health expectancy indicators in belgium
DESCRIPTION
HEALTH EXPECTANCY INDICATORS IN BELGIUM. 4th Meeting of the Task Force on Health Expectancies Luxembourg, 4 th June 2007 Herman Van Oyen. FIRST ESTIMATIONS. Belgian Science Policy Office (Dec 1991) - PowerPoint PPT PresentationTRANSCRIPT
Unit of EPIDEMIOLOGY
SCIENTIFIC INSTITUTE OF PUBLIC HEALTH
HEALTH EXPECTANCY INDICATORS IN
BELGIUM
4th Meeting of the Task Force on Health Expectancies
Luxembourg, 4th June 2007
Herman Van Oyen
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FIRST ESTIMATIONS
Belgian Science Policy Office (Dec 1991)Project: Disability-free life expectancy in the elderly. A method for well-being planning and decision-making
•Data availability? Only small/local studiesEurobarometer
•Indicators: Healthy life expectancy• Disability free Life expectancy• Dementia free life expectancy
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Healthy life years, Eurobarometer, 1989-1990
Van Oyen H. et al. Tijdschrift Geneeskunde, 49:1169, 1993
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Dementia free life expectancy, 1991Epidemiologic research on dementia, Antwerp, Belgium
Roelands M. et al. Eur J Pub Hlth 4: 33, 1994
0
2
4
6
8
10
12
14
16
18
65 70 75 80 85 65 70 75 80 85
LE
DemFLE
DemLE
AGE
FEMALESMALES
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Healthy life years, Eurobarometer, 1989-1990Regional differences
Van Oyen H. et al. Soc Sci Med 43:1673, 1996
Age Flemish HLE
Walloon HLE
Difference in HLE
Z-score difference
Males 15 56.5
(55.5-57.6) 50.2
(48.4-51.9) 6.3 5.95
45 29.3 (28.8-30.2)
23.4 (21.6-25.1)
5.9 5.83
65 13.31 (12.2-14.4)
9.2 (7.4-11.0)
4.1 3.86
Females 15 61.3
(59.8-62.8) 58.1
(56.1-60.0) 3.2 2.56
45 33.3 (31.8-34.7)
30.7 (28.9-32.6)
2.6 2.12
65 16.0 (14.5-17.6)
14.3 (12.4-16.2)
1.7 1.44
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CONCLUSION
Monitoring system
•Cross-sectional data series: Health survey 97-01-04-08Census 2001
•Longitudinal data : still no data
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Mortality: 97, 01, 04
Life table: last interval 100-105 years
Health: Health Interview Survey 97, 01, 04 Face to Face
N: 10,000 – 13,000 each survey
Response rate: 60%
DATA
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Screening: chronic morbidity
Do you suffer from one or more longstanding diseases, chronic conditions or handicaps?
YES — NO
HEALTH QUESTIONS DISABILITY
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Are you restricted in your daily activities due to this (these) illness(es), chronic condition(s) or handicap(s)?
continuously severe disability every now and then moderate disability seldom or not / no disability
no chronic disease
HEALTH QUESTIONS DISABILITY
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Total Life Expectancy, Disability Free Life Expectancy and Life Expectancy with Disability at age 65, Belgium, 1997-2004
MALES Total Life Expectancy 15.53 16.24 16.79 DFLE 9.00 9.69 10.96 With Disability 6.53 6.55 5.83 Moderate 2.69 2.33 2.25 Severe 3.84 4.22 3.58 FEMALES Total Life Expectancy 19.80 20.23 20.66 DFLE 11.70 11.07 12.71 With Disability 8.10 9.16 7.95 Moderate 2.60 3.14 2.62 Severe 5.50 6.02 5.33
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Disability free life expectancy (DFLE) and life expectancy with moderate (MDLE) and severe (SDLE) disability as % of the total life expectancy at age 65, 1997-2004, Belgium
MALES FEMALES 1997 2001 2004 1997 2001 2004 DFLE 58 60 65 59 55 62 DLE 42 40 35 41 45 38 MDLE 17 14 13 13 15 13 SDLE 25 26 22 28 30 25
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Change in total life expectancy (LE), disability free LE (DFLE) and LE with moderate (MDLE) and severe (SDLE) disability at ages 65 and 80 by gender, 1997-2004, Belgium
-1.00
-0.50
0.00
0.50
1.00
1.50
2.00
2.50
LE
DFLE
MDLE
SDLE
Males Females
80 65 8065
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SUMMARY-TRENDHIS 1997-2004
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SES-INEQUALITIESFollow-up census for mortality (1991-1996)Health survey (1997)
0.00
10.00
20.00
30.00
40.00
50.00
LOWHIGH
Partial LE and DFLE between ages 25-74 by relative level of education, Belgim 1991-1996/1997
M_LEF_LE
M_DFLEF_DFLE
Bossuyt N. et al. Public Health 118:3, 2004
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DIFFERENTIAL INEQUALITY IN DFLE BY REGION between ages 25-74
VAN OYEN H. et al. Soz-Präventivmed 50:301, 2005
Flemish Region Walloon Region Level of Education LE Inequity in LE
LE Inequity in LE
Difference in inequity
in LE between the Regions
Men Bottom 44.86
(44.84 – 44.89) 1.62
(1.57 - 1.66) 42.77
(42.73 – 42.80) 2.15
(2.09 - 2.21) 0.53
(0.43 – 0.64) Top
46.48 (46.46 – 46.50)
44.92 (44.89 - 44.94)
All 45.77 (45.75 – 45.79)
43.88 (43.86 – 43.91)
Women Bottom 46.86
(46.84 – 46.88) 1.04
(1.01 – 1.07) 45.44
(45.42 - 45.46) 1.46
(1.41 - 1.50) 0.42
(0.34 – 0.49) Top
47.90 (47.89 – 47.91)
46.90 (46.88 - 46.91)
All 47.42 (47.41 – 47.43)
46.16 (46.15 – 46.18)
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DECOMPOSITION OF SES-DIFFERENCES IN DFLE
NUSSELDER W. et al. AJPH:95, 2035, 2005
LE-30 (years) LED-30 (years) DFLE-30 (years) Total Total Mortality Disability Total Men 3.6 -4.4 1.5 6.5 8.0 Cancer 1.0 0.3 0.4 0.2 0.6 Heart disease/stroke 0.9 -0.6 0.4 1.2 1.5 Asthma/COPD 0.5 -0.6 0.2 1.0 1.2 Diabetes mellitus 0.1 0.3 0.0 -0.3 -0.2 Back complaints 0.0 -2.1 0.0 2.1 2.1 Arthritis 0.0 -1.3 0.0 1.3 1.3 Other diseases 1.1 -1.3 0.5 1.9 2.4 Background 0.0 0.9 0.0 -0.9 -0.9 Women 2.6 -3.3 0.6 5.3 5.9 Cancer 0.3 -0.2 0.1 0.4 0.5 Heart disease/stroke 1.2 -0.4 0.2 1.4 1.6 Asthma/COPD 0.2 -1.3 0.0 1.5 1.5 Diabetes mellitus 0.1 -0.6 0.0 0.7 0.7 Back complaints 0.0 0.2 0.0 -0.2 -0.2 Arthritis 0.0 -2.2 0.0 2.2 2.2 Other diseases 0.8 0.4 0.2 0.2 0.3 Background 0.0 0.8 0.0 -0.8 -0.8
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HEALTH EXPECTANCIES BASED ON CENSUS DATA (among males)
0 20 40 60 80
Vlaams BrabantAntwerpen
LimburgWest-Vlaanderen Brabant WalloonOost-Vlaanderen
BrusselsLiège
LuxembourgNamur
HainautVlaams Brabant
AntwerpenLimburg
West-Vlaanderen Brabant WalloonOost-Vlaanderen
BrusselsLiège
LuxembourgNamur
HainautVlaams Brabant
AntwerpenLimburg
West-Vlaanderen Brabant WalloonOost-Vlaanderen
BrusselsLiège
LuxembourgNamur
Hainaut
Sub
ject
ive
Hea
lthC
hron
ic m
orbi
dity
Dis
abili
ty
Good
Bad
Severe
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PLANS FOR THE FUTURE
Evolution in SES-differences over time
Decomposition of regional differences
Estimation of health expectancies by life style factors
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USE OF THE INDICATOR WITHIN BELGIUM
Ministry of Social Affairs
Federal Planning Office
Health Insurance Agency
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