Estimating and Decomposing Disease-Free Life Expectancies by Sex and Educational Attainment for Major Groups of Causes in Spain, 2012-17.

Octavio Bramajo , Centre d'estudis Demogràfics, Universitat Autònoma de Barcelona
Iñaki Permanyer, Centre d'Estudis Demogràfics
Elisenda Rentería , Centre d'Estudis Demogràfics
Pilar Zueras , Institute for Social and Economic Research (ISER) - University of Essex

Introduction and objective: Certain diseases tend to affect individuals at different stages of their lives. Those differences tend to vary by condition, sex, and educational attainment. This study intended to estimate the health burden of six major groups of chronic diseases (Back Pain, Cardiovascular conditions, Diabetes, Mental Disorders and Respiratory conditions) in Spain, by computing the Disease Free Life Expectancy at age 35. Furthermore, we decomposed gaps between health expectancies by sex and educational attainment. Methods: We used the 2012, 2014 and 2017 health surveys in Spain (Spanish and European Health Surveys) along with the mortality files provided by the Spanish National Institute of Statistics (Instituto Nacional de Estadística) for the same period, pooling the data in a cross-sectional analysis. We computed life expectancies, disease-free health expectancies and applied a decomposition procedure to disentangle mortality and morbidity effects in health expectancy differentials by sex (females minus males) and educational attainment (high educated minus low educated) for each group of diseases. Results: A clear educational and sex gradient in the morbidity component was found for mental disorders, favoring males and highly educated individuals. In the remaining diseases, differences in health expectancy by educational attainment were rarely explained by the morbidity component. However, such component was an important contributor to differences in Diabetes and Cardiovascular conditions when addressing sex gaps. Discussion: Decomposing differences in health expectancies separately by groups of causes may offer a better understanding of how inequalities in health (by sex and educational attainment) operate differently for each case.

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 Presented in Session 20. Adding Healthy Life Years to Our Lives