Self-Rated Healthy Life Expectancy Changes in Jiangxi Province of China by Gender and Urban–Rural Differences, 2013–2018

Abstract

Background: Globalization has brought about rapid economic and technological development, and life expectancy (LE) is constantly increasing. However, it is not clear whether an increase in LE will result in an increase in healthy life expectancy (HLE). This study evaluates trends in the self-rated healthy life expectancy (SRHLE) of residents aged 15 and older in Jiangxi Province of China from 2013 to 2018 and analyzes gender differences and urban–rural differences. This study provides a basis for the formulation of relevant public health policies.Methods: Based on two National Health Services Survey databases of Jiangxi in 2013 and 2018 as well as infant mortality rates and under-5 mortality rates from the Health Commission of Jiangxi, the Sullivan method was used to calculate SRHLE. The changes in SRHLE were decomposed into health and mortality effects using the decomposition method.Results: SRHLE decreased from 56.55 to 55.54 years and from 60.00 to 57.87 years for men and women aged 15 from 2013 to 2018, respectively. The SRHLE of women aged 15 was 3.45 and 2.34 years longer than that of men in 2013 and 2018, respectively. The SRHLE of urban men aged 15 was 2.9 and 4.46 years longer than that of rural men in 2013 and 2018, respectively, and that of urban women aged 15 was 3.28 and 5.57 years longer than that of rural women.Conclusions: The decreased SRHLE indicated that the self-rated health (SRH) status of residents in Jiangxi has worsened, and it provided evidence for the expansion of morbidity, mainly due to the increased prevalence of chronic diseases and the improvement in residents' health awareness. Policy efforts are necessary to control the increased morbidity of chronic diseases and reduce gender and urban–rural differences in the quantity and quality of years lived.

Trends of Healthy Life Expectancy of the Elderly in China in 1994–2015: Revisiting From the Perspective of Morbidity Transition

“…Older people are less likely to receive adequate treatment due to limited income or lack of access to adequate health resources due to lack of health coverage ( 17 , 20 , 40 ). Consequently, life expectancy increases while overall health declines ( 16 , 25 , 26 ), leading to expanded morbidity.…”

“…The above three hypotheses have their empirical supports, probably due to different research designs, such as longitudinal or cross-sectional data, countries, ages under study, social groups and health measurements (5,6,(11)(12)(13)(14)(15)(16). In China, evidence is mixed.…”

A Review of the Types and Characteristics of Healthy Life Expectancy and Methodological Issues

“…on a 5-point scale (very good, good, moderate, bad, or very bad) [17]. Individuals who respond "bad" or "very bad" on self-rated health surveys are considered to have an "unhealthy" status, for which a health weight of 0 is assigned in the estimation of self-rated HLE [18]. Thus, self-rated HLE resembles QALE and disability-free life expectancy.…”

“…Self-rated health is also referred to as self-reported health, self-assessed health, or perceived health and, despite slight differences in phrasing, it is generally defined as the collection of responses to the question “How do you rate your health?” on a 5-point scale (very good, good, moderate, bad, or very bad) [ 17 ]. Individuals who respond “bad” or “very bad” on self-rated health surveys are considered to have an “unhealthy” status, for which a health weight of 0 is assigned in the estimation of self-rated HLE [ 18 ]. Thus, self-rated HLE resembles QALE and disability-free life expectancy.…”

Multi-Dimensional Comparison of the Impact Mechanism of the Self-Rated Health Status of Urban and Rural Residents in Chinese Social Environments

“…The association between residential green space and health is stronger in high-density urban areas than in low-density urban and rural areas [ 24 ]. As a result, rural residents have higher rates of chronic disease and lower self-rated life expectancy [ 25 ]. However, rural residents also have some advantages.…”