Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Max Planck Institute for Demographic Research, Rostock, Germany.
Scand J Public Health. 2024 Mar;52(2):175-183. doi: 10.1177/14034948221144348. Epub 2023 Jan 4.
Several studies have revealed widening of inequalities in life expectancy, but little is known about the recent changes in health expectancy nationally and between socioeconomic groups. This study examines dynamics of national and education-specific life expectancy and health expectancies at age 50 years in Denmark from 2004/2007 to 2015.
Nationwide register data on education and mortality were linked and combined with Danish health data from the Survey of Health, Ageing and Retirement in Europe and changes in life expectancy and three health expectancy indicators were estimated by Sullivan's method.
From 2004 to 2015, national life expectancy at age 50 years increased by 2.4 years for men and 2.1 years for women. Simultaneously, after an initial rapid improvement from 2004 to 2007, the pace of progress in health expectancy decreased. From 2007 to 2015, the difference in life expectancy at age 50 years between men with long and short education increased from 4.3 to 5.0 years. For women, the corresponding increase in the life expectancy gap was less pronounced from 3.5 to 3.8 years. The educational gap in lifetime without long-term illness decreased from 4.6 years to 3.1 years for men and from 6.1 years to 4.6 years for women. On the contrary, the educational gap increased for lifetime without activity limitations and in self-rated good health.
Previously observed improvements in health expectancy in Denmark slowed down despite continuing progress in life expectancy. This worrying change coincides with persistent educational inequalities in life expectancy and health expectancy and is a challenge to a sustainable social and health development in the future.
多项研究表明,预期寿命的不平等现象正在扩大,但人们对全国范围内和社会经济群体之间最近的健康预期变化知之甚少。本研究考察了丹麦从 2004/2007 年到 2015 年期间,50 岁时的全国和特定教育水平的预期寿命以及健康预期的动态变化。
将教育和死亡率的全国性登记数据进行了关联,并与欧洲健康、老龄化和退休调查中的丹麦健康数据相结合,通过 Sullivan 法估计了预期寿命和三个健康预期指标的变化。
从 2004 年到 2015 年,50 岁男性的全国预期寿命增加了 2.4 年,女性增加了 2.1 年。同时,在 2004 年至 2007 年初期快速改善之后,健康预期的进展速度放缓。从 2007 年到 2015 年,50 岁男性中受教育程度长短之间的预期寿命差距从 4.3 年增加到 5.0 年。对于女性,预期寿命差距的相应增加则从 3.5 年到 3.8 年不太明显。男性终身无长期疾病的教育差距从 4.6 年缩小到 3.1 年,女性从 6.1 年缩小到 4.6 年。相反,在无活动能力限制和自我评估健康状况良好方面,教育差距有所增加。
尽管预期寿命仍在继续延长,但丹麦此前观察到的健康预期改善速度放缓。这种令人担忧的变化与预期寿命和健康预期方面持续存在的教育不平等现象相吻合,是对未来可持续社会和健康发展的挑战。