Regional inequities in health expectancy in Belgium

Abstract

Mortality differs substantially between the Flemish and Walloon regions in Belgium. The question remains as to whether the health status of both populations varies in a similar way. The difference in healthy life expectancy, an indicator of population health, between the Flemish and Walloon regions was therefore assessed. In 1989–1990 a cross-sectional survey in the general population was performed in which 2640 persons were selected by a multistage random process. Perceived health status was determined through a validated question: “On the whole, how would you describe your health for the moment? Would you say it is very good/good/fair/rather bad/bad?” The prevalence of “being in good health (very good to fair)” was combined with mortality data (Sullivan method) to estimate the healthy life expectancy (HLE), and the following results were found. Among males, life expectancy (LE) and HLE at age 15 was 58.9 years and 56.5 years in the Flemish region, compared with 56.6 and 50.2 years in the Walloon region. At age 65, LE and HLE in the Flemish region was 14.3 and 13.3 years, and only 13.2 and 9.2 years in the Wallon region. Women at age 15 had an LE and HLE in the Flemish region of 65.2 years and 61.3 years, compared to 63.9 and 58.1 years in the Walloon region. At age 65, both the LE and the HLE in the Flemish region were higher, with LE at 18.5 versus 17.7 years, and HLE at 16.0 versus 14.3 years. Similar results were obtained when the criteria of “being in good health” were restricted to those indicating their health to be very good or good. In conclusion, the data indicate that the population in the Walloon region not only has a shorter life but apparently also has a shorter healthy life. Research is needed to explain what proportion of these differences can be attributed to differences in the prevalence of diseases, cultural differences and socio-economic differences.