Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-29T17:02:23.130Z Has data issue: false hasContentIssue false
  • English
  • Français

Healthy Life Expectancy Measurement in Scotland

Published online by Cambridge University Press:  10 June 2011

A. S. Macdonald ,
J. Straughn  and
M. Sutton
A. S. Macdonald
Affiliation:
Department of Actuarial Mathematics and Statistics and the Maxwell Institute for Mathematical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K., Tel: +44(0)131-451-3209, Fax: +44(0)131-451-3249, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Health expectancy (HE) was only recently estimated for the Scottish population (Clark et al., 2004). The estimates were based on Sullivan's method, applying the morbidity prevalence in each age group to the expected number of years lived, to obtain the expected number of years lived in good health. First, we compare these estimates with a wide range of estimates in respect of the rest of the United Kingdom and the (pre-accession) countries of the European Union. We find that Scotland's HE is relatively low, especially for men. Second, we examine data comprising the responses to the 1998 Scottish Health Survey, linked to the hospital records of the respondents from 1981 to 2004, and death records from 1998 to 2004, with HE measurement in mind. Although time spent in hospital does not give a satisfactory measure of HE, the linkage presents a rare opportunity for statistical analysis of survey respondents' mortality and morbidity. We show the results of survival analyses, quantifying the effectiveness of various definitions of ‘unhealthy’ as predictors of future mortality and morbidity. The results suggest that enumerating recent serious hospital episodes might help to predict future patterns of demand for acute services.

Keywords

Health ExpectancyHospital EpisodesLife ExpectancyScottish Health Survey
Type
Sessional meetings: papers and abstracts of discussions
Information
British Actuarial Journal , Volume 12 , Issue 2 , 01 July 2006 , pp. 327 - 390
Copyright
Copyright © Institute and Faculty of Actuaries 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bajekal, M., Purdon, S., Woodgate-Jones, G. & Davies, S. (2002). Healthy life expectancy at Health Authority level: comparing estimates from the General Household Survey and the Health Survey for England. Health Statistics Quarterly, 16, 25–37.Google Scholar
Bajekal, M. (2005). Healthy life expectancy by area deprivation: magnitude and trends in England 1994-1999. Health Statistics Quarterly, 25, 18–27.Google Scholar
Bebbington, A.C. (1988). The expectation of life without disability in England and Wales. Social Science in Medicine, 27, 321–326.CrossRefGoogle ScholarPubMed
Bebbington, A.C. (1991). The expectation of life without disability in England and Wales: 1976-1988. Population Trends, 66, 26–29.Google Scholar
Bebbington, A.C. (1992). Expectation of life without disability measured from the OPCS disability surveys. Studies on Medical and Population Subjects, 54, 23–32.Google Scholar
Bebbington, A.C. (1993). Regional and social variations in disability-free expectancy in Great Britain. In Calculation of health expectancies: harmonisation, consensus achieved and future perspectives. Ed. Robine, J.-M., Mathers, C.D., Bone, M.R. & Romieu, I.Coloque INSERM/John Libbey Eurotext Ltd., 226.Google Scholar
Bebbington, A.C. (2003). Sub-national variations in health expectancy. In Determining health expectancies. Ed. Robine, J.-M., Mathers, C. & Jagger, C.John Wiley: London.Google Scholar
Bebbington, A.C. & Darton, R.A. (1996). Healthy life expectancy in England and Wales: recent evidence. Discussion Paper 1205, Personal Social Services Research Unit, University of Kent.Google Scholar
Bisset, B. (2002). Healthy life expectancy in England at subnational level. Health Statistics Quarterly, 14, 21–29.Google Scholar
Bone, M.R., Bebbington, A.C., Jagger, C., Morgan, K. & Nicolaas, G. (Eds.) (1995). Health expectancy and its uses. HMSO, London.Google Scholar
Buratta, V. & Egidi, V. (2003). Data collection methods and comparability issues. In Determining health expectancies. Ed. Robine, J.-M., Jagger, C., Mathers, C.D., Crimmins, E.M. & Suzman, R.M.John Wiley.Google Scholar
Carstairs, V. & Morris, R. (1991). Deprivation in Scotland. Aberdeen University Press.Google Scholar
Clark, D., McKeon, A., Sutton, M. & Wood, R. (2004). Healthy life expectancy in Scotland. Information Services Division, National Health Scotland.Google Scholar
CMIB (1991). Continuous Mortality Investigation Bureau Report No. 12. Faculty of Actuaries and Institute of Actuaries.Google Scholar
Fries, J.P. (1980). Aging, natural death, and the compression of morbidity. New England Journal of Medicine, 31, 407–428.Google Scholar
Fries, J.P. (1989). The compression of morbidity: near or far? New England Journal of Medicine, 67, 208–232.Google ScholarPubMed
Gruenberg, E.M. (1977). The failure of success. Milbank Memorial Foundation Quarterly/Health and Society, 55, 3–24.CrossRefGoogle Scholar
Hooker, P.F. & Longley-Cook, L.H. (1953). Life and other contingencies, Volume 1. Cambridge University Press.Google Scholar
Jagger, C. (1997). Health expectancy calculation by Sullivan's method: a practical guide. Euro-REVES, Montpelier, France.Google Scholar
Kelly, S., Baker, A. & Gupta, S. (2000). Healthy life expectancy in Great Britain, 1980-1996, and its uses as an indicator in the United Kingdom Government strategies. Health Statistics Quarterly, 7, 32–37.Google Scholar
Kramer, M. (1980). The rising pandemic of mental disorders and associated chronic diseases and disabilities. Acta Pschiatrica Scandinavica, 62 (Supplement 285), 285–297.Google Scholar
Ledent, J. (1980). Multistate life tables: movement versus transition perspectives. Environment and Planning A, 12, 533–562.CrossRefGoogle Scholar
Leon, D., Morton, S., Cannegieter, S. & McKee, M. (2003). Understanding the health of Scotland's population in an international context: a review of current approaches, knowledge and recommendations for new research directions. London School of Hygiene and Tropical Medicine.Google Scholar
Manton, K.G. (1982). Changing concepts of morbidity and mortality in the elderly population. Milbank Memorial Fund Quarterly/Health and Society, 60(2), 183–244.CrossRefGoogle ScholarPubMed
Mathers, C.D., Sadana, R., Salomon, J.A., Murray, J.L. & Lopez, J.D. (2000a). Healthy life expectancy in 191 countries, 1999. World Health Report 2000, World Health Organization, Geneva.Google Scholar
Mathers, C.D., Sadana, R., Salomon, J.A., Murray, J.L. & Lopez, A.D. (2000b). Estimation of DALE for 191 countries: methods and results. Global Programme on Evidence for Health Policy working paper No. 16, World Health Organization.Google Scholar
Melzer, D., McWilliams, B., Brayne, C., Johnson, T. & Bond, J. (2000). Socioeconomic status and the expectation of disability in old age: estimates for England. Journal of Epidemiology and Community Health, 54, 286–292.CrossRefGoogle ScholarPubMed
MRC-CFAS (2001). Health and ill-health in the older population in England and Wales: the Medical Research Council cognitive function and ageing study. Age and Ageing, 30, 53–62.CrossRefGoogle Scholar
Murray, C.J.L. & Chen, L.C. (1992). Understanding morbidity change. Population and Development Review, 18, 481–503.CrossRefGoogle Scholar
Murray, C.J.L. & Lopez, A.D. (Eds.) (1996). The global burden of disease. Harvard University Press.Google ScholarPubMed
Olshansky, S.J., Rudbery, M.A., Carnes, B.A., Cassel, C.K. & Brody, J.A. (1991). Trading off longer life for worsening health: the expansion of morbidity hypothesis. Journal of Aging and Health, 3(2), 194–216.CrossRefGoogle Scholar
Robine, J.-M., Colvez, A., Bucquet, D., Hatton, F., Morel, B. & Lelaidier, S. (1986). L'esperance de vie sans incapacite en France en 1982. Population, 6, 1025–1042.Google Scholar
Robine, J.-M. & Ritchie, K. (1993). Measuring changes in population health through disability-free life expectancy calculation: what have we learnt and where should we go? Presented to the IUSSP Conference, Montreal, August 1993.Google Scholar
Robine, J.-M., Romieu, I., Cambois, E., van de Water, H.P.A., Boshuizen, H.C. & Jagger, C. (1995). Global assessment in positive health. Contribution of the Network on Health Expectancy and the Disability Process to the World Health Report 1995: Bridging the Gaps, World Health Organization, REVES paper No. 196, INSERM.Google Scholar
Robine, J.-M. & Romieu, I. (1998). Health expectancies in the European Union: progress achieved. REVES paper No. 319, INSERM.Google Scholar
Robine, J.-M., Romieu, I., Jagger, C. & Egidi, V. (1998). Health expectancies in the European Union, the European Community Household Panel: data analysis, REVES paper No. 320, INSERM.Google Scholar
Robine, J.-M., Jagger, C. & Edidi, V. (Eds.) (2000). Selection of a coherent set of health indicators. Euro-REVES, Montpellier, France.Google Scholar
Robine, J.-M., Jagger, C., Clavel, A. & Romieu, I. (2004). Disability-free life expectancy (DFLE) in E.U. countries from 1991 to 2003. European Health Expectancy Monitoring Unit.Google Scholar
Rogers, A., Rogers, R.G. & Belanger, A. (1990). Longer life but worse health? measurement and dynamics. The Gerontologist, 30, 640–657.CrossRefGoogle ScholarPubMed
Sauvaget, C., Jagger, C. & Arthur, A. (2001). Active and cognitive impairment-free life expectancies: results from the Melton Mowbray 75+ health checks. Age and Ageing, 30, 509–515.CrossRefGoogle ScholarPubMed
Shapiro, J. (2005). Problems of comparability in ECHP-derived health expectancy: causes, cures, policy options. Presented to the EPUNet-2005 Conference, Colchester.Google Scholar
Sullivan, D.F. (1971). A single index of mortality and morbidity. HMSA Health Report, 86, 347–354.Google ScholarPubMed
van Ginneken, J.K. & Bonte, J.T. (1989). Sex differentials in life expectancy free of disability in the Netherlands in 1981-1985. Presented to the International Population Conference, International Union for Scientific Study of Population, New Delhi.Google Scholar
van Ginneken, J.K.S., Dissveldt, A.G., van de Water, H.P.A. & van Sonsbeek, J.L.A. (1991). Results of two methods to determine health expectancy in the Netherlands in 1981-1985. Social Science and Medicine, 32, 1129–1136.CrossRefGoogle ScholarPubMed