Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
Eur J Public Health. 2019 Feb 1;29(1):82-87. doi: 10.1093/eurpub/cky105.
We aimed to investigate the contribution of chronic conditions to gender differences in disability-free life expectancy (DFLE) and life expectancy with disability (LED) in Belgium in 2001, 2004 and 2008.
Data on disability and chronic conditions from participants of the 2001, 2004 and 2008 Health Interview Surveys in Belgium were used to estimate disability prevalence by cause using the attribution method. Disability prevalence was applied to life tables to estimate DFLE and LED using the Sullivan method. Decomposition techniques were used to assess the contribution of mortality and disability and further of causes of death and disability to gender disparities in DFLE and LED.
Higher LE, DFLE and LED were observed for women compared with men in all years studied. A decrease in the gender gap in LE (2001: 5.9; 2004: 5.6; 2008: 5.3) was observed in our cross-sectional approach followed by a decrease in gender differences in DFLE (2001: 1.9; 2004: 1.3; 2008: 0.5) and increase in LED (2001: 4.0; 2004: 4.4; 2008: 4.8). The higher LED in women was attributed to their lower mortality due to lung/larynx/trachea cancer, ischaemic heart diseases, and external causes (2001 and 2004) and higher disability prevalence due to musculoskeletal conditions (2008). Higher DFLE was observed in women owing to their lower mortality from lung/larynx/trachea cancer, ischaemic heart diseases, digestive cancer and chronic respiratory diseases.
To promote healthy ageing of populations, priority should be given to reduce the LED disadvantage in women by targeting non-fatal diseases, such as musculoskeletal conditions.
本研究旨在探讨 2001 年、2004 年和 2008 年比利时慢性疾病对无残疾预期寿命（DFLE）和残疾预期寿命（LED）性别差异的贡献。
使用 2001 年、2004 年和 2008 年比利时健康访谈调查中参与者的残疾和慢性疾病数据，采用归因方法估算各病因导致的残疾流行率。将残疾流行率应用于生命表，采用 Sullivan 法估算 DFLE 和 LED。使用分解技术评估死亡率和残疾率以及死亡和残疾病因对 DFLE 和 LED 性别差异的贡献。
与男性相比，所有研究年份的女性预期寿命（LE）、DFLE 和 LED 均较高。我们的横断面研究显示，LE 性别差距（2001 年：5.9；2004 年：5.6；2008 年：5.3）逐渐缩小，随后 DFLE 性别差异（2001 年：1.9；2004 年：1.3；2008 年：0.5）逐渐缩小，LED 性别差异（2001 年：4.0；2004 年：4.4；2008 年：4.8）逐渐增大。女性 LED 较高归因于其死于肺癌/喉癌/气管癌、缺血性心脏病和外部原因（2001 年和 2004 年）的死亡率较低，以及 2008 年肌肉骨骼疾病导致的残疾流行率较高。女性 DFLE 较高归因于其死于肺癌/喉癌/气管癌、缺血性心脏病、消化道癌和慢性呼吸系统疾病的死亡率较低。
为促进人口健康老龄化，应优先降低女性 LED 劣势，重点关注肌肉骨骼疾病等非致命性疾病。
