Additional national page for Country Report Issue 9
Transcription
Additional national page for Country Report Issue 9
EHLEIS Technical report 2016_4.3 April 2016 Additional national page for Country Report Issue 9 The EHLEIS team comprises: Jean-Marie Robine, INSERM U988 and U1198, Montpellier, France, [email protected] Herman Van Oyen, Scientific Institute of Public Health, Brussels, Belgium, [email protected] Bernard Jeune, University of Southern Denmark, Institute of Public Health, Odense, Denmark, [email protected] Henrik Bronnum Hansen, Department of Public Health, KU, Copenhagen, Denmark, [email protected] Emmanuelle Cambois, INED (Institut National d’Etudes Démographiques), Paris, France, [email protected] Gabriele Doblhammer, Rostock Center for Demographic Change, Germany, [email protected] Viviana Egidi, University la Sapienza, Rome, Italy, [email protected] Wilma J. Nusselder, Erasmus Medical Center, Rotterdam, Netherlands, [email protected] Marten Lagergren, National Board of Health and Welfare (SoS/NBHW), Stockholm, Sweden, [email protected] Carol Jagger, Newcastle University, United-Kingdom, [email protected] Chris White, Office of National Statistics, Newport, United-Kingdom, [email protected] Isabelle Beluche, INSERM U1198, Montpellier, France, [email protected] Loic D’Haillecourt, INSERM U1198, Montpellier, France, [email protected] Christine Perrier, INSERM U1198, Montpellier, France, [email protected] Contact EHLEIS: Jean Marie ROBINE, INSERM Université Montpellier U1198/MMDN – CC105 Place Eugène Bataillon, Bat 24 34095-Montpellier cedex 05 France Email: [email protected] 2 BELGIUM De impact van roken op de bijdrage van chronische ziektes aan de invaliditeitslast in de populatie van 50-80 jarigen, België, 2001-2008 1 De prevalentie van chronische ziektes/aandoeningen en invaliditeit, en bijdrage van elke oorzaak aan de invaliditeitslast volgens categorieën van rokers. Gezondheidsenquête, België , 2001, 2004, 2008 1 Schatting met gebruik van de Toewijzingsmethode voorgesteld door Nusselder en Looman (2004)(1) ; Bijdrages uitgedrukt als prevalantie van invaliditeit 2 Achtergrond komt overeen met de oorzaken van activiteitsbeperking die niet in de analyse werden opgenomen Belangrijkste resultaten: De prevalentie van chronische ademhalingsziektes bij 50-80 jarigen in België is groter bij de actieve rokers (15%) in vergelijking met de ex-rokers (10%) en zij die nooit gerookt hebben (8%). De prevalentie van depressie 50-80 jarigen in België is hoger bij actieve rokers (9%) dan bij ex-rokers (5%) en zij die nooit gerookt hebben (9%). De prevalentie van cardiovasculaire ziektes bij 50-80 jarigen in België is lager bij actieve rokers (5%) dan bij exrokers (10%). De prevalentie van activiteitsbeperkingen bij 50-80 jarigen in België neigt naar een toename volgens categorie van rokers (actief: 32% > ex-rokers: 31% > nooit gerookt: 30%), maar dit verschil is niet statistisch significant. de Er is een hoger aandeel van chronische ademhalingsziektes in activeitsbeperkingen bij actieve rokers (3 in rang ; de de contributie=5%) en ex-rokers (4 in rang ; contributie= 4%) dan bij zij die nooit gerookt hebben (5 in rang ; contributie=2%). Er is een hoger aandeel van cardiovasculaire ziektes in activeitsbeperkingen bij ex-rokers (4%) dan bij actieve rokers (2%). (1) Nusselder WJ, Looman CWN. Decomposition of differences in health expectancy by cause. Demography 2004;41(2):315-34. BRIDGE-Health (Bridging Information and Data Generation for Evidence-based Health Policy and Research Het European Health and Life Expectancy Information System (EHLEIS) maakt deel uit van BRIDGE-Health dat de voorbereiding van een duurzaam en geïntegreerd EU-gezondheidsinformatiesysteem beoogt, binnen het derde EUGezondheidsprogramma, 2014-2020 (www.bridge-health.eu). European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Herman Van Oyen, Scientific Institute of Public Health , [email protected] L’impact du tabagisme sur la contribution de maladies chroniques à la charge d’incapacité dans la population de 50-80 ans, Belgique, 2001-2008 1 Prévalence de maladies/conditions chroniques et d’incapacité, et contribution de chaque cause à la charge d’incapacité entre les catégories de fumeurs. Enquête de santé, 2001, 2004, 2008. Estimation utilisant la méthode d’Attribution proposée par Nusselder et Looman (2004)(1) ; Contributions exprimées comme prévalence d’incapacité. 2 Contexte correspond aux causes d’incapacité qui n’ont pas été incluses dans l’analyse 1 Points clés : La prévalence de maladies respiratoires chroniques est plus élevée chez les fumeurs actifs (15 %) que chez les exfumeurs (10 %) et ceux qui n’ont jamais fumé (8 %) dans la population de 50-80 ans en Belgique. La prévalence de dépressions chez les fumeurs actifs (9 %) est plus élevée que chez les ex-fumeurs (5%) et chez ceux qui n’ont jamais fumé (7%) dans la population de 50-80 ans en Belgique. La prévalence de maladies cardiovasculaires est plus basse chez les fumeurs actifs (5 %) par comparaison avec les ex-fumeurs (10 %) dans la population de 50-80 ans en Belgique. La prévalence d’incapacités tend à augmenter entre catégories de fumeurs (actifs : 32 % > ex-fumeurs : 31 % > jamais fumés : 30%), mais cette différence n’a pas de signification statistique dans la population de 50-80 ans en Belgique. Une contribution plus importante des maladies respiratoires chroniques à ‘lincapacité chez les fumeurs actifs (3 e dans l’ordre ; contribution=5%) et les ex-fumeurs (4 dans l’ordre ; contribution = 4%) que chez ceux qui n’ont e jamais fumé (5 dans l’ordre ; contribution = 2%). e Une contribution plus importante des des maladies cardiovasculaires à l’incapacité chez les ex-fumeur (4%)s par rapport aux fumeurs actifs (2%). (1) Nusselder WJ, Looman CWN. Decomposition of differences in health expectancy by cause. Demography 2004;41(2):315-34. European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Herman Van Oyen, Scientific Institute of Public Health, [email protected] The impact of smoking on the contribution of chronic diseases to the disability burden in the population 50-80 years, Belgium, 2001-2008 1 Prevalence of chronic conditions and disability and contribution of each cause to the disability burden across smoking categories. Health Interview Survey, Belgium, 2001, 2004, 2008. 1 Estimated using the Attribution method proposed by Nusselder and Looman (2004)(1) ; Contributions expressed as disability prevalence. Background corresponds to the disability causes that were not included in the analysis 2 Key points: The prevalence of chronic respiratory diseases is larger in current smokers (15%) compared to former (10%) and never (8%) smokers in individuals aged 50-80 years in Belgium. The prevalence of depression in current smokers (9%) is larger than in former (5%) and never smokers (7%) in individuals aged 50-80 years in Belgium. The prevalence of cardiovascular diseases is lower in current smokers (5%) compared to former smokers (10%) in individuals aged 50-80 years in Belgium. The disability prevalence tends to increase across smoking categories (current: 32% > former: 31% > never: 30%), but this difference is not statistically significant for individuals aged 50-80 years in Belgium. Higher contribution of chronic respiratory diseases to the disability burden in current (3rd in the rank; Contribution = 5%) and former smokers (4th in the rank; Contribution = 4%) compared to never smokers (5th in the rank; Contribution = 2%). Higher contribution of cardiovascular diseases to the disability burden in former smokers (4%) compared to current smokers (2%). (1) Nusselder WJ, Looman CWN. Decomposition of differences in health expectancy by cause. Demography 2004;41(2):315-34. BRIDGE-Health (Bridging Information and Data Generation for Evidence-based Health Policy and Research The European Health and Life Expectancy Information System (EHLEIS) is part of BRIDGE-Health which aims to prepare the transition towards a sustainable and integrated EU health information system within the third EU Health Programme, 2014-2020 (www.bridge-health.eu). European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Herman van Oyen, Scientific Institute of Public Health, [email protected] CYPRUS Self-perceived limitations in daily activities (activity limitation for at least the past 6 months) by Sex, Age and Educational Level (%), 2013 Females First and second stage of tertiary education (levels 5 and 6) Upper secondary and post-secondary non-tertiary education (levels 3 and 4) Pre-primary, primary and lower secondary education (levels 0-2) Males 90.4 84.6 62.3 89 Upper secondary and post-secondary non-tertiary education (levels 3 and 4) 85.5 None Some Severe 2.3 9.8 5.7 20.3 First and second stage of tertiary education (levels 5 and 6) Pre-primary, primary and lower secondary education (levels 0-2) 7.3 67.4 17.3 7.7 9.7 19.4 3.3 4.8 13.1 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100% Key points: According to the SILC 2013, the percentage of persons of both sexes reporting limitations in daily activities decreases for persons attaining higher educational levels. 62,3% of women who had completed educational levels 0-2 reported having no activity limitations, whereas these percentages increase to 84,6% and 90,4% for women completing educational levels 3-4 and levels 5-6 respectively. 20,3% of women who had completed educational levels 0-2 reported having some activity limitations, whereas these percentages decrease to 9,8% and 7,3% for women completing educational levels 3-4 and levels 5-6 respectively. 17,3% of women who had completed educational levels 0-2 reported having severe activity limitations, whereas these percentages decrease to 5,7% and 2,3% for women completing educational levels 3-4 and levels 5-6 respectively. The same picture applies for men as well. Specifically, 67,4% of men who had completed educational levels 0-2 reported having no activity limitations, whereas these percentages increase to 85,5% and 89,0% for men completing educational levels 3-4 and levels 5-6 respectively. 19,4% of men who had completed educational levels 0-2 reported having some activity limitations, whereas these percentages decrease to 9,7% and 7,7% for men completing educational levels 3-4 and levels 5-6 respectively. 13,1% of men who had completed educational levels 0-2 reported having severe activity limitations, whereas these percentages decrease to 4,8% and 3,3% for men completing educational levels 3-4 and levels 5-6 respectively. These results should be interpreted cautiously given the lack of the institutional population, such as people living in nursing homes. European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Eleni Kyriacou – Institute of Health Information and Statistics – [email protected] DENMARK Voksende forskel mellem uddannelsesgrupper i forventet restlevetid med selvvurderet godt helbred i Denmark I en dansk undersøgelse er ændring fra 2000 til 2011 mellem uddannelsesgrupper i forventet restlevetid med selvvurderet godt helbred ved alder 50 beregnet. Undersøgelsen er baseret på nationale registerdata om dødelighed og uddannelse kombineret med data fra Sundheds- og sygelighedsundersøgelserne fra 2000 og 2005, og Survey of Health, Ageing and Retirement in Europe (SHARE) fra 2006/07 og 2010/11. Figuren nedenfor viser en kontinuerlig stigende forskel iforventet restlevetid med selvvurderet godt helbred mellem 50-årige med en kort og lang uddannelse. Den stiplede linje på grafen markerer at svarkategorierne på spørgsmålet om selvvurderet helbred samtundersøgelsesdesign og dataindsamlingsmetode er forskellig mellem Sundheds- og sygelighedsundersøgelserne (2000 og 2005) og SHARE(2006/07 and 2010/11). Derfor kan de absolutte værdier ikke sammenlignes direkte. Figuren viser ingen tegn på,at der under finanskrisen har været en ændring i den vedvarende øgning af den sociale ulighed. Forskel i forventet restlevetid med selvvurderet godt helbred mellem 50-årige med lang og kort uddannelse. Danmark 2000-11 10 Kvinder 9 Sundheds- og sygelighedsundersøgelserne 2000 og 2005 Kvinder Mænd År 8 Mænd SHARE, 2006/07 og 2010/11 7 6 2000 2005 2006/07 2010/11 Flere detaljer i: Brønnum-Hansen H et al. Educational inequalities in health expectancy during the financial crisis in Denmark. International Journal of Public Health 2015; http://dx.doi.org/10.1007/s00038-015-0726-3 European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Henrik Bronnum-Hansen, University of Copenhagen, [email protected] Increasing educational differentials in health expectancy in Denmark A Danish study estimated educational differentials in the changes from 2000 to 2011 in expected lifetime in self-rated good health at age 50. The study was based on nationwide register data on mortality and education combined with data fromthe Danish Health Interview Surveys 2000 and 2005and the Survey of Health, Ageing and Retirement in Europe (SHARE)2006/2007 and 2010/2011. The figure below shows continuously increasing educational differentials in expected lifetime in self-rated good health. The broken line on the graph indicates that the answer categories of the self-rated health question and the design and data collection procedure differed between the Danish Health Interview Surveys (2000 and 2005) and the SHARE surveys (2006/07 and 2010/11). This is why the absolute values cannot be compared directly. The figure demonstrates no sign indicating a change in the persistent trend of the widening social gap during the financial crises. Difference in expected lifetime in self-rated good health between 50-year-olds with a high and a low educational level. Denmark 2000-11 10 Women 9 Danish Health Interview Surveys, 2000 and 2005 Women Years Men 8 Men SHARE, 2006/07 and 2010/11 7 6 2000 2005 2006/07 2010/11 More details in: Brønnum-Hansen H et al. Educational inequalities in health expectancy during the financial crisis in Denmark. International Journal of Public Health 2015; http://dx.doi.org/10.1007/s00038-015-0726-3 European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Henrik Bronnum-Hansen, University of Copenhagen, [email protected] FRANCE Position relative de la France pour les indicateurs d’espérances en santé parmi les pays de l’Union Européenne en 2013 (source : EHLEIS) Espérance de vie en très bonne ou bonne santé perçue Hommes à 16 ans Espérance de vie en très bonne ou bonne santé 43,6 années Sur 26 pays européens (ordre décroissant) 11ème rang Moyenne de l’UE 27 (2012) 43,3 années Maximum Suède 53,0 années Minimum Lettonie 27,9 années Femmes Espérance de vie en très bonne ou bonne santé 43,4 années Sur 26 pays européens (ordre décroissant) 13ème rang Moyenne de l’UE 27 (2012) 43,2 années Maximum Suède 52,9 années Minimum Lettonie 28,4 années Espérance de vie sans problème de santé chronique Hommes à 16 ans Espérance de vie sans probl de santé chronique 40,9 années Sur 26 pays européens (ordre décroissant) 17ème rang Moyenne de l’UE 27 (2012) 42,9 années Maximum Luxembourg 59,4an. Minimum Estonie 32,7 années Femmes Espérance de vie sans probl de santé chronique 42,2 années Sur 26 pays européens (ordre décroissant) 16ème rang Moyenne de l’UE 27 (2012) 44,0 années Maximum Bulgarie 50,6 années Minimum Estonie 34,4 années Espérance de vie sans incapacité Hommes Espérance de vie sans incapacité Sur 26 pays européens (ordre décroissant) Moyenne de l’UE 27 (2012) Maximum Minimum Femmes Espérance de vie sans incapacité Sur 26 pays européens (ordre décroissant) Moyenne de l’UE 27 (2012) Maximum Minimum à 65 ans 7,7 années 10ème rang 6,9 années Suède 12,9 années Lituanie 1,3 année 8,4 années 7ème rang 6,8 années Suède 13,6 années Lituanie 0,6 année à 65 ans 6,9 années 13ème rang 7,3 années Lux. 11,7 années Estonie 3,3 années 8,7 années 11ème rang 7,9 années Danemark 13,3 an. Estonie 3,1 années à la naissance 63,0 années 10ème rang 61,5 années Malte 71,6 années Lettonie 51,7 années à 65 ans 10,7 années 6 ème rang 8,6 années Suède 12,9 années Lettonie 4,0 années 64,4 années 7ème rang 62,1 années Malte 72,7 années Lettonie 54,2 années 9,9 années 8ème rang 8,6 années Suède 13,8 années Slovaquie 3,7 années On constate une grande différence entre le classement de la France en termes d’espérance de vie à la ème naissance (7 rang chez les hommes, premier chez les femmes) et les classements pour les indicateurs d’espérances en santé. Ceci reflète le fait que la proportion d’années vécues respectivement avec une santé perçue passable ou mauvaise, avec une morbidité chronique ou avec une limitation d’activité est relativement importante en France Les classements relatifs sont meilleurs pour les espérances à 65 ans du fait en particulier de l’avantage en termes d’espérance de vie totale, qui est la plus élevée de l’Union Européenne pour les femmes mais aussi pour les hommes. Cette page a été réalisée par le Ministère des Affaires sociales et de la Santé. Relative rank of France for health expectancy indicators among the European Union Member States in 2013 (EHLEIS data) Life expectancy in good or very good self-perceived health Men At age 16 Life expectancy in very good or good health 43.6 years Rank among the EU28 (descending order) 11th rank EU 27 average 43.3 years Maximum Sweden 53.0 years Minimum Latvia 27.9 years Women Life expectancy in very good or good health 43.4 years Rank among the EU28 (descending order) 13th rank EU27 average 43.2 years Maximum Sweden 52.9 years Minimum Latvia 28.4 years Life expectancy without chronic morbidity Men Life expectancy without chronic morbidity Rank among the EU28 (descending order)) EU 27 average Maximum Minimum Women Life expectancy without chronic morbidity Rank among the EU28 (descending order) EU27 average Maximum Minimum Life expectancy without activity limitation (HLY) Men Life expectancy without activity limitation Rank among the EU28 (descending order) EU27 average Maximum Minimum Women Life expectancy without activity limitation Rank among the EU28 (descending order) EU27 average Maximum Minimum At age 65 7.7 years 10th rank 6.9 years Sweden 12.9 years Lithuania 1.3 years 8.4 years 7th rank 6.8 years Sweden 13.6 years Lithuania 0.6 year At age 16 40.9 years 17h rank 42.9 years Lux. 59.4 years Estonia 32.7 years At age 65 6.9 years 13thrank 7.3 years Lux. 11.7 years Estonia 3.3 years 42.2 years 16th rank 44.0 years Bulgaria 50.6 years Estonia 34.4 years 8.7 years 11th rank 7.9 years Denmark 13.3 years Estonia 3.1 years At birth 63.0 years 10th rank 61.5 years Malta 71.6 years Latvia 51.7 years At age 65 10.7 years 6th rank 8.6 years Sweden 12.9 years Latvia 4.0 years 64.4 years 7th rank 62.1 years Malta 72.7 years Latvia 54.2 years 9.9 years 8th rank 8.6 years Sweden 13.8 years Slovakia 3.7 years th There is a big difference between the ranking of France in terms of life expectancy at birth (7 rank in men, first in women) and rankings for health expectancies. This reflects the fact that the proportion of years lived in fair or poor perceived health, with chronic morbidity and with limitation in usual activity, respectively, is relatively high in France (in particular it is systematically higher than the average proportion for the EU27). Relative rankings are better for health expectancies at age 65, especially because of the advantage in terms of total life expectancy, which is the highest of the European Union for women but also for men. This page was realised by the French Ministry of Health and Social Affairs GREECE Προσδόκιμο ζωής (ΠΖ) και Έτη Υγιούς Ζωής (ΕΥΖ) στις ηλικίες 0, 16, 50 και 65 στην Ελλάδα κατά φύλο Βασικά σημεία: Το 2013, το προσδόκιμο ζωής (ΠΖ) κατά τη γέννηση ήταν 78,9 έτη για τους άνδρες και 84,2 έτη για τις γυναίκες, ενώ το προσδόκιμο ζωής χωρίς περιορισμό δραστηριοτήτων (Έτη Υγιούς Ζωής) ήταν 64,9 έτη για τους άνδρες και 65,2 έτη για τις γυναίκες. Στην ηλικία των 16 το ΠΖ ήταν 63,1 έτη για τους άνδρες και 68,4 έτη για τις γυναίκες (δηλαδή, 5,4 έτη περισσότερο). Ωστόσο, ενώ κατά τη γέννηση τα ΕΥΖ ήταν περισσότερα για τις γυναίκες σε σύγκριση με τους άνδρες, καθώς η ηλικία αυξάνεται, τα ΕΥΖ για τις γυναίκες μειώνονται σε σύγκριση με τους άνδρες (49,5 για τις γυναίκες και 49,2 για τους άνδρες). Τα αποτελέσματα δείχνουν ότι οι γυναίκες αναμένεται να ζήσουν περισσότερα έτη από τους άνδρες αλλά περνούν πολύ μεγαλύτερο μέρος της ζωής τους με «κακή» υγεία. Πιο συγκεκριμένα, κατά τη γέννηση, οι γυναίκες αναμένεται να περάσουν το 77,4% της υπολειπόμενης ζωής τους χωρίς περιορισμό δραστηριοτήτων (που αντιστοιχεί στα Προσδοκώμενα ΕΥΖ), ενώ οι άνδρες κατά τη γέννηση αναμένεται να περάσουν το 82,3% της υπολειπόμενης ζωής τους χωρίς περιορισμό δραστηριοτήτων. Στην ηλικία των 50 ετών οι γυναίκες αναμένεται να περάσουν το 50,0% της υπολειπόμενης ζωής τους χωρίς περιορισμό δραστηριοτήτων ενώ οι άνδρες της ίδιας ηλικίας αναμένεται να περάσουν το 58,7% της υπολειπόμενης ζωής τους χωρίς περιορισμό δραστηριοτήτων. Στην ηλικία των 65 ετών οι γυναίκες αναμένεται να περάσουν το 31,6% της υπολειπόμενης ζωής τους χωρίς περιορισμό δραστηριοτήτων ενώ οι άνδρες της ίδιας ηλικίας αναμένεται να περάσουν το 43,0% της υπολειπόμενης ζωής τους χωρίς περιορισμό δραστηριοτήτων. European Health and Life Expectancy Information System – EHLEIS - ιστοσελίδα: http://www.eurohex.eu Υπεύθυνος Έργου : Jean-Marie Robine – Συντονισμός Εκθέσεων Χωρών : Isabelle Beluche Επικοινωνία: Giorgos Ntouros, Hellenic Statistical Authority (ELSTAT), [email protected] Life expectancy (LE) and Healthy Life Years (HLY) at ages 0, 16, 50 and 65 for Greece by sex Key points: In 2013, LE at birth was 78.9 years for men and 84.2 years for women, while disability-free life expectancy (Healthy Life Years) was 64.9 years for men and 65.2 years for women. At age 16 LE was 63.1 years for men and 68.4 years for women (that is, 5.4 years above men). However, while at birth HLY were more for women compared to men, as age increases, HLY for women decrease compared to men (49.5 for women and 49.2 for men). The results indicate that women may expect to live more years but spend a much larger proportion of their life in ill health. More specifically, at birth, women can expect to live 77.4% of their remaining life without activity limitations (corresponding to HLY), while at birth men can expect to live 82.3% of their remaining life without activity limitations At age 50 women can expect to live 50.0% of their remaining life without activity limitations while at the same age men can expect to live 58.7% of their remaining life without activity limitations. At age 65 women can expect to live 31.6% of their remaining life without activity limitations, while at the same age men can expect to live 43.0% of their remaining life without activity limitations. European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine - Coordination of the Country reports : Isabelle Beluche Contact: Giorgos Ntouros, Hellenic Statistical Authority (ELSTAT), [email protected] ITALY Speranze di vita per condizioni di salute a 65 anni calcolate sulla base della limitazione di attività (HLY), morbosità cronica e salute percepita per l’Italia. Dati SILC 2007-2013 12 12 10 10 8 6 4 LE in buona salute LE senza limitazioni nelle attività 2 Uomini Donne 8 6 4 LE in buona salute LE senza limitazioni nelle attività 2 LE senza malattie croniche LE senza malattie croniche 0 0 2007 2008 2009 2010 2011 2012 2013 2007 2008 2009 2010 2011 2012 2013 Per tutti gli indicatori del 2010 sono state utilizzate delle stime calcolate come media dei dati 2009 e 2011. Risultati principali Ci sono tante speranze di vita per condizioni di salute quanti sono i diversi concetti di salute e ciascuna descrive un aspetto specifico; a volte può essere difficile scegliere un'unica misura e potrebbe essere invece utile analizzare contemporaneamente tutte le speranze di vita al fine di avere un quadro che sia il più completo possibile dello stato di salute di un singolo paese. Le tre dimensioni della salute indagate dal MEHM mostrano differenti livelli e differenti andamenti temporali per l’Italia. Dal 2007 al 2013 il trend delle tre differenti HE converge: HLY è rimasta stabile, LE senza malattia croniche è diminuita e LE in buona salute percepita è aumentata (+1,7 sia per gli uomini sia per le donne). Tuttavia nel 2013 si evidenzia un peggioramento della LE in buona salute: dal 2012 al 2013 questa diminuisce di 0,5 e di 0,2 anni rispettivamente per donne e uomini. In questo periodo i valori degli HLY restano costanti, anche se per le donne si osserva una leggera diminuzione pari a 0,1 anni. Per gli uomini si osserva un leggero aumento fino al 2011, con una diminuzione tra il 2011 ed il 2012 di 0,4 anni; i dati del 2013 sono invece simili a quelli del 2012. Nell’intero periodo la LE senza malattie croniche diminuisce di 1,5 anni per le donne e di 0,7 anni per gli uomini. L’analisi di questi risultati apparentemente incoerenti, necessita di alcuni accorgimenti: 1) le risposte al questionario SILC sono autodichiarate e potrebbero essere influenzate dalle caratteristiche culturali ed individuali dei rispondenti; 2) l’analisi di differenti dimensioni della salute e delle correspettive misure potrebbe portare a risultati diversi: per esempio una persona potrebbe dichiarare una buona percezione del proprio stato di salute ma essere affetta da una malattia cronica o avere una limitazione funzionale; 3) al fine di avere una panoramica esaustiva sullo stato di salute della popolazione sarebbe opportuno che i decisori politici analizzassero congiuntamente tutti gli indicatori di salute disponibili. European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project Leader : Jean-Marie Robine- Coordination of the Country reports : Isabelle Beluche Contact: Luisa Frova & Alessandra Battisti, ISTAT, [email protected], [email protected] Health expectancies based on activity limitation (HLY), chronic morbidity and perceived health for Italy based on SILC 2007-2013 12 12 10 10 8 Men Women 8 6 4 6 LE in good perceived health 4 LE without limitation LE in good perceived health LE without limitation 2 LE without morbidity 0 2 LE without morbidity 0 2007 2007 2008 2009 2010 2011 2012 2008 2009 2010 2011 2012 2013 2013 For all the indicators of 2010 estimated data were used calculated as the mean of 2009 and 2011 data. Key points There are as many health expectancies (HE) as concepts of health and each one describes a specific aspect of health, sometimes it could be difficult to use a specific measure only and it could be useful to analyze all HE in order to have a complete picture of the health status of a population. The three dimensions of health investigated by MEHM show different levels and time trends of HE for Italy. As observed in the previous reports the trends of three different HE are converging in the whole period 2007-2012: HLY is stable, LE without chronic diseases decreases, while LE in good health increases (+1.7 both for women and men). However in 2013 figures show a worsening of the perceived health status: from 2012 to 2013 the LE in good health decreased of 0.5 and 0.2 years respectively for women and men. Over this period HLY values tend to be stable, in women a slight decrease of 0.1 year is observed. In men there is a slight increment until 2011, when a drop of 0.4 years from 2011 to 2012 is observed; 2013 data are similar to 2012 ones. In the overall period the LE without chronic diseases decreases of 1.5years for women and of 0.7years for men. From these apparently incoherent results some warnings are necessary: 1) The answers provided in SILC questionnaire are self-reported and may be affected by cultural and individual characteristics of respondents; 2) Different dimensions of health and corresponding measures may lead to different results: for example a person may declare of being in good health also if affected by a chronic disease or by a functional limitation; 3) To have an exhaustive picture of a population health status and to provide useful information to the stakeholders it is therefore necessary to analyze jointly all the available healthy expectancy indicators. Therefore caution is needed in using these data and in drawing conclusions from figures and instruments of recent application that are still evolving. European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project Leader : Jean-Marie Robine - Coordination of the country reports : Isabelle Beluche Contact: Luisa Frova e Alessandra Battisti – ISTAT – Viale Liegi 13 – 00198 Roma - Italia Tel :+39-0646737382 e +39-0646737582/e-mail : [email protected], [email protected] LITHUANIA Vyrai Moterys Vyrai Moterys 65 m. amžiaus Europos šalių gyventojų Sveiko gyvenimo metai (SGM) ir Vidutinė tikėtina gyvenimo trukmė (VGT) (sveikatos duomenys iš SILC 2013 m.) Pagrindiniai aspektai: 65 m. amžiaus Lietuvos vyrų VGT siekė 14,1 metų, o moterų – 19,2 m. Nors moterys užėmė geresnę vietą bendroje valstybių struktūroje pagal VGT nei vyrai, abiejų lyčių įverčiai buvo žemesni nei 28 ES valstybių vidurkis. Remiantis 2013 m. SILC tyrimo duomenimis, 65 m. amžiaus Lietuvos vyrai ir moterys galėjo tikėtis būti geros sveikatos dar atitinkamai 5,9 ir 6,3 metus. Palyginus su kitomis Europos valstybėmis, Lietuvos gyventojų SGM trukmė yra žemesnė nei 28 Europos valstybių SGM vidurkis (ES 28 vyrų 8,5 m., moterų 8,6 m.), tačiau geresnė nei kitų Baltijos šalių. Europos sveikatos ir gyvenimo trukmės informacinė sistema – EHLEIS – tinklapis: http://www.eurohex.eu Koordinatoriai : Robine Jean Marie, projekto vadovas Kontaktai : Zilvine Naslène, Institute of Hygiene, Health Information Center, [email protected] Women Men Women Men Life Expectancy (LE) Healthy life years (HLY) Healthy Life Years (HLY) and Life Expectancy (LE) at the age of 65 in European Countries based on SILC 2013 Key points: Life Expectancy for Lithuanian men at the age of 65 was 14.1 years, and for women of the same age – 19.2 years. Although women were doing much better with regard to LE, both estimates (for men and women) were lower than the EU 28 average. According to 2013 SILC data, Lithuanian men and women at the age of 65 could have expected to live 5.9 and 6.3 years in good health, accordingly. Compared with other countries’ estimates, Lithuania’s HLY was lower than the EU 28 average (EU 28 8,5years for men and 8,6 years for women) and was similar for both sexes, but better than other Baltic countries. European Health andLife Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project Leader : Jean-Marie Robine – Coordination of the Country Reports : Isabelle beluche Contact: Nadezda Lipunova- Health Information Centre, Institute of Hygiene- Didizioji. Str. 22, Vilnius LT-01128 Lithuania e-mail: [email protected] The NETHERLANDS Vergelijking tussen EU‐SILC gezondheidsprevalenties en Gezondheidsenquête als bron voor J.W. Bruggink (Centraal Bureau voor de Statistiek) en W.J Nusselder (Erasmus MC) De gezonde levensverwachtingen, zoals die in dit country report gepresenteerd worden, zijn gebaseerd op de “Minimum European Health Module” (MEHM) uit EU‐SILC. Daarnaast voert het Centraal Bureau voor de Statistiek (CBS) jaarlijks een gezondheidsenquête (GE) uit en berekentdaaruit de levensverwachting in als goed ervaren gezondheid, de levensverwachting zonderlichamelijke beperkingen en de levensverwachting zonder chronische ziekten. Deze nationale cijfersworden gepubliceerd op Statlineen worden gebruikt in diverse nationale publicaties. Beide tijdreeksen over gezode levensverwachting hebben hun toegevoegde waarde en ze dienen verschillende doelen. De nationale cijfers zijn gebaseerd op de GE met gedetailleerde enquêtevragen over lichamelijke beperkingen en chronische ziektes en aandoeningen. In de enquête zitten ook vragen over leefstijl en andere gezondheidsgerelateerde items. De EU‐data komen uit een brede enquête naar inkomen en leefomstandigheden (EU‐SILC), waarin de MEHM en slechts enkele andere vragen over gezondheid gaan. EU‐SILC is internationaal echter goed vergelijkbaar. De nationale en de Europese enquête worden op verschillende manieren afgenomen. EU‐SILC is in Nederland een vervolgonderzoek dat geplaatst is achter de vijfde peiling van de Enquête Beroepsbevolking, met als gevolg een lager responspercentage in vergelijking met de nationale GE. Een ander verschil is dat de GE door het hele jaar heen wordt afgenomen en EU‐SILC alleen in de periodejuni t/m september. De publicatie van twee cijferreeksen over gezonde levensverwachting roept de vraag op over vergelijkbaarheid. In 2013waren de enquêtevragen van den MEHM ookopgenomen in de nationale GE. Figuur 1 toont dat de MEHM-uitkomsten van beide enquêtesniet helemaalovereenkomen. De totaalprevalentie (rechts in the figuur) van chronische ziekte/aandoening en die van GALIbeperkingen is in SILC hoger dan in de GE (p < 0,05). Figuur 1. Prevalenties MEHM-indicatoren, Nederland, 2013 European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Wilma Nusselder, Erasmus University, [email protected] Comparison between Dutch EU-SILC and Dutch HIS as source for health prevalences J.W. Bruggink (Statistics Netherlands) and W.J. Nusselder (Erasmus MC) The health expectancies presented in this country report are based on the Minimum European Health Module (MEHM) in EU‐SILC. However, in the Netherlands also time series of health expectancies based on national survey(s) are published. Statistics Netherlands (known as “CBS”) yearly conducts a health interview survey and calculates life expectancy in good perceived health, life expectancy without chronic conditions and life expectancy without disability. These national figures can be found on Statline, and are used in several national publications. Both series of health expectancies have an important added value and each serves a different purpose. The national set is based on the health survey that includes detailed questions on disability and chronic diseases ‐ as well as detailed questions on life style and other health‐related factors. The EU set is part of a broad survey on income and living conditions (EU‐SILC) and includes only the MEHM questions on health and some questions on unmet needs, but is comparable between EU countries. In addition, there are important differences in the data collection. The EU‐SILC in the Netherlands is a follow up survey placed after the fifth wave of the Dutch Labour Force Survey, which resulted in a lower response rate compared to the national HIS. Another difference is that the HIS has a continuous observation throughout the year, while EU‐SILC runs from June until September. The publication of two series of health expectancies raises the question how comparable the two sources are. In 2013, the survey questions of the MEHM were also part of the national HIS. Figure 1 shows that the MEHM-outcomes of both surveys are not in alle cases comparable. The total prevalence (right side of the figure) of both longstanding illness/condition and GALI-limitations is higher within SILC, compared to HIS (p < 0,05). Figure 1. Prevalence of MEHM-indicators, The Netherlands, 2013 European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Wilma Nusselder, Erasmus University, [email protected] POLAND Oczekiwana dalsza długość życia i długość życia w zdrowiu osób w wieku 65 lat w Polsce,z uwzględnieniem ograniczonej aktywności z powodów zdrowotnych (HLY), występowaniem przewlekłej chorobowości oraz samooceną stanu zdrowia osób mieszkających na wsi oraz w miastach o różnej wielkości wg płci w Polsce, 2011-2013 (dane zdrowotne z SILC 20112013) Mężczyźni Kobiety Najważniejsze fakty: W Polsce w latach 2011-2013 oczekiwana dalsza długość życia mężczyzn w wieku 65 lat mieszkających w miastach wynosiła 15,8 lat i była o rok większa niż mieszkających na wsi. Mężczyźni w największych miastach powyżej 500 tys. ludności mogli oczekiwać dłuższego o 1,5 roku życia niż mężczyźni w małych miastach poniżej 20 tys. ludności i o 1,8 roku niż mieszkający na wsi.W przypadku kobiet w tym samym wieku różnice w oczekiwanej długości życia związane z miejscem zamieszkania były o ponad połowę mniejsze niż wśród mężczyzn. Oczekiwana dalsza długość życia bez ograniczonej sprawności (HLY) mężczyzn w miastach była o prawie rok (0,9 roku) dłuższa niż mężczyzn na wsi ale w przypadku mężczyzn w miastach powyżej 500 tys. ludności była o 1,8 roku dłuższa niż mężczyzn mieszkających w małych miastach oraz na wsi. Kobiety mieszkające w miastach mogły oczekiwać dłuższego o 0,4 roku życia bez ograniczonej sprawności niż mieszkanki wsi a w przypadku kobiet mieszkających w miastach powyżej 500 tys. ludności różnica ta wynosiła nawet 1,2 roku. Dosyć niespodziewanie zarówno mężczyźni jak i kobiety w wieku 65 lat mieszkający w miastach mogli oczekiwać trochę krótszego dalszego życia bez przewlekłego problemu zdrowotnego niż mieszkający na wsi (odpowiednio o 0,4 i 1,1 roku). Ponadto mieszkańcy dużych miast nie byli w korzystniejszej sytuacji niż mieszkańcy małych miast. Mężczyźni i kobiety mieszkający w miastach mogli oczekiwać dłuższego dalszego życia w bardzo dobrym lub dobrym zdrowiu niż mieszkańcy wsi odpowiednio o 1 rok i 0,8 roku, a mieszkańcy największych miast dłuższego o 1,3 roku życia w co najmniej dobrym zdrowiu niż mieszkańcy najmniejszych miast. Przedstawione wyniki powinny być interpretowane z ostrożnością ze względu na nie uwzględnienie w badaniu osób mieszkających w gospodarstwach zbiorowych takich jak domy pomocy społecznej, zakłady opiekuńczo-lecznicze itp. Prezentowana analiza była wykonana w ramach projektu predefiniowanegoProgramu Operacyjnego PL13 „Ograniczanie społecznych nierówności w zdrowiu” finansowanego ze środków Norweskiego Mechanizmu Finansowego. Life and health expectancies at age 65 based on activity limitation (Healthy Life Years), chronic morbidity and perceived health of men and women in rural area and in towns/cities by number of residents, Poland 20112013 (Health data from SILC 2011-2013) Men Women Key points: In Poland in 2011-2013 life expectancy for men aged 65 years living in urban area was 15.8 years, and was a year longer than for those living in rural area. Men in the largest cities over 500 thousand inhabitants could expect to live by 1.5 years longer than men living in small towns below 20 thousand population and about 1.8 years longer than those living in rural area. For women aged 65 differences in life expectancy related to the place of residence were more than by half smaller than that for men. Men in urban area can expect to spend nearly a year (0,9) more of their remaining life without activity limitation (HLY) than men in rural area. However, men living in the cities over 500 thousand population could expect to live about 1.8 years longer without activity limitation than men living in small towns or in rural area. The corresponding differences in HLY in women were of the same direction but smaller magnitude. Quite unexpectedly, both men and women aged 65 years living in urban area can expect a shorter life without chronic health problem than residents of rural area (by 0.4 and 1.1 years, respectively). In addition, residents of large cities have not been in a more favourable situation than residents of small towns. This may suggest greater awareness of own health problems among residents of urban than rural area. Men and women aged 65 living in urban area can expect longer life in very good or good health than rural residents by a year and 0.8 years, respectively and residents of the largest cities longer life by 1.3 years than those living in the smallest towns. These results should be interpreted cautiously given the lack of the institutional population, such as people living in nursing homes. Acknowledgement: This analysis was carried out within the scope of the predefined project of the Programme PL13 “Reducing social inequalities in health” financed by Norwegian Financial Mechanism UNITED KINGDOM Two Facts about the trend in disability-free life expectancy in the UK Chris White (Office of National Statistics) Babies born in 2009-11 are expected to live more years in ‘Good’ health, than those born a decade ago A 65 year-old in 2009-11 will live longer free from disability compared to the previous decade, in the UK European Health and Life Expectancy Information System – EHLEIS - website: http://www.eurohex.eu Project leader : Jean-Marie Robine – Coordination of the Country reports : Isabelle Beluche Contact: Chris White, Office of National Statistics, [email protected] Co-funded by: 10 Member States, and two French institutions: the Ministry of Health and the National Solidarity Fund for Autonomy (CNSA). 3