Evaluating compression or expansion of morbidity in Canada: trends in life expectancy and health-adjusted life expectancy from 1994 to 2010

Abstract

Introduction: The objective of this study was to investigate whether morbidity in Canada, at the national and provincial levels, is compressing or expanding by tracking trends in life expectancy (LE) and health-adjusted life expectancy (HALE) from 1994 to 2010. "Compression" refers to a decrease in the proportion of life spent in an unhealthy state over time. It happens when HALE increases faster than LE. "Expansion" refers to an increase in the proportion of life spent in an unhealthy state that happens when HALE is stable or increases more slowly than LE.

The transition in health in a population aged 65 years and over in Europe

“…Both indicators (especially HALE calculated with different methodologies, see Zafeiris and Skiadas 2015), when measured over time, are commonly used to in a verification of expansion and compression hypothesis (e.g. Steensma et al 2017).…”

“…A 'health-adjusted life expectancy' (HALE) (defined as the average number of healthy years that a person would live under the mortality and morbidity prevailing at that time) is a useful metric of health expectancy (Saito et al 2014). Existing in the literature analyses monitor these trends usually for one particular country (e.g., Crimmins and Beltrán-Sánchez 2011;Cutler et al 2014;Steensma et al 2017). It is commonly underline in the literature that comparison health of different countries is difficult because of cultural differences, differences in recording and classification practices, and different methodologies of data collecting.…”

Food Insecurity and Aging: A Scoping Study of the Literature

“…Such assumptions equating old age with illness and requiring expensive medical intervention are increasingly being questioned. On the contrary, there is evidence to suggest that older people are experiencing improved (health adjusted) life expectancy (Cutler, Ghosh, & Landrum, 2014;Steensma, Loukine, & Choi, 2017).…”

Editorial - Reducing premature mortality among young and middle-aged adults

“…25 Certainly, acknowledgement of and proper accounting for these and other inequities can help young adult populations to achieve a healthier body mass, as highlighted in the current issue of Health Promotion and Chronic Disease Prevention in Canada, by Bhawra et al, 25 Frankish et al 26 and Rao et al 27 In another paper published in the current issue, Steensma and colleagues present national data on health-adjusted life expectancy (HALE)-a hybrid measure not only of quantity of life, but of quality of life as well. 28 Across Canada, about 45% of the variation of HALE by health region was previously explained by differences in socioeconomic status, 29 and Steensma et al suggest that things may be worse in Newfoundland and Labrador and Prince Edward Island, especially among males. 28 This analysis may in fact be conservative, considering that the data were available only up to 2010, and the study could not include people living on Indian reserves, certain remote areas of Ontario and Quebec and within the three Canadian territories-areas where disability-free life expectancy (a metric similar to HALE) tends to be worse.…”

“…28 Across Canada, about 45% of the variation of HALE by health region was previously explained by differences in socioeconomic status, 29 and Steensma et al suggest that things may be worse in Newfoundland and Labrador and Prince Edward Island, especially among males. 28 This analysis may in fact be conservative, considering that the data were available only up to 2010, and the study could not include people living on Indian reserves, certain remote areas of Ontario and Quebec and within the three Canadian territories-areas where disability-free life expectancy (a metric similar to HALE) tends to be worse. 29 Certainly, a consideration of HALE that specifically focusses on those aged 20 to 45 years can reveal the degree to which some of the factors that influence premature loss of life also concomitantly reduce quality of life in early and middle adulthood.…”