Luy Marc
Vienna Institute of Demography, Österreichische Akademie der Wissenschaften, Dominikanerbastei 16, 1010, Wien, Österreich.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 May;67(5):538-545. doi: 10.1007/s00103-024-03874-w. Epub 2024 Apr 24.
Demographic ageing yields many societal consequences that depend strongly on the health status of the population. Special indicators have been developed for tracking and assessing population health, which are referred to with the overarching term healthy life expectancy (HLE). The derivation of HLE is intuitive and easily comprehensible. However, an overly simplistic interpretation hides the extreme complexity inherent in adding the health dimension to the life table. This makes HLE compared to classic life expectancy (LE) extremely sensitive to certain conceptual and methodological features. In the article, this is presented in more detail for three aspects: the underlying definition of health, the choice of survey data as a basis for estimating health status, and the reporting behavior of survey participants. It is shown that the impact on HLE can be enormous, leading to considerable bias in the interpretation of levels and trends, but also in the analysis of differences between populations. Nevertheless, the extension of classical LE to HLE is an important achievement that must not be abandoned. Therefore, the article also discusses ways in which the HLE indicator could be made more robust and reliable. Until this is achieved, however, the high methodological sensitivity of HLE must not be ignored if it is used to assess the health status of populations and as a basis for health policy measures.
人口老龄化产生了许多很大程度上取决于人口健康状况的社会后果。已经制定了专门的指标来跟踪和评估人口健康状况，这些指标统称为健康预期寿命（HLE）。HLE的推导直观且易于理解。然而，过于简单化的解释掩盖了在生命表中加入健康维度所固有的极端复杂性。这使得HLE与经典预期寿命（LE）相比，对某些概念和方法特征极为敏感。在本文中，将从三个方面更详细地阐述这一点：健康的基本定义、作为估计健康状况基础的调查数据的选择以及调查参与者的报告行为。结果表明，其对HLE的影响可能是巨大的，会导致在对水平和趋势的解释上出现相当大的偏差，在对不同人群之间差异的分析中也是如此。尽管如此，将经典的LE扩展到HLE是一项重要成就，绝不能放弃。因此，本文还讨论了使HLE指标更稳健、更可靠的方法。然而，在实现这一点之前，如果将HLE用于评估人口健康状况并作为卫生政策措施的基础，就绝不能忽视其高度的方法敏感性。
