8.1. Life expectancy and healthy life expectancy at age
In OECD countries, life expectancy at
age 65 has increased significantly for both men and women during the past 50 years. Some
of the factors explaining the gains in life expectancy at age 65 include advances in
medical care combined with greater access to health care, healthier lifestyles and
improved living conditions before and after people reach age 65.
A growing share of the population is
now age 65 and older. Whether longer life expectancy is accompanied by good health among
ageing populations has important implications for health and long-term care systems.
In 2009, people at age 65 in OECD
countries could expect to live for another 20.5 years on average for women and 17.2 years
for men (Figure 8.1.1). Life expectancy at age 65 in the OECD was the
highest in Japan for women (24.0 years) and Switzerland for men (19.0 years). Life
expectancy at age 65 is lower in Turkey as well as in some of the major emerging economies
such as South Africa and the Russian Federation.
On average across OECD countries, life
expectancy at age 65 has increased by 5.6 years for women and 4.4 years for men
since 1960. While the gender gap in life expectancy at age 65 widened in many countries in
the 1960s and the 1970s, it has slightly narrowed over the past 30 years. In some
countries such as the United States, New Zealand and the United Kingdom, the overall gains
in life expectancy at age 65 since 1960 have been greater for men than for women.
Japan has achieved the highest gains
in life expectancy at age 65 since 1960, with an increase of almost ten years for women
and over seven years for men. The gains in life expectancy have been more modest in some
central and eastern European countries, such as the Slovak Republic and Hungary,
particularly for men.
Increased life expectancy at
age 65 does not necessarily mean that the extra years lived are in good health. In Europe,
an indicator of disability-free life expectancy known as healthy life years has recently
been developed and is calculated regularly, based on a general question about disability
in the European Survey of Income and Living Conditions (EU-SILC). Given that this
indicator has only recently been developed, long time series are not yet available.
In 2009, among European countries
participating in the survey, the average number of healthy life years at age 65 was almost
the same for women and men, at 9.0 years for women and 8.8 years for men. The absence of
any significant gender gap in healthy life years means that women are more likely to live
with some type of activity limitation after age 65 than men. Sweden and Norway had the
highest number of healthy life years at age 65 in 2009, with 14 years or more for women
and 13.5 years for men. The Slovak Republic had the lowest number of healthy life years at
less than five for both women and men (Figure 8.1.2).
Other OECD countries also calculate
similar indicators of disability-free life expectancy, although the survey instruments to
measure disability may vary slightly. In Japan, disability-free life expectancy at
aged 65 was estimated to be 15.6 years for women and 12.6 years for men in 2004 (Cabinet
Office, Government of Japan, 2006). In the United States, females born in 2001-02 can
expect to live 66.9 years free from activity limitation, and males 63.6 years (US
Department of Health and Human Services, 2006).
Definition and comparability
Life expectancy measures how long
on average a person of a given age can expect to live, if current death rates do not
change. However, the actual age-specific death rate of any particular birth cohort
cannot be known in advance. If rates are falling, as has been the case over the past
decades in OECD countries, actual life spans will be higher than life expectancy
calculated using current death rates. The methodology used to calculate life
expectancy can vary slightly between countries. This can change a country's estimates
by a fraction of a year.
Disability-free life expectancy,
or healthy life years, are the number of years spent free of activity limitation. In
Europe, Healthy Life Years are calculated annually by Eurostat for EU countries and
some EFTA countries using the Sullivan method (Sullivan, 1971). The disability measure
is the Global Activity Limitation Indicator (GALI) which comes from the European Union
Statistics on Income and Living Conditions (EU-SILC) survey. The GALI measures
limitation in usual activities due to health problems.