Abstract
Aim
This article examines trends in active life expectancy and their dependency on indicators of health using data from the German Socio-Economic Panel (GSOEP).
Subjects and methods
A multistate life-table modelling approach is used to estimate active life years. First, mortality risks and the rates of entering and leaving the health statuses are estimated by applying multivariate hazard models. In a second step, increment-decrement life tables are constructed by applying age-specific transition rates for three different cohorts. Two measures of limitations in the activities of daily life (ADL) and two measures of health satisfaction are used. The study uses a cohort approach instead of the more commonly used method of cross-sectional investigation.
Results
Results show that trends in active life expectancy depend markedly on the indicator chosen. Substantial improvements can be observed for younger cohorts with regard to severe health states. These improvements are a result of the decline in the transition from the independent to the dependent state, whereas no advances in recovery from the dependent state could be found. In contrast, if moderate health limitations in ADLs are investigated, the improvements are less substantial, and moderate health dissatisfaction is not accompanied by any change for younger cohorts.
Conclusions
These findings suggest that, rather than examining trends in the prevalence of each health status, further research should focus on the changing path in and out of differing health status.
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Notes
Sample A also consists of 70 “miscellaneous” foreign households that are not part of the five nationalities of sample B (Hanefeld 1987, p.185).
Another indicator in the GSOEP is: “How would you describe your current health?”. The categories are “very good”, “good”, “satisfactory”, “poor” and “bad”. This item was first surveyed in 1992, and has been included in every survey since 1994. Therefore it cannot be used to distinguish between cohorts.
The multistate life tables are estimated by first transforming the transition rates into a matrix of transition probabilities from which all other life-table functions are derived.
The numbers of deaths among younger age groups in the GSOEP are too small for meaningful analysis.
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Unger, R. Trends in active life expectancy in Germany between 1984 and 2003—a cohort analysis with different health indicators. J Public Health 14, 155–163 (2006). https://doi.org/10.1007/s10389-006-0037-5
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DOI: https://doi.org/10.1007/s10389-006-0037-5