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Using linked data to calculate summary measures of population health: Health-adjusted life expectancy of people with Diabetes Mellitus
Douglas G Manuel, Susan E Schultz
Population Health Metrics , 2004, DOI: 10.1186/1478-7954-2-4
Abstract: The 1996/97 Ontario Health Survey (N = 35,517) was linked to the Ontario Diabetes Database (N = 487,576). The Health Utilities Index (HUI3) was used to estimate health-related quality of life. HALE was estimated using an adapted Sullivan method.Life expectancy at birth of people with DM was 64.7 and 70.7 years for men and women – 12.8 and 12.2 years less than for men and women without DM. The HUI3 was lower for physician-diagnosed DM compared to self-reported DM (0.799 versus 0.872). HALE at birth was 58.3 and 62.8 years for men and women – 11.9 and 10.7 years less than that of men and women without DM.The linked data approach demonstrates that DM is an important cause of disease burden. This approach reduces assumptions when estimating the prevalence and severity of disability from DM compared to methods that rely on self-reported disease status or indirect assessment of disability severity.Summary measures of population health (SMPH) [1], which take into account both mortality and morbidity, fall into two major classes: positive measures of health expectancy [2] such as health-adjusted life expectancy (HALE) [3,4], and measures of health gaps such as loss of healthy life years [5] or disability-adjusted life years (DALYs) [6]. Health expectancy, which is the focus of this study, represents life expectancy adjusted according to the amount of time spent in less than perfect health or with disability.Three data components are needed to estimate all types of SMPH for specific conditions: mortality attributed to the condition; the prevalence or incidence and duration of the condition; and the degree to which health-related quality of life (HRQOL) is affected. While all SMPH commonly use the same source of mortality information, namely vital statistics, there are differences in how other components are measured. Health expectancy measures typically estimate the impact of chronic conditions on HRQOL from population-based health surveys. However, attributing HRQOL to diff
Changing mortality and average cohort life expectancy  [cached]
Robert Schoen,Vladimir Canudas-Romo
Demographic Research , 2005,
Abstract: Period life expectancy varies with changes in mortality, and should not be confused with the life expectancy of those alive during that period. Given past and likely future mortality changes, a recent debate has arisen on the usefulness of the period life expectancy as the leading measure of survivorship. An alternative aggregate measure of period mortality which has been seen as less sensitive to period changes, the cross-sectional average length of life (CAL) has been proposed as an alternative, but has received only limited empirical or analytical examination. Here, we introduce a new measure, the average cohort life expectancy (ACLE), to provide a precise measure of the average length of life of cohorts alive at a given time. To compare the performance of ACLE with CAL and with period and cohort life expectancy, we first use population models with changing mortality. Then the four aggregate measures of mortality are calculated for England and Wales, Norway, and Switzerland for the years 1880 to 2000. CAL is found to be sensitive to past and present changes in death rates. ACLE requires the most data, but gives the best representation of the survivorship of cohorts present at a given time.
Understanding Children’s Physical Activity and Health-Related Quality of Life: An Expectancy-Value Approach  [PDF]
Xiangli Gu
Advances in Physical Education (APE) , 2017, DOI: 10.4236/ape.2017.72013
Abstract: This review paper explores the motivational processes in physical education related to physical activity and health-related quality of life among children and adolescents. First, we review the existing body of literature relating to children’s health-related quality of life. Next, we present the expectancy-value model of achievement choice as a framework for investigating how children’s motivation in physical activity settings interacts with physical activity and health-related quality of life. In the following section, we discuss social-contextual factors within the motivational climate, and how they can enhance or constrain decisions to be physically active and influence health-related quality of life. We conclude by identifying emerging research issues, implications for practice, and suggestions for future research directions.
Sustaining Increase in Life Expectancy in Africa Requires Active Preventive Measures against Non-Communicable Diseases  [PDF]
Efosa K. Oghagbon, Lydia Giménez-Llort
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.45035
Abstract:

It is projected that aged population (≥60 years) will continue to increase globally, including in Africa. This is due to reduced population growth, decreased fecundity and improved medical interventions; factors which increase life expectancy. While this is typical for developed countries, it is not the same for Africa and similar developing regions. In these regions, a significant proportion of death is due to non-communicable diseases (NCD’s) such as hypertension, cerebrovascular accident, coronary heart disease, diabetes mellitus, chronic renal disease and cancer, among others. Rising prevalence of NCD’s due mainly to western style diets and sedentary living is made worse by inadequate nutrition education, high prevalence of low birth weight, poor health services, lack of efficient tobacco control and deficient planning of built environment. In order to halt the possible reduction in life expectancy occasioned by NCD’s, efforts by the community, health planners and governments in Africa to address relevant NCD’s, must be put in place. Suggested measures are: nutrition education, regular community directed physical exercise, improved environmental planning and development. Others are review of present health service model, early detection, prevention and treatment of NCD’s, including improved antenatal care to reduce low birth weights, and establishment of policies and measures that decreased access to tobacco especially by women of childbearing age. Africa and similar developing regions cannot fund the health bill due to NCD’s and their complications; hence it is important that this scourge is attended to with all seriousness.

On the correspondence between CAL and lagged cohort life expectancy  [cached]
Michel Guillot,Hyun Sik Kim
Demographic Research , 2011,
Abstract: It has been established that under certain mortality assumptions, the current value of the Cross-sectional Average length of Life (CAL) is equal to the life expectancy for the cohort currently reaching its life expectancy. This correspondence is important, because the life expectancy for the cohort currently reaching its life expectancy, or lagged cohort life expectancy (LCLE), has been discussed in the tempo literature as a summary mortality measure of substantive interest. In this paper, we build on previous work by evaluating the extent to which the correspondence holds in actual populations. We also discuss the implications of the CAL-LCLE correspondence (or lack thereof) for using CAL as a measure of cohort life expectancy, and for understanding the connection between CAL, LCLE, and underlying period mortality conditions.
Obesity and Trends in Life Expectancy  [PDF]
Helen L. Walls,Kathryn Backholer,Joseph Proietto,John J. McNeil
Journal of Obesity , 2012, DOI: 10.1155/2012/107989
Abstract: Background. Increasing levels of obesity over recent decades have been expected to lead to an epidemic of diabetes and a subsequent reduction in life expectancy, but instead all-cause and cardiovascular-specific mortality rates have decreased steadily in most developed countries and life expectancy has increased. Methods. This paper suggests several factors that may be masking the effects of obesity on life expectancy. Results. It is possible that health and life expectancy gains could be even greater if it was not for the increasing prevalence of extreme obesity. It is also possible that the principal impact of obesity is on disability-free life expectancy rather than on life expectancy itself. Conclusion. If the principal impact of obesity were through disability-free life expectancy rather than on life expectancy itself, this would have substantial implications for the health of individuals and the future burden on the health care system.
New Characteristics of Active Life Expectancy of the Elderly in China  [PDF]
Ping Gao, Han-Dong Li
Advances in Aging Research (AAR) , 2016, DOI: 10.4236/aar.2016.51003
Abstract: Life expectancy of the elderly is a significant problem in China, and it changes not only the health care, but also the pension. This study used tracking data from the Chinese Urban and Rural Elderly Population Survey to calculate the age-specific Active Life Expectancy (ALE) of the Chinese elderly population aged 60 years and over. For analysis, this population was divided into different sub-populations according to gender, census register and region. The main conclusions of our study are as follows: 1) The quality of life for elderly males may be greater than that for elderly females; 2) There were significant differences in Active Life Expectancy (ALE) and Inactive Life Expectancy (ILE) between urban and rural elderly; 3) The differences in ALE between the eastern, central and western regions of China were not significant; and 4) The increased remaining life expectancy of the elderly was mainly attributed to the extended ALE in the lower age group and the expanded ILE in the higher age group. This study expands the knowledge of Chinese elderly’s life expectancy in different health status.
Survival as a Function of Life Expectancy  [cached]
Maxim Finkelstein,James Vaupel
Demographic Research , 2009,
Abstract: It is well known that life expectancy can be expressed as an integral of the survival curve. The reverse - that the survival function can be expressed as an integral of life expectancy - is also true.
Obesity and Trends in Life Expectancy  [PDF]
Helen L. Walls,Kathryn Backholer,Joseph Proietto,John J. McNeil
Journal of Obesity , 2012, DOI: 10.1155/2012/107989
Abstract: Background. Increasing levels of obesity over recent decades have been expected to lead to an epidemic of diabetes and a subsequent reduction in life expectancy, but instead all-cause and cardiovascular-specific mortality rates have decreased steadily in most developed countries and life expectancy has increased. Methods. This paper suggests several factors that may be masking the effects of obesity on life expectancy. Results. It is possible that health and life expectancy gains could be even greater if it was not for the increasing prevalence of extreme obesity. It is also possible that the principal impact of obesity is on disability-free life expectancy rather than on life expectancy itself. Conclusion. If the principal impact of obesity were through disability-free life expectancy rather than on life expectancy itself, this would have substantial implications for the health of individuals and the future burden on the health care system. 1. Introduction Obesity has reached unprecedented levels globally and its rise is projected to continue. This has caused widespread concern, considering the associations between obesity and a range of adverse health conditions. There is a widely held view that the increasing rates of obesity will lead to an epidemic of diabetes, other chronic conditions, and a subsequent reduction in life expectancy. However the picture is complicated. Since the 1960s all-cause and cardiovascular-specific mortality rates have decreased steadily in most developed countries, and life expectancy has consistently increased [1]. The aim of this paper is to suggest several reasons for the discrepancy between increasing levels of obesity and gains in life expectancy, and those factors may be masking the effects of obesity on life expectancy. A better understanding of the way in which obesity affects health and longevity will help determine the most appropriate response to increasing levels of excess body weight and assist our understanding of the likely impact of obesity on the health of individuals and the future burden on the health care system. 2. Population Trends An increasing prevalence of obesity has been observed in most countries worldwide. This is considered to have led to an “epidemic” of type II diabetes. The progression of this epidemic, in tandem with cardiovascular disease and several other morbidities associated with obesity, is predicted to slow or reverse the decline in mortality that has been noted in most Western countries over the past 30–40 years [1]. The data accumulated to date have provided relatively little
Healthy life expectancy in Brazil: applying the Sullivan method
Romero, Dalia Elena;Leite, Iúri da Costa;Szwarcwald, Célia Landmann;
Cadernos de Saúde Pública , 2005, DOI: 10.1590/S0102-311X2005000700002
Abstract: the objective of this study is to present the method proposed by sullivan and to estimate the healthy life expectancy using different measures of state of health, based on information from the world health survey carried out in brazil in 2003. by combining information on mortality and morbidity into a unique indicator, simple to calculate and easy to interpret, the sullivan method is currently the one most commonly used for estimating healthy life expectancy. the results show higher number of healthy years lost if there is a long-term disease or disability that limits daily activities, regardless of the difficulty in performing such activities or the severity of the functional limitations. the two measures of healthy life expectancy adjusted by the severity of functional limitation show results very similar to estimates based on the perception of state of health, especially in advanced age. it was also observed, for all measures used, that the proportion of healthy years lost increases significantly with age and that, although females have higher life expectancy than males, they live proportionally less years in good health.
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