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Health Expectancy by Socio-Economic Status in Belgium

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Health Expectancy by Socio-Economic Status in Belgium Health Expectancy by socio-economic status in Belgium Bossuyt N., Van Oyen H. Scientific Institute of Public Health Unit of Epidemiology Rue Juliette Wytsman 14 B-1050 Brussels ( 32 2 642 57 40 fax. 32 2 642 54 10 email: [email protected] http://www.iph.fgov.be/epidemio/ I Table of contents Table of contents II Table of tables IV Table of figures IX Summary X 1. Introduction 1 1. Socio-economic differences in health 2 1.1 Indications of socio-economic differences in health 2 1.2 Explanatory mechanisms for socio-economic differences in health 3 1.3 Points of action for intervention 5 1.4 Development of the health of a population 5 1.4.1 Epidemiologic transition 5 1.4.2 Ageing 6 1.4.3 Recent developments in health indicators 7 2. Material and methods 10 2.1 Calculation method 10 2.1.1 Methods for calculating health expectancy 10 2.1.2 Practical application of the Sullivan method 10 2.1.3 Age groups 15 2.2 Figures 16 2.2.1 Breakdown of the mortality and morbidity data according to socio-economic status 16 2.2.2 Mortality data of this study 18 2.2.3 Morbidity data in this study 18 2.3 Selection of indicators 22 2.3.1 Indicators of socio-economic status 22 2.3.2 Indicators of state of health 24 2.4 Measuring differences 26 2.5 Conversion from absolute to relative socio-economic status 27 3. Results 30 3.1 Life expectancy according to sex and education level 30 3.2 Prevalences according to education level 31 3.3 Life expectancy in good perceived health 34 3.3.1 Life expectancy in good perceived health according to sex 34 3.3.2 Life expectancy in good perceived health according to education level 35 II 3.3.3 Partial life expectancy in good perceived health, age 25 to 75 years, according to relative education level 38 3.4 Disability-free life expectancy 42 3.4.1 Disability-free life expectancy according to sex 42 3.4.2 Disability-free life expectancy according to educational level 42 3.4.3 Partial disability-free life expectancy, aged 25 to 75 years, according to relative education level 45 3.5 Life expectancy in good mental health 46 3.5.1 Life expectancy in good mental health according to sex 46 3.5.2 Life expectancy in good mental health according to education level 46 3.5.3 Partial life expectancy in good mental health at the age of 25 to 75 years, according to relative education level 49 4. Discussion 51 4.1 Informative value of the basic data 51 4.2 The health expectancy indicator 52 4.3 Nature of the relationship between health expectancy and education level 52 4.4 Size of the differences in health expectancy 53 4.4.1 Absolute education level 53 4.4.2 Relative education level 55 4.5 Which groups spend the most years in poor health? 56 5. Conclusion 58 6. References 59 7. Annexes 67 7.1 Questions in the 1991 census on the highest qualification achieved 67 7.2 Tables 18-20: Questions from the Health Interview Survey 1997 67 7.3 Results 72 7.3.1 Tables 21-26: Life expectancy 72 7.3.2 Tables 27- 36: Life expectancy in good perceived health 75 7.3.3 Tables 37- 66: Disability-free life expectancy and life expectancy with limitations 79 7.3.4 Tables 67 - 76: Life expectancy in good mental health 91 III Table of tables Table 1 Sullivan’s Method: production of a life table (age groups of 5 years) 11 Table 2 Sullivan Method: addition of prevalences to the mortality table 14 Table 3 Subjects covered by the Health Interview Survey 1997 19 Table 4 Partial life expectancy, aged 25 to 75 years, according to relative education level, Belgium, 1991-1996 31 Table 5 Age specific prevalence of poor perceived health according to sex, Health Interview Survey 1997 , Belgium 32 Table 6 Age specific prevalence of disabilities according to sex, Health Interview Survey 1997 , Belgium 32 Table 7 Age specific prevalence of poor mental health according to sex, Health Interview Survey 1997 , Belgium 34 Table 8 Ratio of life expectancy in poor perceived health with respect to the total life expectancy aged 25 years, Belgium, 1991- 1996/1997 38 Table 9 Life expectancy in good perceived health, age 25 to 75 years, according to relative education level, Belgium, 1991-1996/1997 39 Table 10 Comparison of lost health expectancy, ages 25 to 75 years in men in Belgium, Norway and Finland (79) 41 Table 11 Comparison of lost health expectancy, ages 25 to 75 years in women in Belgium, Norway and Finland(79) 41 Table 12 Relationship of life expectancy with disabilities with respect to the life expectancy at the age of 25 years, Belgium, 1991-1996/1997 45 Table 13 Disability-free life expectancy, aged 25 to 75 years, according to relative education level, Belgium, 1991-1996/1997 45 Table 14 Ratio of life expectancy in poor mental health to total life expectancy at the age of 25 years, Belgium, 1991-1996/1997 49 Table 15 Life expectancy in good mental health, aged 25 to 75 years, according to relative education level, Belgium, 1991-1996/1997 50 Table 16 Partial life expectancy and health expectancy, aged 25 to 75 years according to relative education level, Belgium, 1991-1996/1997 55 Table 17 Part of question IV 7 in the 1991 census 67 Table 18 Questions on perceived health (Health Interview Survey 1997) 67 Table 19 Questionnaire on disabilities (CBS – WHO) (Health Interview Survey 1997) 68 Table 20 General Health Questionnaire 70 Table 21 Life expectancy according to education level. Men, Belgium, 1991- 1996 / 1997 72 Table 22 Life expectancy according to education level. Women, Belgium, 1991-1996 / 1997 72 Table 23 Partial life expectancy between ages 25 and 75 years according to education level. Men, Belgium, 1991-1996 / 1997 73 IV Table 24 Partial life expectancy between ages 25 and 75 years according to education level. Women, Belgium, 1991-1996 / 1997 73 Table 25 Partial life expectancy between ages 25 and 75 years according to relative education level, Men, Belgium, 1991-1996 / 1997 74 Table 26 Partial life expectancy between ages 25 and 75 years according to relative education level, Women, Belgium, 1991-1996 / 1997 74 Table 27 Life expectancy in good perceived health according to education level . Men, Belgium, 1991-1996 / 1997 75 Table 28 Life expectancy in good perceived health according to education level, Men, 55+, Belgium, 1991-1996 / 1997 75 Table 29 Life expectancy in good perceived health according to education level, Women, Belgium, 1991-1996 / 1997 76 Table 30 Life expectancy in good perceived health according to education level Women, 55+, Belgium, 1991-1996 / 1997 76 Table 31 Partial life expectancy in good perceived health between ages 25 and 75 years according to education level Men, Belgium, 1991- 1996 / 1997 77 Table 32 Partial life expectancy in good perceived health between ages 25 and 75 years according to education level Men, 55+, Belgium, 1991-1996 / 1997 77 Table 33 Partial life expectancy in good perceived health between ages 25 and 75 years according to relative education level, Men, Belgium, 1991-1996 / 1997 77 Table 34 Partial life expectancy in good perceived health between ages 25 and 75 years according to education level Women, Belgium, 1991-1996 / 1997 78 Table 35 Partial life expectancy in good perceived health between ages 25 and 75 years according to education level Women, 55+, Belgium, 1991-1996 / 1997 78 Table 36 Partial life expectancy in good perceived health between ages 25 and 75 years according to relative education level, Women, Belgium, 1991-1996 / 1997 78 Table 37 Disability-free life expectancy according to education level Men, Belgium, 1991-1996 / 1997 79 Table 38 Disability-free life expectancy according to education level Men, 55+, Belgium, 1991-1996 / 1997 79 Table 39 Life expectancy with moderate limitations according to education level Men, Belgium, 1991-1996 / 1997 80 Table 40 Life expectancy with moderate limitations according to education level Men, 55+, Belgium, 1991-1996 / 1997 80 Table 41 Life expectancy with serious limitations according to education level Men, Belgium, 1991-1996 / 1997 81 Table 42 Life expectancy with serious limitations according to education level Men, 55+, Belgium, 1991-1996 / 1997 81 V Table 43 Disability-free life expectancy according to education level Women, Belgium, 1991-1996 / 1997 82 Table 44 Disability-free life expectancy according to education level Women, 55+, Belgium, 1991-1996 / 1997 82 Table 45 Life expectancy with moderate limitations according to education level Women, Belgium, 1991-1996 / 1997 83 Table 46 Life expectancy with moderate limitations according to education level Women, 55+, Belgium, 1991-1996 / 1997 83 Table 47 Life expectancy with serious limitations between ages 25 and 75 years according to education level Women, Belgium, 1991-1996 / 1997 84 Table 48 Partial life expectancy with serious limitations between ages 25 and 75 years according to education level Women, 55+, Belgium, 1991-1996 / 1997 84 Table 49 Partial disability-free life expectancy between ages 25 and 75 years according to education level Men, Belgium, 1991-1996 / 1997 85 Table 50 Partial disability-free life expectancy between ages 25 and 75 years according to education level Men, 55+, Belgium, 1991-1996 / 1997 85 Table 51 Partial disability-free life expectancy between ages 25 and 75 years according to relative education level, Men, Belgium, 1991-1996 / 1997 85 Table 52 Partial life expectancy with moderate limitations between ages 25 and 75 years according to education level Men, Belgium, 1991- 1996 / 1997 86 Table 53 Partial life expectancy with moderate limitations between ages 25 and 75 years according to education level Men, 55+, Belgium, 1991-1996 / 1997 86 Table 54 Partial life expectancy with moderate limitations between ages 25 and 75 years en fonction du niveau relatif d’enseignement.
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