Estimating Healthy Life Expectancy: A Province-by-Province Study for China

Li, Han; Hanewald, Katja; Wu, Shang

doi:10.2139/ssrn.3027825

Cited by 2 publications

(3 citation statements)

References 61 publications

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“…Our findings are novel in that we were able to measure the ARD burden and disparities across provinces in China and examine the impact of health resource indicators on the burden. Nevertheless, the regional disparities of age-standardised ARD burdens align with their health development status and are similar to the disparities in estimated HALE 50–53. The rank of NCD burdens among the ARDs is consistent with that of the disease burden among older people in China 34.…”

Section: Discussionsupporting

confidence: 62%

“…Nevertheless, the regional disparities of age-standardised ARD burdens align with their health development status and are similar to the disparities in estimated HALE. [50][51][52][53] The rank of NCD burdens among the ARDs is consistent with that of the disease burden among older people in China. 34 Interestingly, we found that increasing health expenditures or workforce density does not significantly decrease the ARD burden, instead the key is to reduce the urban-rural gap in the health workforce density.…”

Section: Discussionmentioning

confidence: 60%

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Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China

Chen

Hanewald

et al. 2022

BMJ Open

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ObjectivesTo measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China.DesignA national comparative study based on Global Burden of Diseases Study estimates and China’s routine official statistics.Setting and participantsThirty-one provinces of Mainland China were included for analysis in the study. No individuals were involved.MethodsWe first identified the ARDs and calculated the disability-adjusted life years (DALYs) of ARDs in 2016. We assessed the ARD burden disparities by province and sex and calculated the provincial ARD burden-adjusted age. We assessed historical changes between 1990 and 2016. Fixed effects regression models were adopted to evaluate the impact of health expenditures and health workforce indicators on the ARD burden in 2010–2016.ResultsIn 2016, China’s total burden of ARDs was 15 703.7 DALYs (95% uncertainty intervals: 12 628.5, 18 406.2) per 100 000 population. Non-communicable diseases accounted for 91.9% of the burden. There were significant regional disparities. The leading five youngest provinces were Beijing, Guangdong, Shanghai, Zhejiang and Fujian, located on the east coast of China with an ARD burden-adjusted age below 40 years. After standardising the age structure, western provinces, including Tibet, Qinghai, Guizhou and Xinjiang, had the highest burden of ARDs. Males were disproportionately affected by ARDs. China’s overall age-standardised ARD burden has decreased since 1990, and females and eastern provinces experienced the largest decline. Regression results showed that the urban–rural gap in health workforce density was positively associated with the ARD burdens.ConclusionChronological age alone does not provide a strong enough basis for appropriate ageing resource planning or policymaking. In China, concerted efforts should be made to reduce the ARDs burden and its disparities. Health resources should be deliberately allocated to western provinces facing the greatest health challenges due to future ageing.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 60%

Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China

Chen

Hanewald

et al. 2022

BMJ Open

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“…Zhong estimated that the concentration indices of self-reported poor health and the prevalence of activities of daily living were −0.0102 and −0.0247, respectively, indicating a socioeconomic gradient among elderly Chinese residents [5]. In Shanghai, life expectancy in women was 83.54 years in 2015, whereas in poorer provinces such as Qinghai Province, it was 74.17 years-a difference of 9.37 years [6]. In addition, the health inequality index of rural residents is higher than that of urban residents in China [7].…”

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confidence: 99%

Health inequalities among middle-aged and elderly people in China: analyses of cross-sectional surveys from the China Health and Retirement Longitudinal Study 2011–2016

Qiu¹,

Zeng²,

Han

et al. 2020

Preprint

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Objectives: China has a history of striving to achieve health equity, including efforts to prevent and control infectious diseases. However, to date, there is no comprehensive assessment of inequalities in chronic diseases in China. Methods: Data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS) conducted from 2011 to 2016. A total of 50,244 Chinese adults aged 45 years and older were included (16,128 in 2011, 16,646 in 2013, and 17,470 in 2015). Principal component analysis was used to construct the socioeconomic status indicator. We calculated concentration indices and corresponding CIs for 14 chronic diseases and comorbidities. We then estimated the Kendall rank correlation coefficient for inequalities and GDP per capita among provinces. Results: For 10 of the 14 chronic diseases, prevalence rates were higher for the poorest tertiles than for the richest tertiles. The concentration indices of dyslipidaemia, diabetes or high blood sugar, and cancer or malignant tumour were, respectively, 0.1256 (95% confidence interval, 0.1052–0.151), 0.098 (0.0704–0.1244), and 0.1305 (0.0528–0.215) in 2015–2016, which indicated pro-rich inequality. Health inequality for chronic lung diseases and eight other diseases grew markedly from 2011 to 2016. Overall, health inequality was lower for urban residents (−0.035 in 2011–2012, −0.036 in 2013–2014, and −0.05 in 2015–2016) than rural residents (−0.053, −0.064, and −0.08, respectively), and inequality was twice as high among women (−0.051, −0.05, and −0.072, respectively) than among men (−0.023, −0.02, and −0.032, respectively). Provinces that were ranked higher for GDP per capita were also ranked higher in the degree to which disease prevalence was higher in people with lower income (Kendall’s τ=−0.2328, p=0.015; Kendall’s τ=−0.3545, p=0.0077; Kendall’s τ=−0.2646, p=0.0079, respectively). Conclusions: Pro-poor health inequalities for many diseases in China are large and widening. Policies associated with health equity, including free public health services and community health programmes, are needed to achieve the Sustainable Development Goals.

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Estimating Healthy Life Expectancy: A Province-by-Province Study for China

Cited by 2 publications

References 61 publications

Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China

Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China

Health inequalities among middle-aged and elderly people in China: analyses of cross-sectional surveys from the China Health and Retirement Longitudinal Study 2011–2016

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