Extra healthy years or just extra years? What do we know about the - - PowerPoint PPT Presentation
Extra healthy years or just extra years? What do we know about the gap between life expectancy and healthy life expectancy on the island of Ireland? 7 March 2013 Kevin P Balanda, Lorraine Fahy, Safa Abdalla, Steve Barron Institute of Public
7 March 2013
Kevin P Balanda, Lorraine Fahy, Safa Abdalla, Steve Barron Institute of Public Health in Ireland (IPH)
McGill 2012
Department of Health – RoI Future Health: A Strategic Framework for Reform of the Health Service 2012-2015 – There will be a new focus on the need to move away from simply treating ill people to a new concentration on keeping people healthy. Future Health recognises the need for a whole-of-government approach to addressing health issues and commits to the development of a comprehensive Health and Wellbeing Policy Framework and the establishment of a Health and Wellbeing Agency. DHSSPS – NI Priority areas related to health and well-being
Well-Being
Health expectancy measures
– Life expectancy (LE)
– Disability-free life expectancy (DFLE)
activities – Healthy life expectancy (HLE)
– Is healthy life expectancy also increasing? – Are the extra years being spent in good or bad health/ with or without activity limitations?
– Use Health expectancy measures to explore this
Description of health expectancies across island of Ireland (DFLE & HLE):
– Over time – By geography
– Gender differences – Socio-economic variation
Comparable with international series
series e.g. ONS, EU-SILC
Using three (very different) data sources:
– Morbidity (SLÁN; NIHSWB); Mortality; Population
– significant differences were noted (by ourselves and
expectancy derived from different data sources
differences
– understand how differences and limitations in data sources affected the findings – Understand the importance of these differences
– Lead to different conclusions on whether or not compression of morbidity
– Lots of different ways health questions are asked – Can have serious effects and implications
case studies
– What health expectancy estimates we would expect from different methodologies – Whether health expectancy estimates were real or because of methodological differences
SLÁN Surveys: Repeated independent cross- sectional samples In general would you say your health is:
EU-SILC Surveys: Routine follow-up of a rotating panel over a long period How is your health in general?
NIHSWB survey 1997, 2001, 2005 (HLE1 – NIHSWB): Independent cross-sectional samples. Face-to-face interviews. Over the last 12 months would you say your health has on the whole been:
SLÁN Surveys (RoI) 1998, 2002, 2006: Independent cross-sectional samples. Self-administered postal questionnaire 1998 & 2002; face-to-face interviews 2006. In general, would you say your health is:
NIHSWB survey 1997 (HLE2 – NIHSWB): Independent cross-sectional sample. Face-to-face interviews. In general, would you say your health is:
Proportion of Male Life Expectancy at age 65 with and without Disability
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% RoI RoI RoI 1998 2002 2006 Disability free With disability 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% NI NI NI 1997 2001 2005 Disability free With disability
NI RoI
– International comparisons – North-South comparisons – Changes over time – Assessment of gender differences and socio-economic variation – Examination of whether compression or expansion of morbidity occurred
– How the question is phrased?
– How the responses are formatted?
– How the questions are administered?
– Survey design
– Break in time series
– Socio-economic classifications used
– does not mean they measure the same aspect of health or health care.
– need to identify health measures that are relevant to different policy & service areas – different health expectancy measures lead to different findings – different findings could affect how health budgets are distributed
– Ensure limitations don’t mislead decision-making (e.g. policy) – Don’t take just one data source on which to base findings – Be aware of methodological differences between and within surveys – Read the fine print – If there are differences between data sources then drill down to explain the differences – Need to assist people with the data that we currently have
– Greater harmonisation between different survey series
lorraine.fahy@publichealth.ie