Healthy life years at birth
In 2018, the number of healthy life years at birth was estimated at 64.2 years for women and 63.7 years for men in the EU-27.
The gender gap was considerably smaller in terms of healthy life years than it was for overall life expectancy
Life expectancy for women in the EU-27 was, on average, 5.5 years longer than that for men in 2018. However, most of these additional years tend to be lived with activity limitations.
Indeed, at just 0.5 years difference in favor of women, the gender gap was considerably smaller in terms of healthy life years than it was for overall life expectancy. Men, therefore, tend to spend a greater proportion of their somewhat shorter lives free from activity limitations.
Across the EU Member States, life expectancy at birth for women in 2018 ranged between 78.6 years in Bulgaria to 86.3 years in Spain; a difference of 7.7 years. A similar comparison for men shows that the lowest level of life expectancy in 2018 was recorded in Latvia 70.1 years and the highest in Italy 81.2 years; a range of 11.1 years.
The corresponding range for healthy life years at birth:
- For women (Figure 1) was between 53.7 years in Latvia and 73.4 years in Malta (a range of 19.7 years),
- While that for men (Figure 2) was between 51.0 years in Latvia and 73.7 years in Sweden (a range of 22.7 years).
The expected number of healthy life years at birth was higher for women than for men in 19 of the Member States, with the difference between the sexes generally relatively small, as there were only two Member States where the gap rose to more than 3.0 years in favour of women — Bulgaria and Poland (see the Table 1).
As such, it is clear that there are considerably wider differences between EU Member States in terms of the quality of life (health wise) that their respective populations may expect to live, when compared with the overall differences in life expectancy. In 2018, a woman born in Slovenia could expect to live 64.7 % of her life free from any limitation, a share that rose to 86.1 % in Bulgaria and 86.8 % in Malta. In 2018, a man born in Estonia, Austria and Slovenia could expect to live between 71.2% – 71.8 % of their lives free from any activity limitation, whereas the share rose to as high as 89.5 % in Bulgaria and 91.1 % in Sweden.
Healthy life years at age 65
An analysis comparing healthy life years between the sexes at the age of 65 in 2018 shows that there were 15 EU Member States where women could expect more healthy life years than men; this was most notably the case in Ireland where women aged 65 could expect to live 1.8 years longer free from disability than men.
By contrast, men could expect to live 0.6 years longer free from disability than women in Italy, 0.9 years longer in Portugal, and 1.2 years longer in Cyprus.
Source data for tables and graphs
Eurostat calculates information relating to healthy life years for three ages — at birth, at age 50 and at age 65 — with the indicator being presented separately for women and men. It is calculated using mortality statistics and data on self-perceived long-standing activity limitations. Mortality data come from Eurostat’s demographic database, while self-perceived long-standing activity limitations data come from a European health module that is integrated within the data collection EU statistics on income and living conditions (EU-SILC).
Self-perceived long-standing limitations in usual activities due to health problems
EU-SILC is documented in more detail in this background article which provides information on the scope of the data, its legal basis, the methodology employed for health-related variables, as well as related concepts and definitions.
The general coverage of EU-SILC is all private households and their members (who are residents at the time of data collection); this therefore excludes people living in collective households.
The relevant EU-SILC question concerning the long-standing activity limitation 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?’
Limitations of the data
The indicator presented in this article is derived from self-reported data so it is, to a certain extent, affected by respondents’ subjective perception as well as by their social and cultural background.
EU-SILC does not cover the institutionalised population, for example, people living in health and social care institutions who are more likely to face limitations than the population living in private households. It is therefore likely that, to some degree, this data source under-estimates the share of the population facing activity limitations. Furthermore, the implementation of EU-SILC was organised nationally, which may impact on the results presented, for example, due to differences in the formulation of questions or changing the related questions in a specific year.
A sizeable break in the series is found in Sweden (2014) and Germany (2015); this impacts, to some degree, on the results presented for the EU-27 aggregate too.
The health status of a population is difficult to measure because it is hard to define among individuals, populations, cultures, or even across time periods. As a result, the demographic measure of life expectancy has often been used as a proxy for the state of a nation’s health, partly because it is based on a characteristic that is simple and easy to understand — namely, that of death. Indeed, life expectancy at birth remains one of the most frequently quoted indicators of health status and economic development and it has risen rapidly in the last century due to a range of factors, including: reductions in infant mortality, rising living standards, improved lifestyles, better education, as well as advances in healthcare and medicine.
While most people are aware that successive generations are living longer, less is known about the health of the EU’s ageing population. Indicators on healthy life years introduce the concept of the quality of life, by focusing on those years that may be enjoyed by individuals free from the limitations of illness or disability. Chronic disease, frailty, mental disorders and physical disability tend to become more prevalent in older age, and may result in a lower quality of life for those who suffer from such conditions, while the burden of these conditions may also impact on healthcare and pension provisions.
Healthy life years also monitor health as a productive or economic factor. An increase in healthy life years is one of the main goals of the EU’s health policy, given that this would not only improve the situation of individuals (as good health and a long life are fundamental objectives of human activity) but would also lead to lower public healthcare expenditure and likely increase the possibility that people continue to work later into life. If healthy life years increase more rapidly than life expectancy, then not only are people living longer, but they are also living a greater proportion of their lives free from health problems.
In November 2010, the European Commission adopted a European disability strategy for the period 2010-2020. For people with disabilities, this aims to improve their social inclusion, their well-being and enable them to fully exercise their rights. The strategy is based on the United Nations Convention on the Rights of Persons with Disabilities. More information is available in an article on functional and activity limitations.
The European innovation partnership on active and healthy ageing is a pilot scheme that aims — by 2020 — to increase the average healthy lifespan of EU citizens by two years, through: improving health and quality of life; ensuring health and social care systems are sustainable and efficient; and creating growth and market opportunities for business. This partnership involves cooperation between the European Commission, EU Member States, regions, industry, health and social care professionals and organisations representing older people and patients. It aims to improve older people’s lives, helping them to contribute to society, and reduce pressure on health and care systems — ultimately contributing to sustainable growth.
In February 2012, the European Commission adopted a Communication titled Taking forward the strategic implementation plan of the European innovation partnership on active and healthy ageing (COM(2012) 83 final) which is designed to accelerate the pace of innovation in relation to healthy and active ageing.