Eurostat, the statistical office of the European Union

F4: Income and living conditions; Quality of life

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We know people are living longer. However, do we live longer and better or do we gain only years of life in bad health?

The indicator of healthy life years (HLY) measures the number of remaining years that a person of specific age is expected to live without any severe or moderate health problems. The notion of health problem for Eurostat's HLY is reflecting a disability dimension and is based on a self-perceived question which aims to measure the extent of any limitations, for at least six months, because of a health problem that may have affected respondents as regards activities they usually do (the so-called GALI - Global Activity Limitation Instrument foreseen in the annual EU-SILC survey). The indicator is therefor also called disability-free life expectancy (DFLE). So, HLY is a composite indicator that combines mortality data with health status data.

HLY also monitor health as a productive or economic factor. An increase in healthy life years is one of the main goals for European health policy. And it would not only improve the situation of individuals but also result in lower levels of public health care expenditure. If healthy life years are increasing more rapidly than life expectancy, it means that people are living more years in better health.

Please note that a revision took place in March 2012: the whole series 2004-2010 were recalculated taking into account:

• the use of the age at interview for the GALI prevalences instead of the age of the income period (as it is traditionally done for many income and living indicators); differences with the previous calculations on outcomes and trends are minimal
• the latest versions of the EU-SILC and Mortality data

There are no special classifications for the data set produced here.

Not applicable

Health expectancies are calculated using the Sullivan method which combines information on mortality and health status data.

1. Variables used for mortality component:

• Age specific death rate (Mx)
• Probability of dying between exact ages (qx)
• Probability of surviving between exact ages (px)
• Number left alive at given exact age (lx)
• Person-years lived between exact age (Lx)
• Life expectancy at given exact age (ex)

     For more information, please refer to metadata pages of Mortality (demo_mor) and Life table (demo_mlifetable).

2. Variable used for health status, in casu disability:

Variable PH030 (Limitation in activities people usually do because of health problems for at least the last 6 months) in EU Statistics on Income and Living Conditions (EU-SILC Survey).

The EU-SILC question 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?

Based on this variable the proportions of the population in healthy (answer code: "not limited at all") and unhealthy conditions (answer codes: "severy limited" and "limited but not severely") are calculated by sex and age.

Statistical observations are individuals.

The whole EU population is covered.

European Union, EU Member States, United Kingdom, Iceland, Norway, Switzerland and Croatia

2004 onwards for Belgium, Denmark, Estonia, Ireland, Greece, Spain, France, Italy, Luxembourg, Austria, Portugal, Finland, Sweden, Iceland and Norway;

2005 onwards for the other EU Member States, except Bulgaria and Romania for which the series starts in 2006 respectively 2007.

Data for Switzerland are available from 2008 and for Croatia from 2010.

Not applicable

Three types of indicators are presented in the table:

• Number of years for Healthy Life Years
• Number of years for Life Expectancy
• Healthy life years expressed as a percentage of the Life Expectancy.

Those indicators can be calculated for women and men and at different ages (at birth, at 50, at 65)

Reference year is defined as the calendar year.

• 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.
• second programme of Community action in the field of health (2008-13): 'Together for Health: A Strategic Approach for the EU 2008-2013
• Through the open method of coordination on social protection and social inclusion, the EU provides a framework for national strategy development, as well as for coordinating policies between EU countries on issues relating to poverty and social exclusion, health care and long-term care as well as pensions.
• Communication to the Commission on 14/10/2004, Point II-8:
  "According to the EU Sustainable Development Strategy and the 6th Environmental Action Plan, and as requested by the Council conclusions of December 8, 2003, indicators on biodiversity and health need to be included in the structural indicators database. Indicators of Healthy Life Years (healthy life expectancy at birth: two gender breakdowns) are added to the database. The indicator looks at the number of years that a person can expect to live in a good health, which is closely related to factors such as ageing, productivity/capacity to work and healthcare expenditure."
• Commission COM (2004) 0029 of 21/01/2004 - report from the Commission to the Spring European Council delivering Lisbon reforms for the enlarged Union : set as priority to examine possibilities for integrating Public Health into the Lisbon strategy by 2005, as a contribution to growth & sustainable development.
  The Commission Communication COM (2003) 585 final of 08/10/2003 on structural indicators recommends to develop an indicator to measure Healthy Life Years.
• Decision 2367/2002/EC of the European Parliament and the Council of 16 December 2002 on the Community statistical programme 2003 to 2007.
• Decision No 1786/2002EC of the European Parliament and of the Council of 23 September 2002 adopting a programme of Community action in the field of public health (2003-2008), OJEC L 271/10

Not applicable

Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society.

Not applicable

March/N+2; (N = year of data collection)

Information upon request.

In line with the Community legal framework and the European Statistics Code of Practice Eurostat disseminates European statistics on Eurostat's website (see item 10 - 'Accessibility and clarity') respecting professional independence and in an objective, professional and transparent manner in which all users are treated equitably. The detailed arrangements are governed by the Eurostat protocol on impartial access to Eurostat data for users.

Yearly.

No regular news releases

• Statistics Explained
• Eurostat  yearbook 2012
• The social situation in the European Union (2005-2006), (2007), (2008), (2009)

Please consult free data on-line or refer to contact details.

Micro-data are not disseminated.

See annexes: methodological description on DFLE (disability free life expectancy) and footnotes.

• For the disability component: National quality reports of EU-SILC .
• For mortality: ESMS page.

Please consult the quality assurance in European Statistics Code of Practice.

The HLY indicators are closely followed by the main policy users, DG SANCO and DG EMPL. Within the European Statistical System, the working group Public Health regularly follows up and discusses remaining problems. Relevance and accuracy are considered very high. The major issue on quality which asked for correction concerns comparability over time and between countries. The reason is basically the national implementation of the GALI question. The latest assessment exercise hereto was held mid 2012. Eurostat analysed in collaboration with the national EU-SILC delegates the wording of the national questions for the GALI. Based on this analysis the comparability degree and stability of the series for all countries were documented. The results of this analysis are available in annex. Data values in the tables have been flagged accordingly to indicate breaks in series (methodological change) or to forward the user to check available information on partial non-comparability.

• Institutional users like other Commission services, particularly DG SANCO (Health and Consumers) for whom the HLY is an important European Community Health Indicator (ECHI) and DG EMPL (Employment and social affairs) for whom the HLY is an indicator in the social inclusion and protection strategy (OMC - Open Method of Coordination).
• The HLY is also used in the EU 2020 flagship initiative on active and healthy ageing.
• Commision services and national authorities in the Member States to feed sectorial or transversal publications such as the Sustainable Development Strategy monitoring reports, the Eurostat yearbook and various publications.

No explicit user satisfaction measurement is done.

HLY data are considered to be very complete. See also 3.4 and 3.7.

The overall accuracy of HLY is considered to be high. However institutional households are not included in the EU-SILC. It is assumed that the population living in the private households covered by EU-SILC is representative for the total population.

For the disability component please see the metadata pages of Income and Living conditions (ilc).

For the disability component please see the metadata pages of Income and Living conditions (ilc).

For almost all countries the timeliness of the HLY indicators is around 15 months. Timeliness is different for disability and mortality data. Please consult timeliness in metadata pages of Income and Living conditions (ilc) and Mortality (demo_mor).

Punctuality is different for disability and mortality data but is considered to be very good for almost all countries.

Please consult timeliness in metadata pages of Income and Living conditions (ilc) and Mortality (demo_mor).

The HLY indicator is calculated using the same method (Sullivan's) for all countries.

Comparability is mainly determined by the comparability of the data sources.

EU-SILC is based on a common framework defined by harmonized lists of target primary and secondary variables, common concepts, a recommended design, common requirements (for imputation, weighting, sampling errors calculation) and classifications aiming at maximising comparability of the information produced. See the ESMS pages of SILC. The disability prevalence data used in the calculation of the Healthy life years (HLY) indicator are provided by the GALI (Global Activity Limitation Instrument) question from EU-SILC. The way this question was implemented by the EU Member States in EU-SILC might hamper cross-country comparisons. Not all countries followed the standard recommendation in the wording of the question as decided in the Minimum European Health Module and the European Health Interview Survey (EHIS).

Eurostat had assessed the wording of the national questions for the GALI and comparability flaws mid 2012 in collaboration with the national EU-SILC delegates. The results of this analysis are available in annex. Data values in the tables have been flagged accordingly to indicate breaks in series (methodological change) or to forward the user to check available information on partial non-comparability.

Examples of problems in the national questions found in the previous years are:

• the 6 months period is considered as a reference period and not as the minimum duration of the limitation
• the reference is to the respondent's own daily activities and not to the ones that people usually do
• the use of 2 answer categories instead of 3
• only persons who declare having a longstanding illness or health problem answer to this question instead of all persons irrespective of having or not a longstanding illness or health problem

The comparability for the mortality data, conducted as a joint demographic data collection in cooperation with United Nation Statistical Division (UNSD), is considered very high. See the ESMS pages of mortality.

The way the GALI (Global Activity Limitation Instrument) question was implemented by the EU Member States in EU-SILC hampers comparison in time for some countries. A detailed overview is in annex. See also the assessment exercise referred above.

Processing 2011 census data introduce a break in population series for following countries: SK, CZ, LV, LT, BG, PT, PL, CH and IE. For Cyprus this break occurred in 2010.

See also the ESMS pages of SILC and mortality.

HLY is only available in this collection and calculated from EU-SILC and Mortality data.

The statistical outputs are consistent.

HLY is derived from other data sources and in this sense costs and burden for countries in the calculation, description and evaluation are very limited.

A revision took place in March 2012: the whole series 2004-2010 were updated taking into account:

• the use of the age at interview for the SILC-GALI prevalences instead of the age of the income period (as it is traditionally done for many income and living indicators); differences with the previous calculations on outcomes and trends are minimal
• the latest versions of the EU-SILC and Mortality data

Revisions occur when previous missing values are available and replace the estimated/provisional ones or when the data sources are revised.

For the mortality part: demography statistics.

For the disability part: EU-SILC

See the relevant ESMS pages

Annual

See the metadata pages of mortality statistics and EU-SILC

Please see data validation procedures in the metadata pages of mortality and EU-SILC statistics.

See the annex on the Sullivan Method for the calculation

To find statistical procedures used for adjusting the data, please refer to the ESMS pages of mortality and EU-SILC statistics.

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