Mind the gap—reaching the European target of a 2-year increase in healthy life years in the next decade

Background: The European Innovation Partnership on Active and Healthy Ageing seeks an increase of two healthy life years (HLY) at birth in the EU27 for the next 10 years. We assess the feasibility of doing so between 2010 and 2020 and the differential impact among countries by applying different scenarios to current trends in HLY. Methods: Data comprised HLY and life expectancy (LE) at birth 2004–09 from Eurostat. We estimated HLY in 2010 in each country by multiplying the Eurostat projections of LE in 2010 by the ratio HLY/LE obtained either from country and sex-specific linear regression models of HLY/LE on year (seven countries retaining same HLY question) or extrapolating the average of HLY/LE in 2008 and 2009 to 2010 (20 countries and EU27). The first scenario continued these trends with three other scenarios exploring different HLY gap reductions between 2010 and 2020. Results: The estimated gap in HLY in 2010 was 17.5 years (men) and 18.9 years (women). Assuming current trends continue, EU27 HLY increased by 1.4 years (men) and 0.9 years (women), below the European Innovation Partnership on Active and Healthy Ageing target, with the HLY gap between countries increasing to 18.3 years (men) and 19.5 years (women). To eliminate the HLY gap in 20 years, the EU27 must gain 4.4 HLY (men) and 4.8 HLY (women) in the next decade, which, for some countries, is substantially more than what the current trends suggest. Conclusion: Global targets for HLY move attention from inter-country differences and, alongside the current economic crisis, may contribute to increase health inequalities.

[1]  David A. Leon,et al.  Minding the gap: changes in life expectancy in the Baltic States compared with Finland , 2012, Journal of Epidemiology & Community Health.

[2]  M. Sherriff,et al.  A model of successful ageing in British populations. , 2012, European journal of public health.

[3]  M. Marmot,et al.  Social determinants of health in Europe , 2012, The Lancet.

[4]  J. Mackenbach,et al.  Sharp upturn of life expectancy in the Netherlands: effect of more health care for the elderly? , 2011, European Journal of Epidemiology.

[5]  M. Mckee,et al.  Health effects of financial crisis: omens of a Greek tragedy , 2011, The Lancet.

[6]  M. Suhrcke,et al.  Effects of the 2008 recession on health: a first look at European data , 2011, The Lancet.

[7]  M. Mckee Responding to the economic crisis: Europe's governments must take account of the cost of health inequalities , 2011, Journal of Epidemiology & Community Health.

[8]  J. Mackenbach,et al.  Economic costs of health inequalities in the European Union , 2010, Journal of Epidemiology & Community Health.

[9]  Warren C. Sanderson,et al.  Remeasuring Aging , 2010, Science.

[10]  K. Camargo,et al.  Closing the gap in a generation: Health equity through action on the social determinants of health , 2011 .

[11]  J. Vaupel,et al.  Ageing populations: the challenges ahead , 2009, The Lancet.

[12]  M. Petticrew,et al.  Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews , 2009, Journal of Epidemiology & Community Health.

[13]  Martin McKee,et al.  The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis , 2009, The Lancet.

[14]  Carol Jagger,et al.  Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis , 2008, The Lancet.

[15]  S. Friel,et al.  Closing the gap in a generation: health equity through action on the social determinants of health , 2008, The Lancet.

[16]  C. Brayne,et al.  The burden of diseases on disability-free life expectancy in later life. , 2007, The journals of gerontology. Series A, Biological sciences and medical sciences.

[17]  J. Vaupel,et al.  Broken Limits to Life Expectancy , 2002, Science.

[18]  W. Nusselder,et al.  The elimination of selected chronic diseases in a population: the compression and expansion of morbidity. , 1996, American journal of public health.

[19]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[20]  W. Gulbinat,et al.  Reliability of the AMDP‐System A PRELIMINARY REPORT ON A MULTICENTRE EXERCISE ON THE RELIABILITY OF PSYCHOPATHOLOGICAL ASSESSMENT , 1980, Acta psychiatrica Scandinavica.

[21]  Morton Kramer,et al.  The rising pandemic of mental disorders and associated chronic diseases and disabilities , 1980 .

[22]  J F Fries,et al.  Aging, natural death, and the compression of morbidity. , 1980, The New England journal of medicine.

[23]  D. Sullivan,et al.  A single index of mortality and morbidity. , 1971, HSMHA health reports.

[24]  K. McKee FUTURAGE : A road map for European ageing research , 2011 .

[25]  M. Marmot Fair society, healthy lives : the Marmot Review : strategic review of health inequalities in England post-2010. , 2010 .

[26]  L. Jonung,et al.  European Commission Directorate-General for Economic and Financial Affairs Publications , 2006 .

[27]  L. Jonung,et al.  DIRECTORATE-GENERAL FOR ECONOMIC AND FINANCIAL AFFAIRS , 1725 .

[28]  N. Grassly,et al.  United Nations Department of Economic and Social Affairs/population Division , 2022 .