Considerations for data production > Healthy Canadians > 37-HLT: Health adjusted life expectancy (HALE)37b-HLT: Health adjusted life expectancy (HALE) by incomeDefinition DefinitionHealth Adjusted Life Expectancy (HALE) is an indicator of overall population health. It combines measures of both age- and sex-specific health status, and age- and sex-specific mortality into a single statistic. HALE represents the number of expected years of life equivalent to years lived in full health, based on the average experience in a population. In this sense, HALE is not only a measure of quantity of life but also a measure of quality of life. Rationale and notes for interpretationCanadians have been experiencing continuing increases in life expectancy for many decades. However, with the increasing prevalence of chronic disease, there has been an international debate as to whether or not these added years of life expectancy are years spent in good or poor health. By examining trends in HALE in conjunctions with trends in life expectancy (LE), it is possible to assess whether Canadians' increasing life expectancy is associated with a "compression or an expansion of morbidity". In other words, if HALE increases more over time than LE, we can then conclude that added years of life expectancy are indeed more often years in better health. This example is one illustration of the use and interpretation of HALE. As with life expectancy, HALE is a standardized statistical indicator. It is not the number of full health equivalent years a particular newborn (or person currently age 65) can actually expect to live. The reason is that mortality rates and levels of health status only for the observation period (e.g. 2001) are used, and these are averages for the entire population. Historically, mortality rates in Canada have been falling, so that the mortality rates individuals are likely to face in future years as they age may be lower. Canada does not yet have consistent data over a sufficiently long period to know what the trends in health status have been, or are likely to be in the future. Moreover, individuals' circumstances vary so that, for example, if they had become chronically ill at an early age, their particular health-adjusted life expectancy would be less. This indicator should be presented by sex since HALE of women and men differs so much. Coefficients of variation, confidence intervals (both of which are provided by Statistics Canada), and tests of significance must be analyzed before differences between provinces can be interpreted as real (statistically significant). HALE will be calculated by income tercile. Technical specifications
Data availability
Considerations for indicator quality and comparabilityHALE will be calculated at birth and age 65. However, HALE at birth will be based on data for those aged 15 and over. Because of the small sample size for the institutional component of the NPHS the average HUI for institutional residents will be calculated for people under 65 and people aged 65 and over. As well, the NPHS provides only regional data so the average HUI for institutional residents will be calculated for the Atlantic Provinces, Quebec, Ontario, the Prairie Provinces, and British Columbia. The average HUI will be the same for all income terciles of institutional residents. The ecological approach based on enumeration area (EA link) is not appropriate to use for institutional residents since institutional residents move to an institution not because of the neighbourhood but because of their need for health care. Thus neighbourhood income is not necessarily a reflection of the income of institutional residents. The EA link and coding of deaths to EAs is based on the average incomes in each EA in 1996. The tercile each EA was assigned to in 1996 is then applied to the 2000/2001 CCHS. As well, the same percentage of deaths in each income tercile in 1996 is applied to the 2000/2001 life tables (i.e. if 40% of deaths occurred in the lowest income tercile in 1996 then 40% of deaths occurred in the lowest income tercile in 2000/2001).Responsibility to produce the dataStatistics Canada |
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