Gender difference in trends in healthy life expectancy in 2005-2012 for adults aged 50 years and older in South Africa
Data characterizing older people’s life expectancy by good or poor health is important for policy and fiscal planning. This study aims to examine trends and investigate gender differences in healthy life expectancy (HLE) for older people in South Africa for the period 2005–2012. Using data from three repeated cross-sectional surveys conducted in 2005, 2008, and 2012, we applied a self-rated health measure to estimating HLE. The Sullivan method was used in the calculations. We found that unhealthy life expectancy decreased over the period, while HLE and the proportion of life spent in good health increased more than total life expectancy in the same period. Gender disparities were evident: Women had higher life expectancy than men, yet they spent a greater proportion of their lifetime in poor health. We concluded that HLE of older people in South Africa has improved over the period under investigation.
Alves LC and Arruda NM. (2017). Socioeconomic differentials and disease-free life expectancy of the elderly in Brazil. International Journal of Population Studies, 3(1): 64–78. https://doi.org/10.18063/ijps.2017.01.001.
Ardington C and Gasealahwe B. (2014). Mortality in South Africa: Socioeconomic profile and association with self-reported health. Development Southern Africa, 31(1): 127–145. https://doi.org/10.1080/0376835X.2013.853611.
Bor J, Herbst AJ and Newell ML, et al. (2013). Increases in adult life expectancy in rural South Africa: Valuing the scale-up of HIV treatment. Science (New York, N.Y.), 339(6122): 961–965. https://doi.org/10.1126/science.1230413.
Burström B. (2012). Commentary: Self-rated health and mortality in low income settings. International Journal of Epidemiology, 41(6): 1727–1728. https://doi.org/10.1093/ije/dys197.
Christensen K, Doblhammer G and Rau R, et al. (2009). Ageing populations: The challenges ahead. The Lancet, 374(9696): 1196– 208. https://doi.org/10.1016/S0140-6736(09)61460-4.
Crimmins EM. (1996). Mixed trends in population health among older adults. Journal of Gerontology: Social Sciences, 51B(5): S223– 225. https://doi.org/10.1093/geronb/51B.5.S223.
Crimmins EM. (2004). Trends in the health of the elderly. Annual Review of Public Health, 25(1): 79–98. https://doi.org/10.1146/annurev.publhealth.25.102802.124401.
Depp CA and Jeste DV. (2006). Definitions and predictors of successful aging: A comprehensive review of larger quantitative studies. American Journal of Geriatric Psychiatry, 14: 6–20. https://doi.org/10.1097/01.jgp.0000192501.03069.bc.
DeSalvo KB, Jones TM and Peabody J, et al. (2009). Health care expenditure prediction with a single item, self-rated health measure. Medical Care, 47(4): 440–447. https://doi.org/10.1097/MLR.0b013e318190b716.
Doblhammer G and Kytir J. (2001). Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998. Social Science and Medicine, 52: 385–391. https://doi.org/10.1016/S0277-9536(00)00141-6.
Dorrington RE, Bradshaw D and Laubscher R. (2014). Rapid Mortality Surveillance Report 2012. Cape Town: South African Medical Research Council.
Dutch National Committee for International Cooperation and Sustainable Development. (2008). An African football World Cup at Last! But What Will be the Effects? Maximising Positive Impact of the 2010 FIFA World Cup. Stellenbosch, South Africa; 2008. Available from: http://www.sportdevelopment.org/wp content/uploads/2010/10/Mega_event_boekje.pdf. [Last Accessed on
Jun 20].
European Health Expectancy Monitoring Unit. (2007). Interpreting Health Expectancies. France: EHEMU Technical Report 2007.
European Health Expectancy Monitoring Unit. (2009). Trends in Disability-Free Life Expectancy at Age 65 in the European Union 1995-2001: A Comparison of 13 EU Countries. France: Ehemu Technical Report 2009.
Feng Q, Zhu H, Zhen Z and Gu D. (2016). Self-rated health, interviewer-rated health, and their predictive powers on mortality at old ages. Journal of Gerontology: Social Sciences, 71(3): 538–550. https://doi.org/10.1093/geronb/gbu186.
Gibson HJ, Walker M and Thapa B, et al. (2014). Psychic income and social capital among host nation residents: A pre-post analysis of the 2010 FIFA World Cup in South Africa. Tourism Management, 44: 113–122. http://dx.doi.org/10.1016/j.tourman.2013.12.013.
Gruenberg E. (1977). The failures of success. The Milbank Memorial Fund Quarterly. Health and Society., 55(1), 3–24. https://doi.org/10.1111/j.1468-0009.2005.00400.x.
Gu D, Dupre ME and Warner D, et al. (2009). Changing health status and health expectancies among older adults in China: Gender differences from 1992 to 2002. Social Science and Medicine, 68(10): 2170–2179. https://doi.org/10.1016/j.socscimed.2009.03.031.
Idler LI and Benyamini Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38: 21–37. https://doi.org/10.2307/2955359.
Jagger C, Cox B and Le Roy S, et al. (2006). Health Expectancy Calculation by the Sullivan Method. 3rd ed. France: EHEMU Technical Report.
Jagger C, Gillies C and Cambois E, et al. (2010). The global activity limitation index measured function and disability similarly across European countries. Journal of Clinical Epidemiology, 63: 892–899. https://doi.org/10.1016/j.jclinepi.2009.11.002.
Jylhä M. (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science and Medicine, 69: 307–316. https://doi.org/10.1016/j.socscimed.2009.05.013.
Kaplan GA and Camacho T. (1983). Perceived health and mortality: A nine-year follow-up of the human population laboratory cohort. American Journal of Epidemiology, 117: 292–304. https://doi.org/10.1093/oxfordjournals.aje.a113541.
Karcharnubarn R and Rees P. (2009). Population Ageing and Healthy Life Expectancy in Thailand. New Hampshire, USA: In: The 5th International Conference on Population Geographics.
Kinsel B. (2005). Resilience as adaptation in older women. Journal of women and aging, 17(3): 23–39. https://doi.org/10.1300/J074v17n03_03.
Lehohla P. (2013). Use of health facilities and levels of selected health conditions in South Africa: Findings from the General Household Survey, 2011. Pretoria: Statistics South Africa.
Manton KG. (1982). Changing concepts of morbidity and mortality in the elderly population. The Milbank Memorial Fund Quarterly. Health and Society, 60: 183–244. https://doi.org/10.2307/3349767.
Mathers CD and Robine JM. (1997). How good is Sullivan’s method for monitoring changes in population health expectancies?Journal of Epidemiology and Community Health, 51, 80–86. https://doi.org/10.1136/jech.51.1.80.
Mayosi BM and Benatar SR. (2014). Health and Health Care in South Africa 20 Years after Mandela. The New England Journal of Medicine, 37: 1344–1353. https://doi.org/10.1056/NEJMsr1405012.
Møller V. (2014). Happiness, National pride and the 2010 World Cup. In: Sullivan GB, editor. Understanding Collective Pride and Group Identify: New Directions in Emotion Theory, Research and Practice. New York: Routledge, Taylor and Francis Group. p110–123.
Mossey JM and Shapiro E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72: 800–808. https://doi.org/10.2105/AJPH.72.8.800.
Oksuzyan A, Juel K and Vaupel JW, et al. (2008). Men: Good health and high mortality sex differences in health and aging. Aging Clinical and Experimental Research, 20(2): 91–102. https://doi.org/10.1007/BF03324754.
Padayachee V. (2010). Global economic recession: Effects and implications for South Africa at a time of political challenges. Claves de la Economia Mundial, 23(4): 1-20. Available from: http://www.lse.ac.uk/international Development/20th Anniversary Conference/Impact of the Global FC.pdf. [Last accessed on 2018 Jun 22].
Phillips H and Noumbissi A. (2004). Disability in South Africa. African Population Studies, 19: 107–130.
Rena R and Msoni M. (2014). Global financial crises and its impact on the South African economy: A further update. Journal of Economics, 5(1): 17-25. doi.org/10.1080/09765239.2014.11884980.
Robine JM and Michel JP. (2004). Looking forward to a general theory on population aging. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 59(6): M590–M597. https://doi.org/10.1093/gerona/59.6.M590.
Robine JM, Romieu I and Cambois E. (1999). Health expectancy indicators. Bulletin of the World Health Organization, 77(2): 181–185.
Sabatini F. (2014). The relationship between happiness and health: Evidence from Italy. Social Science and Medicine, 114: 178–187. https://doi.org/10.1016/j.socscimed.2014.05.024.
Saito Y, Robine JM and Crimmins E. (2014). The methods and materials of health expectancy. Statistical Journal of the IAOS, 30: 209–223. https://doi.org/10.3233/SJI-140840.
Saito Y, Qiao X, and Jitapunkul S. (2003). Health expectancy in Asian countries. In: Robine RI, Jagger C, and Mathers C, editors. Determining Health Expectancies. Chichester: John Wiley and Sons. p289-317.
Schatz E, Gómez-Olivé X and Ralston M, et al. (2012). The impact of pensions on health and wellbeing in rural South Africa: Does gender matter? Social Science and Medicine, 75: 1864–1873. https://doi.org/10.1016/j.socscimed.2012.07.004.
Sen A. (2002). Health: Perception versus observation. BMJ, 324: 860–861. https://doi.org/10.1136/bmj.324.7342.860.
Shisan, O, Rehle T and Simbayi LC, et al. (2014). South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. Cape Town: HSRC Press.
Shisana O, Rehle T and Simbayi LC, et al. (2005). South African national HIV prevalence, HIV incidence, Behaviour and communication survey. Cape Town: HSRC Press.
Shisana O, Rehle T and Simbayi LC, et al. (2009). South African National HIV Prevalence, Incidence, Behaviour and Communication Survey 2008: A Turning Tide Among Teenagers? Cape Town: HSRC Press.
Spiers N, Jagger C and Clarke M (1996). Physical function and perceived health: Cohort differences and interrelationships in older people. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 51: S226–S233. https://doi.org/10.1093/geronb/51B.5.S226.
Statistics South Africa. (2014). Mid-Year Population Estimates 2014. Pretoria: Republic of South Africa.
Subramanian SV, Subramanyam MA and Selvaraj S, et al. (2009). Are self-reports of health and morbidities in developing countries misleading? Evidence from India. Social Science and Medicine, 68: 260–265. https://doi.org/10.1016/j.socscimed.2008.10.017.
Suchman EA, Phillips BS and Streib GF. (1958). An analysis of the validity of health questionnaires. Social Forces, 36: 223–232. https://doi.org/10.2307/2573809.
Suhrcke M, Fumagalli E and Hancock R. (2010). Is there a wealth dividend of aging societies? Public Health Review, 33(2): 377–400. https://doi.org/10.1007/BF03391608.
Sullivan DF. (1971). A single index of mortality and morbidity. HSMHA Health Reports, 86(4): 347–354. https://doi.org/10.2307/4594169.
United Nations. (2017). World Population Prospects: The 2017 Revision. New York: United Nations.
Yong V and Saito Y. (2009). Trends in healthy life expectancy in Japan: 1986-2004. Demographic Research. 20: 467–494. https://doi.org/10.4054/DemRes.2009.20.19.
Zack MM, Moriaarty DG and Ford ES, et al. (2004). Worsening trends in adult health-rated quality of life and self-rated health-United States, 1993-2001. Public Health Report, 119(5): 493–505. https://doi.org/10.1016/j.phr.2004.07.007.
Zimmer Z, Hidajat M and Saito Y. (2015). Changes in total and disability-free life expectancy among older adults in China: Dothey portend a compression of morbidity? International Journal of Population Studies, 1(1): 4-18. https://doi.org/10.18063/IJPS.2015.01.001.