Policy Applications of Health Expectancy

Abstract

Empirical estimates of trends in health expectancy throughout the nations of the developed world provide conflicting evidence on the debate whether increasing life expectancy is accompanied by a compression or expansion of morbidity and disability. Complicating this issue is the fact that various methods are available for calculating health expectancy, each requiring a unique and often difficult to obtain source of data. It is suggested here that to reliably communicate the policy relevance of the measure of health expectancy it is necessary for countries such as the United Kingdom to make a long-term commitment to developing longitudinal databases that permit the most reliable estimates of trends in the health status of the population.

How many, how old, how soon?

“…I also obtained age and sex specific prevalence rates for different markers of disability. Rates of people who reported they were unable to carry out four activities of daily living (bathing, transfer from bed, feeding, getting to the toilet) were taken from Bone et al,2 who derived rates from the General Household Survey for England and Wales in different years. I also used rates for self reported illness by cause based on 1989 survey data for Great Britain 3.…”

“…In 1991, in England and Wales, the total expectation of life at 65-74 years was 14.2 years for men and 17.9 years for women; healthy life expectancy (that is, without limiting long standing illness) was 7.9 years for men and 9.8 years for women 2. Thus, about half the remaining years were spent with some limitation.…”

“…Projected numbers of people aged over 65 years in United Kingdom, 1996-2066, unable to perform activities of daily living independently, based on estimates from different years2…”

“…Projections are based on published estimates, which showed a fall in the number of such people over the past two decades 2. Thus, based on 1976 prevalence estimates, the numbers of people unable to perform the four activities of daily living will rise from about 1.7 million in 1996 to nearly 3.5 million in 2051.…”

Pressures in UK healthcare: challenges for the NHS

“…On the basis of data from the GHS, Bone et al (1995) have constructed estimates of how the number of years of healthy life expectancy, or so-called 'health expectancy', has changed between 1976 and 1992. These estimates show that, as life expectancies have grown, the number of years a person can expect to live free from limiting longstanding illness has remained roughly the same, so that additional years have tended to be iller ones.…”