RT Journal Article
SR Electronic
T1 Health expectancies in the European Union: same concept, different methods, different results
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 764
OP 771
DO 10.1136/jech-2020-213791
VO 75
IS 8
A1 João Vasco Santos
A1 João Viana
A1 Brecht Devleesschauwer
A1 Juanita A Haagsma
A1 Cristina Costa Santos
A1 Walter Ricciardi
A1 Alberto Freitas
YR 2021
UL http://jech.bmj.com/content/75/8/764.abstract
AB Background Healthy life expectancy (HLE) is a population health measure that combines mortality and morbidity, which can be calculated using different methods. In this study, we aimed to assess the correlation, reliability and (dis)agreement between two estimates monitored in the European Union (EU), that is, the European Commission's HLE based on self-perceived health (SPH-HLE) and the Institute for Health Metrics and Evaluation's HLE based on disability weight (DW-HLE), by sex, and comparing these results with LE and proportion of life spent in good health (%GH).Methods We performed a retrospective study in the EU28 countries, between 2010 and 2017. The HLE methods differ in definition, measurement and valuation of health states. While SPH-HLE relies directly on one question, DW-HLE relies on epidemiological data adjusted for DW. Spearman’s r, intraclass correlation coefficient, information-based measure of disagreement and Bland-Altman plots were used to assess reliability, correlation and disagreement in HLE resulting from both methods and in LE or %GH measured by both institutions.Results Correlation and reliability between SPH-HLE and DW-HLE were good (better for males), with low disagreement, and were even better for LE between both institutions. The HLE Bland-Altman plots suggest a variability range of approximately 6 years for both sexes, higher for females. There was also an increasing HLE difference between methods with higher average HLE for both sexes.Conclusion We showed wide variations between both methods with a clear and different high impact on female and male HLE, showing a tendency for countries with higher health expectancies to yield larger gaps between SPH-HLE and DW-HLE.All data relevant to the study are included in the article or uploaded as online supplemental information. All data used in the study are uploaded as online supplemental information (online supplemental table 1).