Correlates of healthy life expectancy in low- and lower-middle-income countries

Md Shariful Islam,Md Ismail Tareque,Hafiz T A Khan,Md Munsur Ahmed,Md Aminur Rahman,Md Nazrul Islam Mondal,Md Nazrul Hoque

doi:10.1186/s12889-018-5377-x

Abstract

BackgroundHealthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country’s population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries.MethodsIn accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives.ResultsThe lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors.ConclusionTo increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

Highlights

Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country’s population
The HALE, mean years of schooling, health expenditure, physician density, improved sanitation using rate, freedom of the press, economic freedom, and achieving a level of health-related millennium development goals (MDGs) are observed very low among the African countries
The highest HALE, mean years of schooling, health expenditure, physician density, improved drinking-water sources using rate, improved sanitation using rate, freedom of the press, corruption perceptions index (CPI), economic freedom, and achieving a level of health-related MDGs are seen in the Asian countries

Summary

Introduction

Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country’s population. Increasing mean years of schooling [4], health expenditure, physician density, entrance to improved drinking-water sources and hygienic sanitation system, economic freedom [5], freedom of the press, corruption perceptions index (CPI), achieving a level of health-related millennium development goals (MDGs), and gross national income (GNI) per capita; and decreasing the human immunodeficiency virus (HIV) prevalence rate [6], total fertility rate (TFR), carbon dioxide (CO2) emission rate, and prison population rate significantly contribute to increasing the average HALE at birth These factors may vary from one geographic region to the others which need to be examined. The findings may help the policy-makers and researchers to determine the influential factors of HALE in low- and lower-middleincome countries and thereby take appropriate measures as to how to raise HALE in these countries

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Discussion

Conclusion