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Inequality in disability-free life expectancies among older men and women in six countries with developing economies
  1. Ailiana Santosa1,2,
  2. Julia Schröders2,
  3. Masoud Vaezghasemi2,3,
  4. Nawi Ng1,2
  1. 1Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
  2. 2Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  3. 3Umeå Centre for Gender Studies (UCGSs), Umeå University, Umeå, Sweden
  1. Correspondence to Dr Ailiana Santosa, Centre for Demographic and Ageing Research, Umeå University, Umeå 90187, Sweden; ailiana.santosa{at}


Background It is unclear whether the increase in life expectancy (LE) globally is coupled with a postponement of morbidity and disability. Evidence on trends and determinants of disability-free life expectancies (DFLEs) are available in high-income countries but less in low and middle-income countries (LMICs). This study examines the levels of and inequalities in LE, disability and DFLE between men and women across different age groups aged 50 years and over in six countries with developing economies.

Methods This study utilised the cross-sectional data (n=32 724) from the WHO Study on global AGEing and adult health (SAGE) in China, Ghana, India, Mexico, the Russian Federation and South Africa in 2007–2010. Disability was measured with the activity of daily living (ADL) instrument. The DFLE was estimated using the Sullivan method based on the standard period life table and ADL-disability proportions.

Results The disability prevalence ranged from 13% in China to 54% in India. The prevalence of disability was highest and occurred at younger age in both sexes in India. Women were more disadvantaged with higher prevalence of disability across all age groups, and the situation was worst among older women in Mexico and the Russian Federation. Though women had higher LE, their proportion of remaining LE free from disability was lower than men.

Conclusions There are inequalities in the levels of disability and DFLE among men and women in different age groups among people aged over 50 years in these six countries. Countermeasures to decrease intercountry and gender gaps in DFLE, including improvements in health promotion and healthcare distribution, with a gender equity focus, are needed.

  • Health inequalities

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