Abstract
This paper studies gender differences in disability free life expectancy (DFLE), taking into account mortality and disability contributions. After analysing the types of disability that account for such differences, it goes on to examine temporal variability and age contributions to mortality and disability variation. The method used is an extension of Arriaga’s model proposed by Nusselder. In 2005, disability free life expectancy at age 30 was 46.23 years for men and 48.74 years for women, with a gender difference of 2.51 years. Decomposing this difference we find that the mortality effect is 3.70 years, while the disability effect is negative and equal to −1.19 years. Ten years earlier, in 1994, DFLE at age 30 was 43.24 years for men and 46.55 years for women, with a difference between genders of 3.32 years. This broke down to a mortality effect of 4.33 years and a disability effect of −1.02 years. In conclusion, the gap in DFLE between men and women is narrowing, thanks to the more rapid drop in mortality rates in men. With respect to disabilities women are disadvantaged, although the difference (in both total disability and different types of disability) has been almost stable in recent years.
Similar content being viewed by others
Notes
This, obviously, is also true for measurements obtained by the Sullivan-based decomposition model.
References
Alho JM (1992) On prevalence, incidence, and duration in general stable populations. Biometrics 48:587–592
Andreev E, Shkolnikov V, Begun AZ (2002) Algorithm for decomposition of differences between aggregate demographic measures and its application to life expectancies, healthy life expectancies, parity-progression ratios and total fertility rates. Demogr Res 7(14):499–522
Arriaga EE (1984) Measuring and explaining the change in life expectancy. Demography 21:83–96
Arriaga EE (1989) Changing trends in mortality decline during the last decades. In: Ruzicka L, Wunsch G, Kane P (eds) Differential mortality: methodological issues and biosocial factors. Clarendon Press, Oxford, England, pp 105–129
Bah SM (1998) Assessing the contribution of age-sex differentials in causes of death due to infectious and parasitic diseases to the trends in age-sex differentials in life expectancy in Mauritius. Soc Biol 45(3–4):260–272
Bebbington A, Bajekal M (2003) Sub-national variations health expectancy. In: Robine JM, Jagger C, Mathers CD, Crimmins EM, Suzman RM (eds) Determining health expectancy. Wiley, Chichester, England, pp 127–147
Bellini P, Dalla Zuanna G, Marsili M (1992) Trends in geographical differential mortality in Italy (1970–1990): tradition and change. Genus 48(1–2):155–182
Bongaarts J (2006) A decomposition of life expectancy levels and trends. Paper presented at the Annual Meeting of Population Association of America
Brønnum-Hansen E (2005) Health expectancy in Denmark, 1987–2000. Eur J Public Health 15(1):20–25
Brønnum-Hansen H, Baadsgaard M (2008) Increase in social inequality in health expectancy in Denmark. Scand J Public Health 36:44–51
Brouard N, Robine JM (1992) A method for calculation of health expectancy applied to longitudinal surveys of the elderly in France. In: Robine JM, Blanclet M, Dowd EJ (eds) Health expectancy. OPCS, HMSO, London, pp 87–94
Buhalis D, Eichhorn V, Michopoulou E, Miller G (2006) Accessibility market and stakeholder analysis. OSSATE/ University of Surrey
Burgio L, Murianni L, Folino-Gallo P (2009) Differences in life expectancy and disability free life expectancy in Italy. A challenge to health systems. Soc Indic Res 92:1–11
Conti S, Farchi G, Masocco M, Toccaceli V, Vichi M (1999) The impact of the major causes of death on life expectancy in Italy. Int J Epidemiol 28(5):905–910
Conti S, Farchi G, Masocco M, Minelli G, Toccaceli V, Vichi M (2003) Gender differentials in life expectancy in Italy. Eur J Epidemiol 18(2):107–112
Crimmins EM, Cambois E (2003) Social inequalities in health expectancy. In: Robine JM, Jagger C, Mathers CD, Crimmins EM, Suzman RM (eds) Determining health expectancy. John Wiley & Sons, Chichester, England, pp 111–125
Crimmins EM, Saito Y (2001) Trends in healthy life expectancy in the United States, 1970–1990: gender, racial, and educational differences. Soc Sci Med 52(11):1629–1641
Das Gupta P (1994) Standardisation and decomposing of rates from cross-classified data. Genus 50(3–4):71–196
Egidi V, Frova L, Pappagallo M, Spizzichino D (2004) Sopravvivenza e mortalità per causa nelle regioni italiane. In: Rapporto Osservasalute 2004, Vita e Pensiero, pp 23–46
Eurostat (2003) Employment of disabled people in Europe in 2002. ISBN 1024-4352, catalogue number: KS-NK-03-026-EN-N, European Communities 2003, viewed on 06th of April 2005. http://epp.eurostat.cec.eu.int/cache/ITY_OFFPUB/KSNK-03-026/EN/KS-NK-03-026-EN.PDF
Freeman J, Hutchison GB (1980) Prevalence, incidence and duration. Am J Epidemiol 112(5):707–723
Frova L, Prati S (1999) L’evoluzione della mortalità e della sopravvivenza. In: La mortalità in Italia nel periodo 1970–1992: evoluzione e geografia. Fuori Collana, ISTAT-ISS, Istituto Poligrafico e Zecca dello stato, Roma, pp 21–34
Gerlin A (2005) Access Denied. Time Europe, vol 165 (15). Viewed on 18th of April 2005. http://www.time.com/time/europe/magazine/article/0,13005,901050411-044655,00.html?promoid=rss_world
Gómez-Redondo R, Boe G (2005) Decomposition analysis of Spanish life expectancy at birth: evolution and changes in components by sex and age. Demogr Res 13:521–546
Imai K, Soneji S (2007) On the estimation of disability-free life expectancy: Sullivan’s method and its extension. J Am Stat Assoc 102(480):1199–1211
ISTAT (2003) La qualità della sopravvivenza: salute e autonomia. In: Rapporto Annuale - La situazione del Paese nel 2002. Roma
Jagger C, Gillies C, Mascone F, Cambois E, Van Oyen H, Nusselder WJ, Robine J-M, (2008) EHLEIS team. Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis. Lancet 372(9656):2124–2131
Keiding N (1991) Age-specific incidence and prevalence: a statistical perspective. J R Stat Soc A 154(3):371–412
Klenk J, Rapp K, Büchele G, Keil U, Weiland SK (2007) Increasing life expectancy in Germany: quantitative contributions from changes in age- and disease-specific mortality. Eur J Public Health 17:587–592
Kochanek KD, Maurer JD, Rosenberg HM (1994) Why did black life expectancy decline from 1984 through 1989 in United States? Am J Public Health 84:938–944
Mathers C, Robine JM (1993) Health expectancy indicators: a review of the work of REVES to date. In: Robine JM (ed) Calculation of health expectancies, harmonization, consensus achieved and future perspectives. Libbey, Paris
Matthews FE, Miller LL, Brayne C, Jagger C, the Medical Research council Cognitive Function, Aging Study (MRC CFAS) (2006) Regional differences in multidimensional aspects of health: findings from the MRC cognitive function and ageing study. BMC Public Health 6:90
Nusselder WJ, Looman CWN (2004) Decomposition of differences in health expectancy by cause. Demography 41(2):315–334
Nusselder WJ, Looman CWN, Mackenbach JP, Huisman M et al (2005) The contribution of specific diseases to educational disparities in disability-free. Am J Public Health 95:2035–2041
OECD (2005) Impact of population ageing on health and long-term care expenditure: assessing the effect of morbidity, disability and other cost drivers. Health Division, OECD, Workshop organised by the European Commission (Working Group on Ageing) 21–22 Feb, Brussels
Pollard JH (1988) On the decomposition of changes in expectation of life and differentials in life expectancy. Demography 25:265–276
Pollard JH (1990) Morbidity and mortality: differentials and their trends. Eur J Popul 6:205–225
Pressat R (1985) Contributions des écarts de mortalité per âge à la différence des vies moyennes. Population 40(4–5):766–770
Preston SH (1987) Relations among standard epidemiologic measures in a population. Am J Epidemiol 126(2):336–345
Robine JM, Michel JP (1992) Towards international harmonization of health expectancy indices. In: 5th international workshop of REVES, Ottawa, Reves paper 86
Robine JM, Mathers C, Bronard N (1993) Trends and differentials in disability-free life expectancy. Paper presented at the conference on Health and Mortality trends among elderly populations: determinants and implications, Sendai City, Japan
Robine JM, Romieu I, Cambois E (1999) Health expectancy and assessment of populations’ health status. Bull World Health Organ 77:181–185
Robine JM, Jagger C, the Euro-Reves group (2003a) Creating a coherent set of indicators to monitor health across Europe. Eur J Public Health 13:6–14
Robine JM, Romieu I, Michel JM (2003b) Trend in health expectancy. In: Robine JM et al (eds) Determining health expectancy. John Wiley & Sons, Chichester, England, pp 75–101
Robine JM, Jagger C, Clavel A, Romieu I (2004) Disability-free life expectancy (DFLE) in EU countries from 1991 to 2003. Technical Report 1, August
Robine J-M, Jagger C, Van Oyen H et al (2005a) Are we living longer, healthier lives in the EU? Technical Report 2, July
Robine J-M, Jagger C, Van Oyen H et al (2005b) Différentes estimations des espérances de santé dans les pays de l’union européenne en 2002. Technical Report 3, July
Schmidt U (2004) Die Politik der Bundesregierung für behinderte Menschen ist eine Erfolgsstory. Press release of the Ministry for Health and Social Security, 15th of December 2004, Berlin
Shkolnikov VM, Valkonen T, Begun AZ, Andreev EM (2001) Measuring inter-group inequalities in length of life. Genus LVII(3–4):33–62
Sullivan DF (1971) A single index of mortality and morbidity. HSMHA Health Rep 86:347–354
Trovato F, Lalu NM (1998) Contribution of cause specific mortality to changing sex differences in life expectancy: seven nation case study. Soc Biol 45(1–2):1–20
Van Oyen H, Bossuyt N, Deboosere P, Gadeyne S, Abatih E, Demarest SS (2005) Differential inequity in health expectancy by region in Belgium. Soc Prev Med 50(5):301–310
Velkova A, Wolleswinkel-van den Bosch JH, Mackenbach JP (1997) The east-west life expectancy gap: differences in mortality from conditions amenable to medical intervention. Int J Epidemiol 26(1):75–84
WHO European Observatory on Health Systems and Policies (2009) Health in the European Union. Trends and analysis. Observatory studies series n. 19
Yoshinaga K, Une H (2005) Contributions of mortality changes by age group and selected causes of death to the increase in Japanese’s life expectancy at birth from 1950 to 2000. Eur J Epidemiol 20:49–57
Acknowledgments
We would like to thank Wilma J. Nusselder for her contribution to the application of the model to the Italian data and Marie-Hélène Hayles for the English revision.
Author information
Authors and Affiliations
Corresponding author
Additional information
Communicated by Henrik Brønnum-Hansen, Bernard Jeune & Dorly J.H. Deeg.
All the authors contributed equally to this work.
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Frova, L., Burgio, A. & Battisti, A. Are gaps in disability free life expectancies diminishing in Italy?. Eur J Ageing 7, 239–247 (2010). https://doi.org/10.1007/s10433-010-0173-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10433-010-0173-1