Healthy life expectancy at birth and at age 65

Healthy life expectancy is an important indicator of population health. It indicates whether any gains in life expectancy are lived in good health or with some health problems and disabilities. A greater number of healthy life years generally means a healthier workforce, fewer early retirements due to health problems, and reduced long-term care needs.

The main indicator of healthy life years used in the European Union is the number of years lived free of activity limitations due to health problems (in other words, disability-free life expectancy). On average across EU countries, people can expect to live about 80% of their lives free of disability (Figure 3.5). This proportion of healthy life years is lower among women than men (77% vs 81%) because women generally report more activity limitations due to health problems at any given age and also because women live longer. Whereas the gender gap in life expectancy at birth is about 5.5 years on average across EU countries, there is virtually no gap in healthy life expectancy (64.2 years for women compared with 63.5 years for men). Women in EU countries can expect to live over 19 years of their lives with some disabilities compared with less than 15 years for men.

In 2016, Malta and Sweden were the two countries with the highest healthy life expectancy among both women and men. In these two countries, women can expect to live more than 85% of their life expectancy free of disability, and this share reaches around 90% for men. Latvia, Estonia and the Slovak Republic had among the lowest healthy life expectancy, reflecting both relatively low life expectancy and a substantial share of life lived with some disability.

As people get older, the share of the remaining years of life that they can expect to live free of disability falls. At age 65, people can only expect to live about 50% of their remaining years of live free of disability across EU countries (Figure 3.6). Again, this proportion is substantially smaller among women (47% only) than men (54%), because women report more disability at any specific age and because they live longer. Women can expect to live another 21.6 years when they reach age 65 across the EU, but only about 10 of these years can be expected to be free of activity limitation, with the other 11.5 years lived with some disabilities. For men, the remaining life expectancy at age 65 is more than three years shorter (18.2 years), but they can expect to live also about 10 years free of disability on average. The number of healthy life years for men at age 65 is greater than for women in about half of EU countries.

Inequalities in healthy life years by socioeconomic status are even greater than inequalities in life expectancy, because women and men with lower education or income are much more likely to report some activity limitations throughout their lives than those with higher level of education or income (see indicator “Self-reported health and disability”).

A wide range of policies is required to increase healthy life expectancy and reduce inequalities. These include greater efforts to prevent health problems starting early in life, promote equal access to care for the whole population, and better manage chronic health problems when they occur to reduce their disabling effects (OECD, 2017).

Definition and comparability

Healthy life years (HLY) are defined as the number of years spent free of long-term activity limitation (this is equivalent to disability-free life expectancy). Healthy life years are calculated annually by Eurostat based on life table data and age-specific prevalence data on long-term activity limitations. The disability measure is the Global Activity Limitation Indicator (GALI), which measures limitation in usual activities, coming from the EU-SILC survey.

The comparability of the data on healthy life years is limited by the fact that the indicator is derived from self-reported data which can be affected by people’s subjective assessment of their activity limitation (disability) and by social and cultural factors. There are also differences across countries in the formulation of the question on disability in national languages in EU-SILC, limiting data comparability (Eurostat, 2017).

Reference

OECD (2017), Preventing Ageing Unequally, OECD Publishing, Paris, https://doi.org/10.1787/9789264279087-en.

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