Successful aging in spite of bad habits: introduction to the special section on 'Life style and health expectancy'.

Abstract

It was with great delight that I accepted the Editors’ invitation to create a Special Section for the European Journal of Ageing: Social, Behavioural and Health Perspectives (EJA) from amongst the papers given at the 19th Annual Meeting of Reseau Esperance de Vie en Sante (REVES) held in May 2007, in St. Petersburg, Florida, USA. REVES is an international organization that promotes the use of health expectancy as a population health indicator in research. Health expectancy (HE) simultaneously estimates mortality and morbidity or disability in order to quantify answers to the question of whether people are living longer with better or worse health. Whether approaching the question from an incidence or prevalence perspective, the result is an estimate of both the length of remaining life (life expectancy) and the length of remaining life one can expect to life in a healthy state (health expectancy), however defined. HE is useful for cross-national comparisons of the health status of populations, so REVES members are also concerned with the definition, measurement, and comparison of health globally. In addition, the theme of the 2007 Meeting emphasized healthy lifestyles, which are often found to be related to both life and health expectancy throughout the developed world. Negative relationships of obesity, smoking, heavy drinking, poor diet, and lack of physical activity with morbidity and mortality have been shown in studies conducted in Scandinavia (Jensen et al. 2008; Juel 2008), the Netherlands (Franco et al. 2005), UK (Ebrahim et al. 2000) and USA (Ferrucci et al. 1999; Reed et al. 1998; Reynolds et al. 2005). This section is designed to give EJA’s readers a snapshot of some of the best work coming out of the REVES meeting, not all of which deals directly with HE. The four papers range from an examination of changes in HE in Denmark and comparisons of HE estimations in France (Cambois et al. 2008; Jeune and Bronnum-Hansen 2008), to an analysis of health trends in Sweden (Parker et al. 2008), and a comparison of trends in health risk factors in US and Mexico (Wong et al. 2008). As such, these articles give the reader examples of the different ways REVES members approach population health, including both social and behavioral factors. In this introduction, I will briefly summarize each paper, comment on each, and draw some conclusions about population research, based on implications of these articles. In the first article, Jeune and Bronnum-Hansen address the principal concern of REVES, health expectancy. This study examines HE in Denmark between 1987 and 2005, encompassing a period in which both improvements and deterioration in health have been observed, in Denmark and elsewhere (Bronnum-Hansen 2005, Crimmins et al. 1997). Using the Denmark Health Interview Studies (DHIS) from 1987, 1994, 2000, and 2005, the authors use prevalence methods (Sullivan 1971) to track trends in HE. Measures they use for HE include self-report of long-standing illness, report of whether the long-standing illness caused restriction in daily activities (long-standing limiting illness), functional limitations (mobility, communication), and self-rated health. Their findings indicate that, in addition to increased life expectancy for men and women, life expectancy with long-standing limiting illness, life expectancy with mobility and communication limitation, and life expectancy in fair or poor self-rated health all decreased over the period. Along with their findings, the authors make several interesting observations. One relates to a stagnation period S. L. Reynolds (&) School of Aging Studies, University of South Florida, 4202 E. Fowler Avenue, MHC 1344, Tampa, FL 33620, USA e-mail: sreynold@cas.usf.edu