Estimating life expectancy using an age-cohort model in Taiwan.

OBJECTIVES: Life expectation is a valuable summary index in public health and actuarial science. The life expectancies published in the vital statistics, however, are derived from the "current" rather than from the "cohort" life table. The former is based on a strong assumption of constant mortality in the population, whereas the latter calls for a recording of the mortality experience of a group of individuals, which is often an impossible task. Thus, a method of calculating cohort life expectancy without actual follow up is much needed. METHODS: Estimation of cohort life expectancy was based on an age-cohort model. Mortality data for the male population in Taiwan from 1951 to 1990 are used to illustrate the methodology. RESULTS: The increment of life expectancy over time in Taiwan is actually steeper than was previously thought using the current life table technique. CONCLUSIONS: The method is easy to implement and the data required are the usual age and period cross classified mortality data. It warrants further investigation.     

Bridging the management-employee gap

The chief executive willing to experiment with new ways to reach employees should consider four programs used to good effect in a west coast hospital. The benefits match the efforts expended.     

Gender gap in life expectancy: the reasons for a reduction of female advantage

BACKGROUND: After a large increase during the 19th and the 20th century, for two decades the gap in life expectancy between sexes has been reducing in most industrialised countries. In France, where it was specially large, it stopped increasing in the early 1980s and decreased in the most recent years. The paper investigates reasons for these recent trends in France and in the industrialised countries. METHODS: Two types of data are used for analysis. Death probabilities from life tables are used for calculating male excess mortality by age and estimating the role of various age groups in life expectancy differences by sex. Sex- and cause-specific mortality rates from INED database for France and from WHO database for other countries are used to assess the part played by various causes of death in the gender gap and its evolution. RESULTS: In France, the stabilisation of the gap is mainly related to the decrease in cardiovascular mortality for men who benefit from the same progress but later than women. In the most recent years, the reduction of the gap is due to the trend reversal of male cancer mortality which is now decreasing, specially because of the reduction of lung cancer mortality. In European countries, taken as examples (England & Wales, Sweden, Switzerland, Italy) cardiovascular mortality is also the main responsible for the decreasing differences. Conversely, in Japan, the gap is still increasing specially for mortality from cancer and respiratory diseases. CONCLUSIONS: The recent gap narrowing between male and female life expectancy in France is not a specific case. It does not mean that female health situation is worsening but it is related to an acceleration of progress for males. This reduction will most probably go on in the next years, except if females would enjoy dramatic progression in old age mortality.     

Bridging the gap in South Africa

The South African government's proposed national insurance scheme aims to tackle the stark divide in health care between rich and poor. Claire Keeton reports.     

上海市居民期望寿命与健康期望寿命的差异分析

目的:分析不同年龄、性别的上海市居民期望寿命和健康期望寿命的差异。方法:分析比较上海市和全球长寿国家/地区期望寿命的变化趋势;利用全球疾病负担研究建立的疾病和健康结局的失能权重,应用Sullivan法测算上海市居民健康期望寿命,并分析不同年龄、性别人群的健康寿命损失。结果:近40年,上海市期望寿命增长了10.86岁,2...     

北京市城乡老年人预期寿命和健康预期寿命比较

目的 了解北京市老年人预期寿命(LE)、健康预期寿命(ALE)及健康预期寿命比值(ALE/LE)的地区性差异,分析高血压对不同地区老年人生命质量的影响。方法样本来自“北京市老龄化多维纵向研究”,研究对象为北京市城区（宣武区）、农村（大兴区和怀柔区）≥60岁老年人群,2004年基线调查1847人,2007年随访,由调访员入户调查不同地区人群的文化程度、职业及年龄构成,以能否独立完成日常生活活动认定功能健康与否,同时进行高血压病史的调查和现场测量血压,应用多状态寿命表IMaCH软件计算各个年龄段不同地区（城市及农村）的LE、ALE及ALE/LE,分析高血压对于不同地区老年人上述指标的影响。结果研究显示北京市老年人的文化程度、职业构成存在地域差异,农村老年人文化程度低（文盲占66.2％）,体力劳动比重高(占95.5％),与城市老年人的差异有统计学意义;农村地区各年龄组LE、ALE均低于城市,ALE/LE农村则高于城市,女性各年龄组城乡差距较男性明显;农村女性各年龄段正常血压组ALE高于城市,而高血压组则低于城市（以60～岁年龄组为例,正常血压农村女性ALE为24.61±2.08,城市女性为20.56±1.92;高血压农村女性ALE为16.34±1.15,城市女性为18.47±3.78）,强调了高血压对农村老年女性生命质量的影响。结论北京市老年人的LE、ALE、ALE/LE存在城乡差异,女性城乡差距更大,高血压则增加了城乡差距,降低了农村老年人的生活质量。提示了地域因素对于老年人生活质量的影响,强调了高血压防治的意义。     

Impact of diabetes mellitus on life expectancy and health-adjusted life expectancy in Canada

ABSTRACT: The objectives of this study were to estimate life expectancy (LE) and health-adjusted life expectancy (HALE) for Canadians with and without diabetes and to evaluate the impact of diabetes on population health using administrative and survey data.Mortality data from the Canadian Chronic Disease Surveillance System (2004 to 2006) and Health Utilities Index data from the Canadian Community Health Survey (2000 to 2005) were used. Life table analysis was applied to calculate LE, HALE, and their confidence intervals using the Chiang and the adapted Sullivan methods.LE and HALE were significantly lower among people with diabetes than for people without the disease. LE and HALE for females without diabetes were 85.0 and 73.3?years, respectively (males: 80.2 and 70.9?years). Diabetes was associated with a loss of LE and HALE of 6.0?years and 5.8?years, respectively, for females, and 5.0?years and 5.3?years, respectively, for males, living with diabetes at 55?years of age. The overall gains in LE and HALE after the hypothetical elimination of prevalent diagnosed diabetes cases in the population were 1.4?years and 1.2?years, respectively, for females, and 1.3?years for both LE and HALE for males.The results of the study confirm that diabetes is an important disease burden in Canada impacting the female and male populations differently. The methods can be used to calculate LE and HALE for other chronic conditions, providing useful information for public health researchers and policymakers.