Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.
Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, 169857, Singapore.
BMC Public Health. 2018 Apr 11;18(1):476. doi: 10.1186/s12889-018-5377-x.
Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries.
In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives.
The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors.
To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.
出生时的健康期望寿命（HALE）是衡量一个国家人口健康状况和生活质量的重要指标。然而，目前全球范围内，甚至在特定国家层面，人们对 HALE 的决定因素还知之甚少。因此，我们研究了在低收入和中下等收入国家中与出生时 HALE 相关的因素。
根据世界银行（WB）的分类，我们选择了 79 个低收入和中下等收入国家进行研究。从世界卫生组织、联合国开发计划署、人口参考局、WB、传统基金会、透明国际、自由之家和国际监狱研究中心等多个可靠来源获取了与 HALE、人口统计学、社会经济、社会结构、健康和环境因素相关的数据。我们进行了描述性统计、相关分析和回归分析，以达到研究目的。
HALE 最低和最高的国家分别是塞拉利昂（44.40 岁）和斯里兰卡（67.00 岁）。平均受教育年限、总生育率（TFR）、医生密度、人均国民总收入、卫生支出、经济自由度、二氧化碳排放率、新闻自由、腐败感知指数、监狱人口率和实现与健康相关的千年发展目标（MDGs）水平被认为是 HALE 的相关因素。在所有相关因素中，平均受教育年限、TFR、新闻自由和实现与健康相关的 MDGs 水平被认为是最具影响力的因素。
为了提高低收入和中下等收入国家的 HALE，我们建议降低 TFR，同时增加平均受教育年限、新闻自由和实现与健康相关的 MDGs 水平。
