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Healthy lifespan inequality: morbidity compression from a global perspective

Current measures of population health lack indicators capturing the variability in age-at-morbidity onset, an important marker to assess the timing patterns of individuals’ health deterioration and evaluate the compression of morbidity. We provide global, regional, and national estimates of the vari...

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Autores principales: Permanyer, Iñaki, Villavicencio, Francisco, Trias-Llimós, Sergi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080172/
https://www.ncbi.nlm.nih.gov/pubmed/37027116
http://dx.doi.org/10.1007/s10654-023-00989-3
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author Permanyer, Iñaki
Villavicencio, Francisco
Trias-Llimós, Sergi
author_facet Permanyer, Iñaki
Villavicencio, Francisco
Trias-Llimós, Sergi
author_sort Permanyer, Iñaki
collection PubMed
description Current measures of population health lack indicators capturing the variability in age-at-morbidity onset, an important marker to assess the timing patterns of individuals’ health deterioration and evaluate the compression of morbidity. We provide global, regional, and national estimates of the variability in morbidity onset from 1990 to 2019 using indicators of healthy lifespan inequality (HLI). Using data from the Global Burden of Disease Study 2019, we reconstruct age-at-death distributions to calculate lifespan inequality (LI), and age-at-morbidity onset distributions to calculate HLI. We measure LI and HLI with the standard deviation. Between 1990 and 2019, global HLI decreased from 24.74 years to 21.92, and has been decreasing in all regions except in high-income countries, where it has remained stable. Countries with high HLI are more present in sub-Saharan Africa and south Asia, whereas low HLI values are predominant in high-income countries and central and eastern Europe. HLI tends to be higher for females than for males, and HLI tends to be higher than LI. Globally, between 1990 and 2019 HLI at age 65 increased from 6.83 years to 7.44 for females, and from 6.23 to 6.96 for males. Improvements in longevity are not necessarily accompanied by further reductions in HLI among longevity vanguard countries. Morbidity is compressing, except in high-income countries, where it stagnates. The variability in the ages at morbidity onset tends to be larger than the variability in lifespans, and such divergence broadens over time. As longevity increases worldwide, the locus of health inequality is moving from death-related inequalities to disease- and disability-centered ones. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10654-023-00989-3.
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spelling pubmed-100801722023-04-07 Healthy lifespan inequality: morbidity compression from a global perspective Permanyer, Iñaki Villavicencio, Francisco Trias-Llimós, Sergi Eur J Epidemiol Mortality Current measures of population health lack indicators capturing the variability in age-at-morbidity onset, an important marker to assess the timing patterns of individuals’ health deterioration and evaluate the compression of morbidity. We provide global, regional, and national estimates of the variability in morbidity onset from 1990 to 2019 using indicators of healthy lifespan inequality (HLI). Using data from the Global Burden of Disease Study 2019, we reconstruct age-at-death distributions to calculate lifespan inequality (LI), and age-at-morbidity onset distributions to calculate HLI. We measure LI and HLI with the standard deviation. Between 1990 and 2019, global HLI decreased from 24.74 years to 21.92, and has been decreasing in all regions except in high-income countries, where it has remained stable. Countries with high HLI are more present in sub-Saharan Africa and south Asia, whereas low HLI values are predominant in high-income countries and central and eastern Europe. HLI tends to be higher for females than for males, and HLI tends to be higher than LI. Globally, between 1990 and 2019 HLI at age 65 increased from 6.83 years to 7.44 for females, and from 6.23 to 6.96 for males. Improvements in longevity are not necessarily accompanied by further reductions in HLI among longevity vanguard countries. Morbidity is compressing, except in high-income countries, where it stagnates. The variability in the ages at morbidity onset tends to be larger than the variability in lifespans, and such divergence broadens over time. As longevity increases worldwide, the locus of health inequality is moving from death-related inequalities to disease- and disability-centered ones. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10654-023-00989-3. Springer Netherlands 2023-04-07 2023 /pmc/articles/PMC10080172/ /pubmed/37027116 http://dx.doi.org/10.1007/s10654-023-00989-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Mortality
Permanyer, Iñaki
Villavicencio, Francisco
Trias-Llimós, Sergi
Healthy lifespan inequality: morbidity compression from a global perspective
title Healthy lifespan inequality: morbidity compression from a global perspective
title_full Healthy lifespan inequality: morbidity compression from a global perspective
title_fullStr Healthy lifespan inequality: morbidity compression from a global perspective
title_full_unstemmed Healthy lifespan inequality: morbidity compression from a global perspective
title_short Healthy lifespan inequality: morbidity compression from a global perspective
title_sort healthy lifespan inequality: morbidity compression from a global perspective
topic Mortality
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080172/
https://www.ncbi.nlm.nih.gov/pubmed/37027116
http://dx.doi.org/10.1007/s10654-023-00989-3
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