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. 2016 Sep;70(9):855-61.
doi: 10.1136/jech-2015-206640. Epub 2016 Mar 18.

Inequality in disability-free life expectancies among older men and women in six countries with developing economies

Ailiana Santosa  1 , Julia Schröders  2 , Masoud Vaezghasemi  3 , Nawi Ng  1
Affiliations

Inequality in disability-free life expectancies among older men and women in six countries with developing economies

Ailiana Santosa et al. J Epidemiol Community Health. 2016 Sep.

Abstract

Background: It is unclear whether the increase in life expectancy (LE) globally is coupled with a postponement of morbidity and disability. Evidence on trends and determinants of disability-free life expectancies (DFLEs) are available in high-income countries but less in low and middle-income countries (LMICs). This study examines the levels of and inequalities in LE, disability and DFLE between men and women across different age groups aged 50 years and over in six countries with developing economies.

Methods: This study utilised the cross-sectional data (n=32 724) from the WHO Study on global AGEing and adult health (SAGE) in China, Ghana, India, Mexico, the Russian Federation and South Africa in 2007-2010. Disability was measured with the activity of daily living (ADL) instrument. The DFLE was estimated using the Sullivan method based on the standard period life table and ADL-disability proportions.

Results: The disability prevalence ranged from 13% in China to 54% in India. The prevalence of disability was highest and occurred at younger age in both sexes in India. Women were more disadvantaged with higher prevalence of disability across all age groups, and the situation was worst among older women in Mexico and the Russian Federation. Though women had higher LE, their proportion of remaining LE free from disability was lower than men.

Conclusions: There are inequalities in the levels of disability and DFLE among men and women in different age groups among people aged over 50 years in these six countries. Countermeasures to decrease intercountry and gender gaps in DFLE, including improvements in health promotion and healthcare distribution, with a gender equity focus, are needed.

Keywords: DISABILITY; HEALTH EXPECTANCY; Health inequalities.

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Figures

Figure 1
Figure 1
Prevalence of disability among men and women in each age group in the six WHO-SAGE countries. The darker bars and the solid lines represent men, the lighter bars and the dashed lines represent women. All the country-specific proportions were weighted by the country-specific weights. WHO-SAGE, WHO Study on global AGEing and adult health.
Figure 2
Figure 2
Life expectancy among men (left panel) and women (right panel) in each age group in the six WHO-SAGE countries. The lower bar represents years lived without disability/disability-free live expectancy (DFLE) and the upper bar represents years lived with disability/disability life expectancy (DLE). WHO-SAGE, WHO Study on global AGEing and adult health.
Figure 3
Figure 3
Relative differences between women and men in total life expectancy and disability-free life expectancy at 50 years of age in the six WHO-SAGE countries. WHO-SAGE, WHO Study on global AGEing and adult health.
See this image and copyright information in PMC

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