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by Cameron N. McIntosh, Philippe Finès, Russell Wilkins and Michael C. Wolfson
Health-adjusted life expectancy is a summary measure of population health that combines mortality and morbidity data into a single index. This article profiles differences in health-adjusted life expectancy across income categories for a representative sample of the Canadian population.
Mortality data were obtained from the 1991-2001 Canadian census mortality follow-up study, which linked a 15% sample of the 1991 adult non-institutional population with 11 years of death records from the Canadian Mortality Data Base. Information on morbidity was obtained from the Health Utilities Index Mark 3 instrument on the 2000/2001 Canadian Community Health Survey. The Sullivan method was used to compute health-adjusted life expectancy for national deciles of population ranked by income.
For both sexes, and with few exceptions, a nearly linear gradient across income deciles emerged for health-adjusted life expectancy at age 25. Compared with people in higher-income deciles, those in lower-income deciles had fewer years of health-adjusted life expectancy. These disparities were substantially larger than those revealed by life expectancy alone.
These findings highlight the generally worse health-related quality of life of lower-income groups. The results demonstrate that assessments of socio-economic disparities in health should include the effects of both mortality and morbidity.
health inequalities, Health Utilities Index, life expectancy, socio-economic, Sullivan method
The dramatic increase in life expectancy in Canada and other economically developed nations during the last century stands as testimony to the success of improvements in public health and advances in medical care. But despite these gains in longevity, inequalities in health outcomes across different subpopulations are still pervasive in Canada and other industrialized countries. [Full text]
Cameron N. McIntosh (1-613-949-4135; Cameron.McIntosh@ps.sp.gc.ca) is with Public Safety Canada. Philippe Finès (1-613-951-3896; Philippe.Fines@statcan.gc.ca) and Russell Wilkins (1-613-951-5305; Russell.Wilkins@statcan.gc.ca) are with the Health Analysis Division at Statistics Canada. Michael C. Wolfson (1-613-951-8216; Michael.Wolfson@statcan.gc.ca) is with Statistics Canada, Ottawa, Ontario, K1A 0T6.