March 2011

We know people are living longer. However, do we live longer and better or do we gain only years of life in bad health?

The indicator of healthy life years (HLY) measures the number of remaining years that a person of specific age is expected to live without any severe or moderate health problems. The notion of health problem for Eurostat's HLY is reflecting a disability dimension and based on a self-perceived question which aims to measure the extent of any limitations because of a health problem that may have affected respondents as regards activities they usually do, for at least six months (the so-called GALI - Global Activity Limitation Instrument foreseen in the annual EU-SILC survey). The indicator is therefor also called disability-free life expectancy (DFLE).

So, HLY is a composite indicator that combines mortality data with health status data.

Healthy life years also monitor health as a productive or economic factor. An increase in healthy life years is one of the main goals for European health policy. And it would not only improve the situation of individuals but also result in lower levels of public health care expenditure. If healthy life years are increasing more rapidly than life expectancy, it means that people are living more years in better health.

Please note that an important revision took place in March 2012: the whole series 2004-2010 were recalculated taking into account:

• the use of the age at interview for the GALI prevalences instead of the age of the income period (as it is traditionally done for many income and living indicators); differences with the previous calculations on outcomes and trends are minimal
• the latest versions of the EU-SILC and Mortality data

There are no special classifications for the data set produced here.

Not applicable

Health expectancies are calculated using the Sullivan method which combines information on mortality and health status data.

1. Variables used for mortality component:

• Age specific death rate (Mx)
• Probability of dying between exact ages (qx)
• Probability of surviving between exact ages (px)
• Number left alive at given exact age (lx)
• Person-years lived between exact age (Lx)
• Life expectancy at given exact age (ex)

     For more information, please refer to metadata pages of Mortality (demo_mor) and Life table (demo_mlifetable).

2. Variable used for health status, in casu disability:

Variable PH030 (Limitation in activities people usually do because of health problems for at least the last 6 months) in EU Statistics on Income and Living Conditions (EU-SILC Survey). based on this variable the proportions of the population in healthy and unhealthy conditions are calculated by sex and age.

Statistical observations are individuals.

The whole EU population is covered.

European Union, EU Member States, Iceland, Norway, Switzerland and Croatia

2004 onwards for Belgium, Denmark, Estonia, Ireland, Greece, Spain, France, Italy, Luxembourg, Austria, Portugal, Finland, Sweden, Iceland and Norway;

2005 onwards for the other EU Member States, except Bulgaria and Romania for which the series starts in 2006 respectively 2007.

Data for Switzerland are available from 2008 and for Croatia from 2010.

Not applicable

Three types of indicators are presented in the table:

• Number of years for Healthy Life Years
• Number of years for Life Expectancy
• Healthy life years expressed as a percentage of the Life Expectancy.

Those indicators can be calculated for women and men and at different ages (at birth, at 50, at 65)

Reference year is defined as the calendar year.

• Communication to the Commission on 14/10/2004, Point II-8:
  "According to the EU Sustainable Development Strategy and the 6th Environmental Action Plan, and as requested by the Council conclusions of December 8, 2003, indicators on biodiversity and health need to be included in the structural indicators database. Indicators of Healthy Life Years (healthy life expectancy at birth: two gender breakdowns) are added to the database. The indicator looks at the number of years that a person can expect to live in a good health, which is closely related to factors such as ageing, productivity/capacity to work and healthcare expenditure."
• Commission COM (2004) 0029 of 21/01/2004 - report from the Commission to the Spring European Council delivering Lisbon reforms for the enlarged Union : set as priority to examine possibilities for integrating Public Health into the Lisbon strategy by 2005, as a contribution to growth & sustainable development.
  The Commission Communication COM (2003) 585 final of 08/10/2003 on structural indicators recommends to develop an indicator to measure Healthy Life Years.
• Decision 2367/2002/EC of the European Parliament and the Council of 16 December 2002 on the Community statistical programme 2003 to 2007.
• Decision No 1786/2002EC of the European Parliament and of the Council of 23 September 2002 adopting a programme of Community action in the field of public health (2003-2008), OJEC L 271/10

Not applicable

Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society.

Not applicable

March/N+2; (N = year of data collection)

Information upon request.

In line with the Community legal framework and the European Statistics Code of Practice Eurostat disseminates European statistics on Eurostat's website (see item 10 - 'Dissemination format') respecting professional independence and in an objective, professional and transparent manner in which all users are treated equitably. The detailed arrangements are governed by the Eurostat protocol on impartial access to Eurostat data for users.

Yearly.

No regular news releases

• Statistics Explained
• Eurostat  yearbook 2011
• The social situation in the European Union (2005-2006), (2007), (2008), (2009)

Please consult free data on-line or refer to contact details.

Micro-data are not disseminated.

See annexes: methodological description on DFLE (disability free life expectancy) and footnotes.

• For the disability component: National quality reports of EU-SILC .
• For mortality: ESMS page.

Please consult the quality assurance in European Statistics Code of Practice.

• Any fluctuations in mortality data and disability data have an impact on the Healthy life years.
• Indicators are regularly verified with the EHLEIS team (European Health and Life Expectancy Information System).

• Institutional users like other Commission services, particularly DG SANCO (Health and Consumers) for whom the HLY is an important European Community Health Indicator (ECHI) and DG EMPL (Employment and social affairs) for whom the HLY is an indicator in the social inclusion and protection strategy (OMC - Open Method of Coordination).
• The HLY is also used in the EU 2020 flagship initiative on active and healthy ageing.
• Statistical users in Eurostat or in Member States National Statistical Institutes to feed sectorial or transversal publications such as the Annual Progress Report on the Lisbon Strategy (structural indicators), the Sustainable Development Strategy monitoring report, the Eurostat yearbook and various pocketbooks, among other reports;
• End users - including the media - interested in public health in the EU.

No explicit user satisfaction measurement is done.

HLY data are considered to be very complete. See also 3.4 and 3.7.

The overall accuracy of HLY is considered to be high.

However institutional households are not included in the EU-SILC. It is assumed that the population living in the private households covered by EU-SILC is representative for the total population.

In some cases, because of a lack of information, the life expectancy of the previous year is used to complete the data of the last year with provisional estimates. These cases concern Italy, United Kingdom and consequently the EU aggregates.

For the disability component please see the metadata pages of Income and Living conditions (ilc).

Not applicable for the calculation of HLY indicator.

For almost all countries the timeliness of the HLY indicators is around 15 months. Timeliness is different for disability and mortality data. Please consult timeliness in metadata pages of Income and Living conditions (ilc) and Mortality (demo_mor).

Punctuality is different for disability and mortality data but is considered to be very good for almost all countries.

Please consult timeliness in metadata pages of Income and Living conditions (ilc) and Mortality (demo_mor).

The HLY indicator is calculated using the same method (Sullivan's) for all countries.

Comparability is determined also by the comparability of the data sources.

EU-SILC is based on a common framework defined by harmonized lists of target primary and secondary variables, common concepts, a recommended design, common requirements (for imputation, weighting, sampling errors calculation) and classifications aiming at maximising comparability of the information produced. See the ESMS pages of SILC. The disability prevalence data used in the calculation of the Healthy life years (HLY) indicator are provided by the GALI (Global Activity Limitation Instrument) question from EU-SILC. The way this question was implemented by the EU Member States in EU-SILC might hamper cross-country comparisons. Not all countries followed the standard recommendation in the wording of the question as decided in the Minimum European Health Module and the European Health Interview Survey (EHIS).

Examples of problems in the national questions found in the previous years are:

• the 6 months period is considered as a reference period and not as the minimum duration of the limitation
• the reference is to the respondent's own daily activities and not to the ones that people usually do
• the use of 2 answer categories instead of 3
• only persons who declare having a longstanding illness or health problem answer to this question instead of all persons irrespective of having or not a longstanding illness or health problem

A detailed overview is in annex.

Comparability for the mortality data, conducted as a joint demographic data collection in cooperation with United Nation Statistical Division (UNSD), is considered very high. See the ESMS pages of mortality.

The way the GALI (Global Activity Limitation Instrument) question was implemented by the EU Member States in EU-SILC hampers comparison in time for some countries. A detailed overview is in annex.

See also the ESMS pages of SILC and mortality.

HLY is only available in this collection and calculated from EU-SILC and Mortality data.

The statistical outputs are consistent.

HLy is derived from other data sources and in this sense costs and burden for countries in the calculation, description and evaluation are very limited.

Revisions occur when previous missing values are available and replace the estimated/provisional ones or when the data sources are revised.

An important revision took place in March 2012: the whole series 2004-2010 were updated taking into account:

• the use of the age at interview for the SILC-GALI prevalences instead of the age of the income period (as it is traditionally done for many income and living indicators); differences with the previous calculations on outcomes and trends are minimal
• the latest versions of the EU-SILC and Mortality data

The normal update is done in March/N+1; (N = year of data dissemination); For some mortality data and SILC revisions an update a few months later might occur.

For the mortality part: demography statistics.

For the disability part: EU-SILC

See the relevant ESMS pages

Annual

See the metadata pages of mortality statistics and EU-SILC

Please see data validation procedures in the metadata pages of mortality and EU-SILC statistics.

Experts from the Joint Action European Health and Life Expectancy Information System (EHLEIS) use the same methodology for calculating the healthy life year indicator and their results are compared with the ones of Eurostat.

See the annex on the Sullivan Method for the calculation

To find statistical procedures used for adjusting the data, please refer to the ESMS pages of mortality and EU-SILC statistics.

For comparability issues, see the tabular overview on the GALI question implementation. (In preparation - April 2012).