Healthy Lifespan Inequality across Europe

Iñaki Permanyer , Centre for Demographic Studies and ICREA
Jeroen J. A. Spijker, Centre d’Estudis Demogràfics (CED), UAB
Amando Blanes, Universitat Autònoma de Barcelona

While death is retreating to increasingly older ages, it is unclear whether the onset of disease and disability are doing the same, an issue that could endanger the proper functioning of contemporary societies (e.g. by threatening the sustainability of pension systems, or the provision of health care to increasingly older populations). A first step towards addressing these challenges is to have good measures of population health, which currently include indicators of (i) average length-of-life (‘life expectancy’), (ii) average length-of-life spent in good health (‘health expectancy’), and (iii) variability in length-of-life (‘lifespan inequality’). What is lacking is a family of indicators measuring the extent to which healthy lifespans are unequally distributed across individuals. Here we propose one such family, the so-called ‘healthy lifespan inequality’ indicators. Applied to 30 European countries, the new indicators show that the variability in the ages at which physical activity limitations start are substantially larger than the variability in the ages at which individuals die, particularly for women. When ‘life years’ are substituted by ‘healthy life years’, we observe that (i) female advantage in terms of higher longevity and lower age-at-death uncertainty disappear; and (ii) the historically strong and negative association between average health attainment and inter-individual health inequality weakens considerably. The suggested indicators uncover new layers of health inequality that are not traceable with currently existing approaches, and hold promise to contribute substantively towards a general theory on population ageing.

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 Presented in Session 5. Health, Wellbeing and Morbidity