At a Glance
Health Expectancies and Disability Dynamics
The length of life has been increasing almost linearly in many countries, and a key policy question is whether these extra years of life are being spent in good or in poor health. Estimates of healthy and unhealthy life expectancy are important supplements to estimates of total life expectancy, and they provide insights into the aggregate burdens of disease, disability, and impaired cognitive functioning in demographically aging populations. We seek to document the levels and to forecast the trends in healthy and unhealthy life expectancy, to analyze whether the improvements in health and survival are equally distributed across sociodemographic groups, and to understand what factors are driving the trends and differentials in healthy and unhealthy life expectancies within and across populations. We also develop methodological approaches that enable us to analyze disability dynamics rather than just the aggregate time spent in healthy and unhealthy states.
To understand the factors driving the patterns in health and disability, we analyze the independent and interacting impacts of behavioral determinants, structural conditions, and sociodemographic factors. Low- and middle-income countries are witnessing major shifts in the distribution of risky health behaviors, as cigarette smoking, previously the dominant damaging health behavior, is replaced by obesity and other risky behaviors. We focus on understanding the implications of this population-level replacement of health behaviors on health expectancies and disability dynamics. We also examine the extent to which differences in health behaviors can explain socioeconomic variation in morbidity and mortality. We use multidimensional measures to study health, including information on physical and cognitive functioning, diagnosed conditions, medication use, as well as other factors.
Our research covers a broad range of low-, middle-, and high-income countries, and a wide range of institutional contexts, birth cohorts, and time periods. This allows us to learn how changes in population health interact not just with individual characteristics but also with the policy environment and the broader socioepidemiological environment. We employ regression techniques and decomposition methods to analyze differentials in disability dynamics across contexts, defined by factors that influence health throughout the life course, such as living conditions, economic development, and access to health care.
The work being conducted in this research area has great policy relevance as we document the current disability burden, examine which individual and contextual factors influence health and disability, and project future disability burdens. Through this work, we aim to develop a better understanding of which factors influence the extent to which individuals have a health or unhealthy life course, of how to increase the years spent in a healthy rather than in an unhealthy state, and of how to reduce health inequalities in populations as well as the costs for social welfare regimes.
Ageing, Mortality and Longevity, Culture, Health Care, Public Health, Medicine, and Epidemiology
Projects of this Research Area