31;45(1):49-53.

H. Bronnum-Hansen, K. Juel, M. Davidsen. The burden of selected diseases among older people in Denmark. J Aging Health. 2006;18(4):491.

H. Bronnum-Hansen. Health expectancy in Denmark, 1987-2000. Eur J Public Health. 2005;15(1):20-25.

Key points:

• In 2006, LE at age 65 in Denmark was 19.2 years for women and 16.2 years for men. • Based on the SILC 2006, at age 65, women spent 14.1 years (73% of their remaining life) without activity limitation

(corresponding to Healthy Life Years (HLY)) and 5.1 years (27%) with activity limitation.* • Men of the same age spent 12.6 years (78% of remaining life) without activity limitation compared to 3.6 years (22%) with

activity limitation.* • Although for all the health expectancies the years of life spent in positive health were greater for women than men,

women spent a larger proportion of their life in ill health. These results should be interpreted cautiously given the lack of the institutional population and the difference in response categories for activity limitation. The sample size for Denmark comprised 540 women and 460 men aged 65+ years. * These may not sum to Life Expectancy due to rounding.

Women Men

Women Men

Women Men








Men Women

Age 65

Age 50

Age 25

Age 65

Age 50

Age 25

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

0% 20% 40% 60% 80% 100%

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25


HLY

Years limited

0 10 20 30 40 50 60

EU10

EU15

EU25

EU10

EU15

EU25

EU10

EU15

EU25

Years of life

HLY

Years limited

About EHEMU




HEALTH EXPECTANCY IN ESTONIA
















References






Life expectancy (LE) and Healthy Life Years (HLY) at age 65 for Estonia and the European Union (EU15 and EU25) based on ECHP (1995-2001) and SILC (2005-2006)

0

2

4

6

8

10

12

14

16

18

20

22

1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Exp

ecte

d y

ea

rs



EU15

Estonia

Estonia

Estonia

Estonia

EU25

EU25


Estonia 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Women : LE 16.1 16.4 16.8 16.5 17.0 17.0 17.3 18.0 18.3

Women : HLY 3.4 3.9

% HLY/LE 19% 21%

0

2

4

6

8

10

12

14

16

18

20

22

1995 1996 1997 1998 1999 2000 2001 2005 2006 2007

Exp

ecte

d y

ea

rs



EU15

Estonia

EU15

Estonia

Estonia

EU25

EU25


Estonia 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Men : LE 12.0 12.2 12.5 12.2 12.6 12.8 12.7 13.1 13.2

Men : HLY 3.4 4.0

% HLY/LE 26% 30%

Key points:

� Estonian life expectancy (LE) at age 65 has increased by 1.9 years for women and 1.0 years for men over the 1996-2006 period: LE for both sexes between 1995-2001 was below the EU15 average and remained below the EU25 average in 2006.

� Because Estonia joined the European Union in 2004, health expectancy based on activity limitation (HLY) over the 1995-2001 period is not available.

� The new HLY series, initiated in 2005 with the SILC data, shows that in 2006 women and men at age 65 could expect to spend 21% and 30% of their life without self-reported long-term activity limitations respectively. In 2006 the HLY values for Estonia are 5.0 and 4.7 years below the EU25 average for women and men respectively. Between 2005 and 2006 HLY increased for both sexes in Estonia.



Life and health expectancies at age 65 based on activity limitation (Healthy Life Years), chronic morbidity and perceived health for Estonia (Health data from SILC 2006) Life Expectancy at age 65 and expected years Without activity limitation With moderate activity limitation With severe activity limitation Life Expectancy at age 65 and expected years Without chronic morbidity With chronic morbidity Life Expectancy at age 65 and expected years In very good or good perceived health In fair perceived health In bad or very bad perceived health 1.8

2.1

3.8

3.8

4.0

3.9

5.7

7.9

5.3

8.3

5.6

8.4

9.3

14.5

4

6

0 2 4 6 8 10 12 14 16 18 20 22

Expected Years

Published results and other reports of health expectancies for Estonia



T. Lai, J. Habicht, M. Reinap, D. Chisholm, R. Baltussen. Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia. Health Policy. 2007;84:75-88.

Naised ja mahed / Women and men. Tallinn: Statistics Estonia; 2006.


K. Vals. Haiguskoormuse tõttu kaotatud eluaastad Eestis [Health loss due to burden of disease in Estonia]: University of Tartu; 2005.

T. Lai, A. Baburin, K. Vals, R. Kiivet. Suremusest ja haigestumusest põhjustatud tervise-kadu Eestis [Health loss due to mortality and disease incidence: disease burden in Estonia]. Eesti Arst 2005;84(7):466–472.

Key points:

• In 2006, LE at age 65 in Estonia was 18.3 years for women and 13.2 years for men. • Based on the SILC 2006, at age 65, women spent 3.9 years (21% of their remaining life) without activity limitation

(corresponding to Healthy Life Years (HLY)), 8.3 years (46%) with moderate activity limitation and 6.0 years (33%) with severe activity limitation.*


• Although the total years lived by men were less than those for women, for all the health expectancies the years of life spent in positive health were similar.


These results should be interpreted cautiously given the lack of the institutional population and in some countries the small sample size. The sample size for Estonia comprised 1537 women and 893 men aged 65+ years. * These may not sum to Life Expectancy due to rounding.

Women Men

Women Men

Women Men








Men Women

Age 65

Age 50

Age 25

Age 65

Age 50

Age 25

0% 20% 40% 60% 80% 100%

Documents

Europa...The EHEMU/EHLEIS team comprises: Jean-Marie Robine, Health and Demography, University of Montpellier, France, [email protected] Carol Jagger, University of Leicester,