Jagger C.; Gillies C.; Moscone F.; Cambois E.; Van Oyen H.; Nusselder W.; Robine J. M.; EHLEIS team (2008).
Inequalities in healthy life years in the EU25. Lancet, 2008 Dec 20;372(9656):2124-31.
Summary:
Background Although life expectancy in the European Union (EU) is increasing, whether most of these extra years are
spent in good health is unclear. This information would be crucial to both contain health-care costs and increase
labour-force participation for older people. We investigated inequalities in life expectancies and healthy life years (HLYs)
at 50 years of age for the 25 countries in the EU in 2005 and the potential for increasing the proportion of older people
in the labour force.
Methods We calculated life expectancies and HLYs at 50 years of age by sex and country by the Sullivan method, which
was applied to Eurostat life tables and age-specifi c prevalence of activity limitation from the 2005 statistics of living
and income conditions survey. We investigated diff erences between countries through meta-regression techniques,
with structural and sustainable indicators for every country.
Findings In 2005, an average 50-year-old man in the 25 EU countries could expect to live until 67·3 years free of
activity limitation, and a woman to 68·1 years. HLYs at 50 years for both men and women varied more between
countries than did life expectancy (HLY range for men: from 9·1 years in Estonia to 23·6 years in Denmark; for
women: from 10·4 years in Estonia to 24·1 years in Denmark). Gross domestic product and expenditure on elderly
care were both positively associated with HLYs at 50 years in men and women (p<0·039 for both indicators and sexes);
however, in men alone, long-term unemployment was negatively associated (p=0·023) and life-long learning positively
associated (p=0·021) with HLYs at 50 years of age.
Interpretation Substantial inequalities in HLYs at 50 years exist within EU countries. Our fi ndings suggest that,
without major improvements in population health, the target of increasing participation of older people into the
labour force will be diffi cult to meet in all 25 EU countries.
