Abstract
For a long time, life expectancy at birth was used as the sole indicator of population health. More recently, population health is also being expressed as healthy life expectancy and it is debated how healthy life expectancy will develop in the future. Since it is known that men and women have very different health and disease trajectories, we compared healthy life expectancy between the sexes, at birth and at age 80. From 1985 to 2010 life expectancy at birth in the Netherlands increased from 73.1 to 78.8 for men and from 79.7 to 82.7 for women. During the same period, the expected number of years without disabilities and in good self-reported health increased parallel, pointing to a shift of disability towards older age. Paradoxically, however, there has been an expansion of morbidity per se, as indicated by a continuing decrease in life expectancy without chronic diseases from 51.4 to 47.2 for men and from 48.8 to 40.6 for women. After these diverging trends of the last thirty years, Dutch women nowadays have a life expectancy that is 3.9 years longer than men but a life expectancy without chronic diseases that is 6.6 years lower. When examining these figures in the oldest old, the number of years expected to live in good health is similar for the sexes, but women of 80 years can expect to live another 9.7 years, still almost two years longer than the 7.9 years for men. All in all, the increase of life expectancy in the Netherlands is accompanied by a shift of disability but an expansion of morbidity, which is much more pronounced in women. It remains to be examined what biological or social mechanisms are behind these large sex differences in healthy life expectancy in the Netherlands.
Published Version
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