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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
2
Life expectancy at birth:
Selected Asian countries, 1990-2002
Life Expectancy
80
China
India
Indonesia
Malaysia
Philippines
Singapore
Sri Lanka
Thailand
75
70
65
60
55
1988
1992
1996
2000
2004
Year
World Bank Indicators, 2003
3
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
4
Percent of total population aged 65
years and older, 1990-2002
8
China
India
Indonesia
Malaysia
Philippines
Singapore
Sri Lanka
Thailand
Percent 65+
7
6
5
4
3
2
1988
1992
1996
2000
2004
Year
World Bank Indicators, 2003
5
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?
6
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
7
п‚Ґ

xпЂЅa
Estimating healthy life expectancy using the
Sullivan (1971) method and life tables:
DPR = Disability prevalence rate for age x from
survey data
1. Lx(hs) = (1 - DPR) * Lx
2. Tx(hs) = пЃ“x=t L
[person years spent in health]
[x(hs) + t] [total person years lived in health]
3. ex(hs) = Tx(hs) / lx
[healthy life expectancy]
Note: hs=healthy state
8
REVES: RГ©seau EspГ©rance de Vie en
SantГ©
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
9
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
10
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)
11
What are the trends in life expectancy
and healthy life expectancy in the
developing countries in Asia?
12
Life Expectancy (LE) and Healthy Life
Expectancy (HLE), China, 1987
Years of expected life
70
60
50
40
LE-Females
HLE-Females
LE-Males
HLE-Males
30
20
10
0
0
15
25
45
65
75
Age
•Females are advantaged with more years of life and more years of healthy life.
Grab et al., 1991
13
Similar trends in other Asian countries:
Females
22
Life Expectancy @ 65
Healthy Life Expectancy @ 65
18
20
16
18
14
16
12
14
10
12
8
10
6
10
12
14
16
Males
18
20
22
6
8
10
12
Males
14
16
18
14
Percent
Percent of life to be spent in health @ 65,
(HLE/LE) China, 1987
100
90
80
70
60
50
40
30
20
10
0
Females
Males
0
15
25
45
65
75
Age
•Males have the advantage with a greater percent of healthy life years.
Grab et al., 1991
15
Percent of Healthy Life @ 65 in selected Asian countries:
Females
1
Malaysia,1984
0.9
China,1992
Thailand,1996
N.Korea,1989
Singapore,1995
0.8
Burma, 1989
0.7
Thailand,1989
Indonesia,1989
Taiwan,1991
China,1987
S. Korea,1984
Sri Lanka,1989
Taiwan,1986
0.6
Thailand,1995 [SRH]
Thailand,1986 [SRH]
0.5
0.5
0.6
0.7
0.8
Males
0.9
1
16
Trends in HLE
For several countries we have more
than one estimate
These estimates can show us possible
trends in HLE and percent HLE
17
Trends in LE @ 65 for selected countries:
Females 22
20
Thailand
1986;1989;1996
18
16
China
1987;1992
Taiwan
1986;1991
14
12
12
14
16
Males
18
20
22
18
Trends in HLE @ 65 for selected countries:
Females 18
16
Thailand
1989;1996
China
1987;1992
14
12
Taiwan
1986;1991
10
Thailand [SRH]
1986;1995
8
6
6
8
10
12
Males
14
16
18
19
Results:
For all three countries:
Years of total life expectancy has increased
Years of healthy life expectancy has
increased
What about percent HLE?
20
Trends in % HLE for selected countries:
1
0.9
Thailand
1989;1996
China
1987;1992
*Little change*
0.8
Taiwan
1986;1991
0.7
0.6
Thailand [SRH]
1986;1995
*Little change*
0.5
0.5
0.6
0.7
0.8
0.9
1
21
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
22
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
23
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
24
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