Chan Angelique, Malhotra Rahul, Matchar David B, Ma Stefan, Saito Yasuhiko
Health Services and Systems Research (HSSR), Duke-NUS Graduate Medical School, Singapore.
Department of Sociology, National University of Singapore, Singapore.
Geriatr Gerontol Int. 2016 Apr;16(4):466-73. doi: 10.1111/ggi.12493. Epub 2015 Apr 14.
The aim of the present study was to compute total life expectancy (TLE), active life expectancy (ALE) and inactive life expectancy among older Singaporeans by gender, education and ethnicity.
Data from a longitudinal survey of older Singaporeans were used. No difficulty in carrying out activities of daily living or instrumental activities of daily living was considered as "active." Transition probabilities across health states (active/inactive/dead) were assessed to develop multistate life tables, which estimated TLE, ALE and inactive life expectancy.
At age 60 years, women, versus men, had significantly higher TLE (25.9, 95% confidence interval [CI] 24.0-27.8 vs 21.6, 95% CI 20.1-23.1), but similar ALE (18.1, 95% CI 17.0-19.2 vs 18.9, 95% CI 17.7-20.2). Those with high (secondary or higher), versus low (primary or less), education had significantly higher TLE (28.5, 95% CI 25.0-32.0 vs 22.5, 95% CI 21.1-23.9) and ALE (23.5, 95% CI 21.2-25.7 vs 17.1, 95% CI 16.1-18.0) at age 60 years. Those of Chinese, versus non-Chinese, ethnicity had significantly higher ALE at age 60 years (19.4, 95% CI 18.4-20.3 vs 15.0, 95% CI 13.4-16.7).
Unlike Western nations, there was no gender difference in ALE among older adults in Singapore. However, difference in ALE by education among older Singaporeans was similar to that observed in Western societies. Policies focusing specifically on improving women's health at all ages, in addition to policies that increase population education levels, are promising approaches to improving ALE. Recognizing ethnic differences in ALE will help target policies that increase ALE in multicultural societies.
本研究旨在按性别、教育程度和种族计算新加坡老年人的总预期寿命(TLE)、健康预期寿命(ALE)和非健康预期寿命。
使用了对新加坡老年人进行的纵向调查数据。将在进行日常生活活动或工具性日常生活活动时没有困难视为“健康”。评估了不同健康状态(健康/非健康/死亡)之间的转移概率,以编制多状态生命表,从而估计总预期寿命、健康预期寿命和非健康预期寿命。
在60岁时,女性的总预期寿命显著高于男性(25.9,95%置信区间[CI]24.0 - 27.8,而男性为21.6,95%CI 20.1 - 23.1),但健康预期寿命相似(18.1,95%CI 17.0 - 19.2,而男性为18.9,95%CI 17.7 - 20.2)。在60岁时,受过高等教育(中学及以上)的人比受低等教育(小学及以下)的人总预期寿命显著更高(28.5,95%CI 25.0 - 32.0,而后者为22.5,95%CI 21.1 - 23.9),健康预期寿命也更高(23.5,95%CI 21.2 - 25.7,而后者为17.1,95%CI 16.1 - 18.0)。在60岁时,华裔老年人比非华裔老年人的健康预期寿命显著更高(19.4,95%CI 18.4 - 20.3,而非华裔为15.0,95%CI 13.4 - 16.7)。
与西方国家不同,新加坡老年人的健康预期寿命不存在性别差异。然而,新加坡老年人中健康预期寿命因教育程度的差异与西方社会观察到的情况相似。除了提高人口教育水平的政策外,专门关注改善各年龄段女性健康的政策是提高健康预期寿命的有前景的方法。认识到健康预期寿命的种族差异将有助于制定在多元文化社会中提高健康预期寿命的针对性政策。