Abstract
BackgroundPrevention aiming at smoking, alcohol consumption, and BMI could potentially bring large gains in life expectancy (LE) and health expectancy measures such as Healthy Life Years (HLY) and Life Expectancy in Good Perceived Health (LEGPH) in the European Union. However, the potential gains might differ by region.MethodsA Sullivan life table model was applied for 27 European countries to calculate the impact of alternative scenarios of lifestyle behavior on life and health expectancy. Results were then pooled over countries to present the potential gains in HLY and LEGPH for four European regions.ResultsSimulations show that up to 4 years of extra health expectancy can be gained by getting all countries to the healthiest levels of lifestyle observed in EU countries. This is more than the 2 years to be gained in life expectancy. Generally, Eastern Europe has the lowest LE, HLY, and LEGPH. Even though the largest gains in LEPGH and HLY can also be made in Eastern Europe, the gap in LE, HLY, and LEGPH can only in a small part be closed by changing smoking, alcohol consumption, and BMI.ConclusionBased on the current data, up to 4 years of good health could be gained by adopting lifestyle as seen in the best-performing countries. Only a part of the lagging health expectancy of Eastern Europe can potentially be solved by improvements in lifestyle involving smoking and BMI. Before it is definitely concluded that lifestyle policy for alcohol use is of relatively little importance compared to smoking or BMI, as our findings suggest, better data should be gathered in all European countries concerning alcohol use and the odds ratios of overconsumption of alcohol.
Highlights
For quite some time, life expectancy has been the most important measure of population health
healthy life years (HLY) is the number of years a person is expected to live without disability, whereas self-perceived health is based on the question, “How good is your health in general?” and reflects perception of health rather than actual functioning
The prevalence of female smokers is still increasing in many countries, such that a future study might find higher potential effects for smoking reduction among women. In this manuscript, we estimate the gains to be made in life expectancy and health expectancy by improving smoking, BMI, and alcohol consumption levels for four European regions covering almost all European countries
Summary
Life expectancy has been the most important measure of population health. In the European Union, two health expectancy indicators that are included in the European Core Health Indicators (ECHI) set serve as a basis for monitoring and comparing health status within the EU These are healthy life years (HLY) and life expectancy in good self-perceived health (LEGPH). HLY is the number of years a person is expected to live without disability, whereas self-perceived health is based on the question, “How good is your health in general?” and reflects perception of health rather than actual functioning. Both measures are based on self-report in surveys of the general population [2].
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