Urban-rural differences in disability-free life expectancy in Bangladesh using the 2010 HIES data.

Md Shariful Islam,Md Ismail Tareque,Sharifa Begum,Md Nazrul Islam Mondal,Ahbab Mohammad Fazle Rabbi,Hafiz T A Khan,Sten H Vermund

doi:10.1371/journal.pone.0179987

Abstract

BackgroundResearch on health expectancy has been carried out in Bangladesh but none of it has examined the differences in Disability-Free Life Expectancy (DFLE) between urban and rural setting in context of rapid urbanization of Bangladesh in past decades.ObjectivesThe present study aims to estimate DFLE for people of all ages living in urban and rural areas in Bangladesh, and to examine the differences in DFLE between these two areas.MethodsData from the Sample Vital Registration System 2010 and the Bangladesh Household Income and Expenditure Survey (HIES) 2010 were used in this study. The Sullivan method was applied to estimate DFLE in Bangladesh.ResultsHigher rates of mortality and disability were observed in rural areas compared to urban areas with few exceptions. Statistically significant differences in DFLE were revealed from birth to age 15 years for both sexes between urban and rural areas. Urban males had a longer life expectancy (LE), longer DFLE and shorter LE with disability both in number and proportion when compared to rural males. Rural females at age 20+ years had a longer LE than urban females but urban females had a longer DFLE and a shorter LE with disability in both number and proportion at all ages than did rural females.ConclusionThis study demonstrates that there were clear inequalities in LE, DFLE and LE with disability between rural and urban areas of Bangladesh along with age-specific differences as well. These findings may serve as useful and benchmark for intervention and policy implications for reducing the gap in health outcomes.

Highlights

Until the late 19th century, life expectancy (LE) had been seen as a sufficient indicator for determining population health and public health priorities [1]
Higher rates of mortality and disability were observed in rural areas compared to urban areas with few exceptions
Significant differences in disability-free life expectancy (DFLE) were revealed from birth to age 15 years for both sexes between urban and rural areas

Summary

Introduction

Until the late 19th century, life expectancy (LE) had been seen as a sufficient indicator for determining population health and public health priorities [1]. DFLE or healthy life expectancy has gained momentum over LE for assessing population health and public health priorities around the world, in developed countries. DFLE focuses on the quality of life whereas LE measures the quantity of life a person expects to live. It is a valuable index for understanding changes in both the physical and mental health states of the general population, for allocating resources, and for measuring the success of political programmes [2, 3]. A remarkable heterogeneity in the choice of health indicators was discovered in the computation of health expectancy [4], health expectancy was reported to be a useful and convenient measure for monitoring and assessing quality of life and for comparing different groups and populations [5]. Research on health expectancy has been carried out in Bangladesh but none of it has examined the differences in Disability-Free Life Expectancy (DFLE) between urban and rural setting in context of rapid urbanization of Bangladesh in past decades

Objectives

Results

Conclusion