Documents Nusselder, Wilma J. 2 results

"Background Life expectancy gaps between Eastern and Western Europe are well reported with even larger variations in healthy life years (HLY).Aims To compare European countries with respect to a wide range of health expectancies based on more specific measures that cover the disablement process in order to better understand previous inequalities.Methods Health expectancies at age 50 by gender and country using Sullivan's method were calculated from the Survey of Health and Retirement in Europe Wave 2, conducted in 2006 in 13 countries, including two from Eastern Europe (Poland, the Czech Republic). Health measures included co-morbidity, physical functional limitations (PFL), activity restriction, difficulty with instrumental and basic activities of daily living (ADL), and self-perceived health. Cluster analysis was performed to compare countries with respect to life expectancy at age 50 (LE50) and health expectancies at age 50 for men and women.Results In 2006 the gaps in LE50 between countries were 6.1 years for men and 4.1 years for women. Poland consistently had the lowest health expectancies, however measured, and Switzerland the greatest. Polish women aged 50 could expect 7.4 years fewer free of PFL, 6.2 years fewer HLY, 5.5 years less without ADL restriction and 9.5 years less in good self-perceived health than the main group of countries (Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden).Conclusions Substantial inequalities between countries were evident on all health expectancies. However, these differed across the disablement process which could indicate environmental, technological, healthcare or other factors that may delay progression from disease to disability."

"Background Discussions on raising pension eligibility age focus more on improvement in life expectancy (LE) and health expectancy measures than on socioeconomic differences in these measures. Therefore, this study assesses the level of socioeconomic differences in these two measures in Western-Europe.Methods Data from seven annual waves (1995–2001) of the European Community Household Panel were used. Health and socioeconomic information was collected using standardised questionnaires. Health was measured in terms of disability in daily activities. Socioeconomic status was determined as education level at baseline. Multi-state Markov modelling was applied to obtain age-specific transition rates between health states for every country, educational level and gender. The multi-state life table method was used to estimate LE and disability free life expectancy (DFLE) according to country, educational level and gender.Results When comparing high and low educational levels, differences in partial DFLE between the ages 50 and 65?years were 2.1?years for men and 1.9?years for women. At age 65?years, for LE the difference between high and low educated groups was 3?years for men and 1.9?years for women, and for DFLE the difference between high and low educated groups was 4.6?years for men and 4.4?years for women. Similar patterns were observed in all countries, although inequalities tended to be greater in the southern countries.Conclusions Educational inequalities, favouring the higher educated, exist on both sides of the retirement eligibility age. Higher educated persons live longer in good health before retirement and can expect to live longer afterwards."