Definitions and methodology CO1.2: at birth at birth is the average number of years a newborn can expect to live if he or she experienced the age-specific mortality rates prevalent in a particular year. Health-adjusted life expectancy (HALE) at birth is the average number of years a person can expect to live in good health or free of disease and injury. Healthy life years (HLY) at birth (a measure used across the EU) is the number of remaining years a person may expect to live without disability (also called disability-free life expectancy). It is important to note that life expectancy is not an indicator of child health specifically as it reflects death rates at all ages Key findings All OECD countries have made remarkable progress in increasing life expectancies at birth. In 2011, a newborn girl in a typical OECD country could expect to live over the age of years, that is, over 10 years more than a baby girl born in 19. Similarly in 2011, a newborn boy could expect to live up to age 77 years; also greater than 10 years more than a boy born in 19 (Chart CO1.2.A). Chart CO1.2.A: Trends in OECD life expectancy at birth: 19-2011, female and males. Source: OECD Health Data (version April 2014). Girls generally tend to live longer than boys. However, the extent of this gender gap varies across countries and across time. Since 19, the gender gap in life expectancy across OECD countries has slightly widened. Whereas in 19 girls could expect to live 5.0 years more than men, in 2011 this difference was on average 5.6 years. However, patterns have changed over time. While the gender gap increased substantially during the 19s and 1970s (reaching a peak of 6.8 years in the mid 80s), it has narrowed during the last 25 years. This narrowing pattern reflects in part a reduction in the gender differences in risk behaviours such as smoking and alcohol use (see CO1.8). Other relevant indicators: CO1.1: Infant mortality rate; CO1.3 and CO1.4: Early childhood indicators: Low and average birth weight, child immunisation; CO1.6: Disease-based indicators: prevalence of diabetes and asthma among children; CO1.7: Obesity among children aged 10 and CO1.8: Regular smokers among 15 year olds by gender. 1
79.6 80.3 79.1 79.4 79.7 79.1 78.7 77.9 77.9 78.4 78.6 77.6 76.9 76.7 75.9 76.2 74.5 72.1 70.6 73.1 71.6 70.5 71.8 70.0 66.0 65.0 76.8 86.4 84.9 85.3 84.6 83.6 83.3 84.7 83.2 83.1 82.7 84.1 82.6 81.4 82.7 81.1 80.9 80.6 80.5 77.8 78.1 OECD Family Database www.oecd.org/social/family/database In 2011, female life expectancy at birth in OECD countries ranged from 76.8 years in Turkey to 86.4 years in Japan (Chart CO1.2.B). Girls born in France, Italy, Korea, Spain and Switzerland could also expect to live particularly long lives (more than 84 years). For boys, life expectancy at birth ranged from a low of 70.5 years in Hungary to a high of 80.3 years in Switzerland, closely followed by Australia, Iceland, Israel, Japan and Sweden. Cross-country differences, though still high, have diminished between 19 and 2011. This reduction is mainly due to important gains in life expectancy by countries like Korea, Mexico and Turkey (28.3, 18 and 26 years, respectively). Catch-up gains in these countries are partly explained by substantive declines in infant mortality rates during this period (see CO1.1). Chart CO1.2.B: at birth, in years, females and males, 2011 1 90 Females at birth Males at birth Population at birth 80 70 Notes: Countries sorted by life expectancy of total population at birth; 1) Data refers to 2007 for non-oecd EU countries, 2008 for Canada, and 2009 for Italy; 2) Footnote by Turkey: The information in this document with reference to «Cyprus» relates to the southern part of the Island. There is no single authority representing both Turkish and Greek Cypriot people on the Island. Turkey recognizes the Turkish Republic of Northern Cyprus (TRNC). Until a lasting and equitable solution is found within the context of United Nations, Turkey shall preserve its position concerning the Cyprus issue ; 3) Footnote by all the European Union Member States of the OECD and the European Commission: The Republic of Cyprus is recognized by all members of the United Nations with the exception of Turkey. The information in this document relates to the area under the effective control of the Government of the Republic of Cyprus; 4) The data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Source: OECD Health Data (version April 2014; and WHO world health statistics (version January 2014) does not provide a full picture of the health status of the population. Extra years of life are not necessarily lived in good health. In 2010, girls and boys in OECD countries could expect to live 72 years in good health; 74 years and 70 years, respectively (Chart CO1.2.C). This means that around 10% of their lifespan could be limited due to disease or injury. In OECD countries, healthy life expectancy (HALE) for women is higher than for men. However, HALE gender gaps are smaller (4 years) than for life expectancy (5.6 years). The ranking of countries by HALE is very similar (Chart CO1.2.C) to that of life expectancy (Chart CO1.2.B), suggesting that countries with the longest life expectancies are also the healthiest (e.g. Australia, France, Japan, Italy, Spain and Switzerland). 2
Chart CO1.2.C: at birth and Healthy Adjusted Life Expectancy at birth (HALE), in years, females and males, 2010 Females at birth Males at birth Healthy life expectancy Healthy life expectancy 86.0 Japan France Italy1 Spain Switzerland Australia Canada 1 Finland Germany Iceland Luxembourg Sweden Austria Belgium Greece Ireland Korea Malta Netherlands New Zealand Norway Slovenia OECD Denmark Portugal United Kingdom 1 Chile Czech Republic United States 1 Estonia Poland Slovak Republic Bulgaria Hungary Mexico Latvia Lithuania Romania Turkey 74.0 67.0 66.0 65.0 70.0 90 80 70 40 40 70 80 90 Notes: sorted by women s HALE; (1) Data refer to 2009 Source: WHO statistical information system (WHOSYS), v. January 2014. The number of Healthy Life Years (HLY), a measure used across the EU, indicates that women in EU countries can expect to live 61 years (75% of their lifespan) without limitations in daily activities. By contrast, men can expect to live.2 years (80% of their lifespan) free of disabilities. The gender gap in HLY is thus marginal, suggesting that in the EU women will live longer lives but not necessarily of greater quality. By contrast, there is substantial variation in healthy life years across countries. While in Denmark, Sweden and Malta females and males can expect to live 67 years or more in good health, in Estonia, Finland, Latvia and the Slovak Republic the number of years a person can expect to live free of disabilities is between and 55 years. Chart CO1.2.D shows that the gender gap in life expectancy in favour of women varies widely across countries. Whereas in Hungary and Poland females can expect to live eight years or more than males, females in Iceland, New Zealand and Sweden can expect to live no more than four more than males. Similarly, the gender gap in healthy life expectancy shows important country variation. The gap is larger (more than five years) in Hungary, Korea, Poland and the Slovak Republic and smaller (less than three years) in the Netherlands, New Zealand, Norway and the UK. Countries with more gender equality, like the Nordics, are amongst the countries with the smallest differences between women and men. 3
Chart CO1.2.D: Life Expectancy at birth and Healthy Life Years at birth, in years, females and males, 2010 Females at birth Males at birth 80.7 81.6 82.1 84.4 84.1 84.4 82.4 82.2 79.6 81.8 81.3 79.9 82.4 82.2 78.4 90 80 70 Healthy life years 40 Malta Greece Denmark Sweden United Kingdom Ireland France Italy Spain Cyprus Netherlands Belgium Poland Luxembourg EU average Slovenia Austria Czech Rep. Germany Portugal Hungary Lithunia Slovakia Estonia Finland Latvia Healthy life years 76.1 77.3 77.4 77.4 76.6 70.9 76.8 74.7 74.4 73.5 75.5 69.2 65.3 70.4 67.4 65.4 40 70 80 90 Source: WHO statistical information system (WHOSYS), v. January 2014 and European Health Expectancy Monitoring Unit. Comparability and data issues Data on Life Expectancy at birth in Chart CO1.2.B has been taken from two sources: the OECD Health Data for OCED countries and the WHO world health statistics for non-oecd countries. The OECD data comes from national statistics. Some of the international variation in life expectancy at birth may be due to variations among countries in registering mortality rates. at birth for the total population is estimated by the OECD Secretariat for all countries, using the unweighted average of life expectancy of men and women. Charts CO1.2.C presents data on Life Expectancy and Health-Adjusted Life Expectancy (HALE) at birth. Both are sourced from the WHO statistical information system (WHOSYS). is estimated using life tables constructed by WHO using Sullivan's method. HALE is calculated using the WHO Global Burden of Disease (GBD) study, WHO Multi-Country Survey Study (MCSS) and World Health Survey (WHS). Data from the WHOGBD study are used to estimate severity-adjusted prevalence by age and sex for all countries. Data from the WHOMCSS and WHS are used to make independent estimates of severity adjusted prevalence by age and sex for survey countries. Prevalence for all countries is calculated based on GBD, MCSS and WHS estimates. Data from these sources is used to develop estimates for the incidence, prevalence, duration and years lived with disability for 135 major causes (http://apps.who.int/gho/indicatorregistry/app_main/browse_indicators.aspx). Chart CO1.2.D presents data on Life Expectancy and Healthy Life Years (HLY), which have been taken from the European Health Expectancy Monitoring Unit. and HLY are calculated by the EU using mortality statistics and data on self-reported disability (http://www.ehemu.eu/). Mortality data 4
come from Eurostat s demographic database and self-reported disability data come from EU-SILC. The question used for constructing this measure is: "For at least the past six months, to what extent have you been limited because of a health problem in activities people usually do? Would you say you have been: severely limited? / limited but not severely? / not limited at all?". Those answering severely limited or limited but not severely are considered as positive cases for the prevalence data. Sources and further reading: OECD Health database: www.oecd.org/health/healthdata; OECD Health at a Glance 2013; WHO Statistical Information System (WHOSIS) http://www.who.int/whosis/en/ ; European Health Expectancy Monitoring Unit: http://www.ehemu.eu/; and, Mathers C.D., Murray C.J., and Samson J. (2003) Methods for Measuring Healthy Life Expectancy. In: Murray C.J., Evans D, eds. Health systems performance assessment: debates, methods and empiricism. Geneva, World Health Organization, Geneva. 5