Abstract
Objectives
The second phase of Healthy Japan 21 seeks to increase disability-free life expectancy (DFLE) more than life expectancy (LE) between 2013 and 2022. In the face of the rising incidence of disability, the feasibility of achieving this goal remains unclear.
Methods
We examine changes in DFLE at birth between 2000 and 2010 across 47 prefectures, with particular attention given to changes in the absolute number of years and in the proportion of disability-free life years.
Results
Although LE increased across all prefectures, there is a variation in DFLE. While the number of disability-free life years increased in many parts of the country, some prefectures had decreases in DFLE. Downturns become particularly evident when DFLE is interpreted in relative terms. The proportion of life spent without disability declined in the majority of prefectures.
Conclusions
Results from subnational level analyses suggest that the rate of increase in DFLE lagged behind that in LE across Japanese prefectures during the past decade. More policy attention should be devoted to health-promotion initiatives at the prefecture level to achieve the nationwide health agenda.
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References
Cabinet Office, Government of Japan (2014) Annual Report on the Aging Society: 2014 (Summary). http://www8.cao.go.jp/kourei/whitepaper/w-2014/zenbun/. Accessed 3 Feb 2016
Freedman VA, Martin LG (2000) Contribution of chronic conditions to aggregate changes in old-age functioning. Am J Public Health 90:1755–1760
Freedman VA, Schoeni RF, Martin LG, Cornman JC (2007) Chronic conditions and the decline in late-life disability. Demography 44(3):459–477
Gruenberg EM (1977) The failure of success. Milbank Meml Fund Q 55(1):3–24
Hashimoto S (2008) Research on standardization of health expectancy measures in region (2007–2008) (in Japanese). http://toukei.umin.jp/kenkoujyumyou/. Accessed 3 Feb 2016
Hashimoto S et al (2010) Trends in disability-free life expectancy in Japan, 1995–2004. J Epidemiol 20(4):308–312
Health and Welfare Department, Aomori Prefecture (2013) Healthy Aomori 21 (second phase). http://www.pref.aomori.lg.jp/welfare/health/21keikaku.html. Accessed 3 Feb 2016
Jagger C, Cox B, Le Roy S, and the EHEMU (2007) Health expectancy calculation by the Sullivan Method. EHEMU Technical Report 2006-3
Jagger C, Matthews R, Matthews F, Robinson T, Robine JM, Brayne C, Medical Council Cognitive Function and Ageing Study Investigators (2007) The burden of diseases on disability-free life expectancy in later life. J Gerontol A Biol Sci Med Sci 62:408–414
Jagger C, McKee M, Christensen K, Lagiweka Km Nusselder W, Van Oyen H, Cambois E, Jeune B, Robine JM (2013) Mind the gap—reaching the European target of a 2-year increase in healthy life years in the next decade. Eur J Public Health 23:829–833
Lagiewka K (2012) European innovation partnership on active and healthy ageing: triggers of setting the headline target of 2 additional healthy life years at birth at EU average by 2020. Arch Public Health 70(1):23
Ministry of Health, Labour, and Welfare (2014a) Patient Survey (in Japanese). http://www.mhlw.go.jp/toukei/saikin/hw/kanja/14/. Accessed 3 Feb 2016
Ministry of Health, Labour, and Welfare (2014b) Annual Health, Labour and Welfare Report 2014 (Summary). http://www.mhlw.go.jp/wp/hakusyo/kousei/14/. Accessed 3 Feb 2016
Ministry of Health, Labour, and Welfare (2015) Evaluations of the Second Phase of Healthy Japan 21 http://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/kenkou/kenkounippon21.html. Accessed 3 Feb 2016
Mitchell OS, Piggott J, Shimizutani S (2006) Aged-care support in Japan: perspectives and challenges. Benefits Q 22(1):7–18
National Institute of Population and Social Security Research (2012) Future projection on population and households. http://www.ipss.go.jp/syoushika/tohkei/Mainmenu.asp. Accessed 3 Feb 2016
Olshansky SJ, Rudberg MA, Carnes BA, Cassel CK, Brody JA (1991) Trading off longer life for worsening health: the expansion of morbidity hypothesis. J Aging Health 3(2):194–216
Robine JM, Michel JP (2004) Looking forward to a general theory on population aging. J Gerontol A Biol Sci Med Sci 59(6):M590–M597
Robine JM, Jagger C, Mathers CD, Crimmins EM, Suzman RM (eds) (2003) Determining health expectancies. Wiley, Chicester
Robine JM et al (2012) Exploring the impact of climate on human longevity. Expl Gerontol 47(9):660–671
Shokuiku Promotion Office, Cabinet Office, Government of Japan (2010) The japanese spirit-food and nutrition education in Japan. http://www8.cao.go.jp/syokuiku/data/eng_pamph/. Accessed 3 February 2016
Sullivan DF (1971) A single index of mortality and morbidity. HSMHA Health Rep 86:347–354
Tamiya N, Noguchi H, Nishi A, Reich MR, Ikegami N, Hashimoto H, Shibuya K, Kawachi I, Campbel JC (2011) Population ageing and wellbeing: lessons from Japan’s long-term care insurance policy. Lancet 378(9797):1183–1192
Tsutsui T, Muramatsu N (2005) Care-needs certification in the long-term care insurance system of Japan. J Am Geriatr Soc 53:522–527
Wohland P, Rees P, Gillies C, Alvanides S, Matthews FE, O’Neill V, Jagger C (2014) Drivers of inequality in disability-free expectancy at birth and age 85 across space and time in Great Britain. J Epidemiol Commun H 68(9):826–833
Yong V, Saito Y (2009) Trends in healthy life expectancy in Japan: 1986–2004. Demog Res 20:467–494
Yong V, Saito Y (2012) National long-term care insurance policy in Japan a decade after implementation: some lessons for aging countries. Ageing Int 37:271–284
Acknowledgments
Support for this research was provided by the Japan Society for the Promotion of Science (Grant-in-Aid for Scientific Research 20638621). We acknowledge the Ministry of Health, Labour, and Welfare for providing us access to the data of Kokumin Seikatsu Kiso Chosa (the Comprehensive Survey of Living Conditions of the People on Health and Welfare).
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Sugawara, Y.M., Saito, Y. Changes in disability-free life expectancy (DFLE) at birth between 2000 and 2010 across Japanese prefectures. Int J Public Health 61, 739–749 (2016). https://doi.org/10.1007/s00038-016-0847-3
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DOI: https://doi.org/10.1007/s00038-016-0847-3