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Gender Differences in Healthy and Unhealthy Life Expectancy

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International Handbook of Health Expectancies

Part of the book series: International Handbooks of Population ((IHOP,volume 9))


There is consistent evidence that women live longer than men at all ages, but spend a higher proportion of their total life expectancy in poorer health, a phenomenon described as the “male-female health-survival paradox” or the “gender paradox in health and mortality”. However, it is difficult to explain the process because morbidity by sex differs considerably across domains of health, age groups, social contexts and severity level. In addition, women and men report differently their health in surveys, making it cumbersome to understand whether what drives the paradox is a higher female morbidity or male mortality, a different reporting behaviour, or all of those aspects together. The aim of this chapter is to demonstrate the magnitude of those differences in Europe using different health domain indicators (activity limitation, chronic morbidity and self-perceived health) from the EHEMU Information System and the reporting behaviour by sex from the SHARE survey vignettes.

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  1. 1.

    For a full description of the survey please refer to

  2. 2.

    Nonetheless, one must account for the fact that issues with harmonization still persist and that the survey excludes the institutionalized population.

  3. 3.

    Member states of EU15 are Belgium, Denmark, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain and United Kingdom, Austria, Finland and Sweden. By July 2013 the number of states increased to 28, with the inclusion of several eastern European countries (Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Slovakia, Slovenia, Bulgaria, Romania, and Croatia) to form the EU28.

  4. 4.

    See Börsch-Supan and Jürges (2005) for methodological documentation about the survey.

  5. 5.

    See full list of SHARE vignettes in

  6. 6.

    The subsample of the SHARE respondents was further subdivided into two groups which received different questionnaire versions A and B. The questions of these survey variants differ only in the gender of the vignette characters, whereas the described health conditions are identical. For instance, the vignette story “Paul has a headache once a month that is relieved after taking a pill. During the headache he can carry on with his day-to-day affairs” from survey version A appears in version B for the vignette character Karen. We refrained from analyzing the vignettes assessments by gender of the vignette characters and separated the answers of female and male survey respondents only by domain and severity of the health condition.

  7. 7.

    The distribution of the vignettes in less severe, intermediate and more severe health conditions presents some exceptions. For the health domain “sleeping difficulties” and for the limitations in the amount and kind of work “because of pain” two vignettes present conditions that are classified in-between intermediate and more severe.


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This work was supported by the European Research Council, within the European Community’s Seventh Framework Programme (FP7/2007–2013), ERC Grant Agreement No. 262663 (HEMOX) and within the EU Framework Programme for Research and Innovation Horizon 2020, ERC Grant Agreement No. 725187 (LETHE).

The SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812) and FP7 (SHARE-PREP: N°211909, SHARE-LEAP: N°227822, SHARE M4: N°261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see

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Correspondence to Vanessa Di Lego .

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Di Lego, V., Di Giulio, P., Luy, M. (2020). Gender Differences in Healthy and Unhealthy Life Expectancy. In: Jagger, C., Crimmins, E.M., Saito, Y., De Carvalho Yokota, R.T., Van Oyen, H., Robine, JM. (eds) International Handbook of Health Expectancies. International Handbooks of Population, vol 9. Springer, Cham.

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