Findings of the project on measuring Life Expectancy by socio-economic status group

Estimating social inequalities in Healthy Life Expectancy: challanges and opportunities, Bruxelles, 10/02/2012

Findings of the project on measuring Life Expectancy by socio-economic status group

Veronica CorsiniEuropean Commission, Eurostat - Population


Content

Background of the project

Methodological issues

Eurostat proposal and its developments

Some results

Next steps


Background of the project

In 2007, Eurostat was requested to develop comparable information on mortality by socio-economic status group (SEG) on a regular basis for all EU Member States.

Proposal prepared by Eurostat and discussed with the countries in June 2009.

Technical Task Force set up in summer 2009 to tackle and resolve methodological and practical issues linked to the regular production and dissemination of such indicator.


Methodological issues

1. Choice of SEG characteristic.

2. Choice of mortality indicator.

3. Cross-sectional/unlinked vs. prospective/record linked studies.


Choice of SEG characteristic

Possible choices: educational attainment, occupational status, income (economic status or wealth).

Decision: use educational attainment as proxy for socio-economic group.

Advantages vs. disadvantages.


Choice of mortality indicator

Several choices: death rates, life expectancy and life table based information, potential years of life lost, premature mortality, etc..

Decision: life expectancy. Life expectancy by educational attainment is

considered a very important indicator of socio-economic inequalities in health.

Calculations done by Eurostat for all available countries.


Cross-sectional vs. record linked studies

1. Cross-sectional studies: the distribution of deaths and population by SEG is identified via two different data sources.

Problem: numerator-denominator bias distortion of mortality indicators for some SEGs.

Example: overestimation of mortality differentials by education.

But: cheaper and more readily available.


Cross-sectional vs. record linked studies

2. Record linked studies: linkage of death certificates with census information or population registers

same source is used to obtain the SEG.

Choice of matching variables: unique identifier, deterministic linkage, probabilistic linkage.

Longer to implement, more resources are needed but results are not affected by numerator-denominator bias.


Eurostat proposal

1. Short term approach: use death and population series from the annual demographic questionnaire. Educational attainment is collected since reference year 2007 using ISCED97 broad groups: ISCED0_2, ISCED3_4, ISCED5_6:

- deaths by sex, age and educational attainment: BG,CZ,DK,EE,IT,HU,MT,PL,PT,RO,SI,FI,SE;NO,ME,HR,MK,BA,RS,XK.

- population by sex, age and educational attainment: DK,MT,FI,SE;NO.


Eurostat proposal

1. Short term approach:

Alternative for population: Labour Force Survey data:

use the % shares of the population (5 years age groups) by ISCED97 groups in the LFS to break down the total population from the demographic data collection.

But: LFS covers ages 15-74 and only private households.


Eurostat proposal

Example:

IT M F

2007 ISCED0_2 ISCED3_4 ISCED5_6 ISCED0_2 ISCED3_4 ISCED5_6

15-19 87% 13% 0% 84% 16% 0%20-24 27% 68% 5% 20% 71% 9%25-29 32% 54% 15% 23% 53% 24%30-34 38% 47% 15% 30% 48% 22%35-39 44% 42% 14% 38% 45% 18%40-44 49% 40% 11% 43% 44% 13%45-49 50% 39% 11% 48% 41% 11%50-54 52% 36% 12% 54% 35% 12%55-59 57% 31% 12% 65% 25% 10%60-64 66% 25% 9% 76% 18% 6%65-69 74% 19% 7% 83% 13% 4%70-74 82% 12% 5% 88% 9% 3%


Eurostat proposal

2. Medium term approach: linkage of death certificates with census information from the 2011 censuses, broken down by educational attainment.

The aim is to achieve a complete coverage of the countries but longer implementation time is needed.

2009 2010 2011 2012 2014

DK,MT,FI,SE,NO; BG,CZ,EE,IT,HU,

PL,PT,RO,SI; HR,MK

CENSUS DATA -> INDICATORS


Some examples

Method Census SEG Deaths certificates

follow-up

Italy Record linkage 1981, 1991 Education;

professional group Respectively, 6 and 12

months after the census

Lithuania Record linkage 2001 Education 3 years and half after

the census

Hungary Cross-section 1980, 1990, 2001 Education 1986-2005

Netherlands Education

Austria Record linkage 1981, 1991, 2001 Education 12 months after each

census

United Kingdom Record linkage Longitudinal from 1971,

only for England and Wales Occupation based

social class continuous

Norway Record linkage 1980 Occupation;

education November 1995 -

October 2000

Switzerland Record linkage Longitudinal from 1990,

link also with 2000 Census Education

Up to end of 1997


Task Force

1. Treatment of « unknown » and « not applicable » ISCED97 categories in deaths and population.

2. Use of LFS data.

3. Closing the life table.

4. Guidelines on census linkage.


1. Treatment of « unknown » and « not applicable » ISCED97 categories

3 possible choices: they are ignored; they are included into category ISCED0_2; they are redistributed into categories ISCED0_2,

ISCED3_4, ISCED5_6 proportionally to their relative sizes by sex and age.

sensitivity analysis

Redistribute proportionally the unknown among the three « known » categories.


2. Use of LFS data

Is it possible to refine the calculations?

What alternatives?– IIASA/VID database on educational attainment

by age and sex for 120 countries, 1970-2050;– EU-SILC sample.

Decision: use LFS as above, but …..


2. Use of LFS data

….. biases are to be expected …..

Demo M F LFS M Fquest. ISCED0_2 ISCED3_4 ISCED5_6 ISCED0_2 ISCED3_4 ISCED5_6 ISCED0_2 ISCED3_4 ISCED5_6 ISCED0_2 ISCED3_4 ISCED5_615-19 98% 2% 0% 97% 3% 0% 15-19 95% 5% 0% 93% 7% 0%20-24 45% 52% 2% 35% 62% 3% 20-24 35% 60% 5% 22% 72% 6%25-29 24% 54% 23% 19% 48% 33% 25-29 16% 52% 32% 13% 45% 42%30-34 21% 47% 32% 16% 42% 42% 30-34 15% 45% 40% 13% 41% 46%35-39 22% 46% 31% 17% 45% 38% 35-39 20% 46% 33% 14% 47% 39%40-44 23% 49% 28% 19% 47% 33% 40-44 22% 48% 30% 18% 47% 35%45-49 26% 47% 28% 26% 41% 33% 45-49 26% 46% 28% 24% 43% 33%50-54 26% 48% 26% 32% 35% 33% 50-54 25% 48% 27% 34% 33% 34%55-59 24% 49% 26% 30% 41% 29% 55-59 24% 50% 26% 32% 43% 26%60-64 29% 46% 25% 39% 39% 21% 60-64 32% 46% 23% 40% 37% 22%65-69 36% 43% 21% 50% 34% 16% 65-69 37% 42% 21% 52% 33% 15%70-74 41% 41% 18% 59% 28% 13% 70-74 43% 41% 16% 60% 27% 13%


3. Closing the life table

85+ Relevant age range is considered to be from 21 up

to 74. (ISCED97) mortality rates up to age 20 and from 75

to 85+ are assumed to be equal to those of the total population.


4. Guidelines on census linkage

Statistics Austria has prepared a list of guidelines and related methodological issues:

• linkage procedure and software, • handling of non-matched deaths,• actual calculation of death rates, • follow-up period,• possible sources of bias (closed population, deaths

abroad, missing data, educational mobility, etc.).

The guidelines have been presented to the countries in May 2010.


4. Guidelines on census linkage

Information of June 2010: Some NSIs are planning to carry out the census

linkage exercise. Some NSIs are already linking different sources to

obtain the needed information. Some NSIs will not carry out the exercise. Some NSIs are not sure or have not decided yet.


Some results 2007-2010

Calculations done for DK, MT, FI, SE, NO using both deaths and population series by ISCED97 from the demographic data collection.

Calculations done for BG, CZ, EE, IT, HU, PL, PT, RO, SI, HR, MK using LFS information on educational attainment percentages.

Results are experimental statistics and will be developed further in the future, so any conclusions should be drawn with caution.


Life expectancy gaps between high and low educational attainment 2010 - 1

Age 30, 2010 (IT, MT: 2008; RO, SI: 2009)

BGCZDKEEIT

HUMTPLPTROSIFI

SENOHRMK

Years15 10 5 5 10 15

Men Women

Age 40, 2010 (IT, MT: 2008; RO, SI: 2009)

BGCZDKEEIT

HUMTPLPTROSIFI

SENOHRMK

Years15 10 5 5 10 15

Men Women


Life expectancy gaps between high and low educational attainment 2010 - 2

Age 50, 2010 (IT, MT: 2008; RO, SI: 2009)

BGCZDKEEIT

HUMTPLPTROSIFI

SENOHRMK

Years15 10 5 5 10 15

Men Women

Age 60, 2010 (IT, MT: 2008; RO, SI: 2009)

BGCZDKEEIT

HUMTPLPTROSIFI

SENOHRMK

Years15 10 5 5 10 15

Men Women


Life expectancy by educational attainment 2010 - 1

Years

Life expectancy at age 30 by educational attainment, women 2010 (IT,MT: 2008; RO,SI: 2009)

10

20

30

40

50

BG EE HU RO MK PL CZ DK HR SI NO FI SE MT PT IT

Low Medium High


10

20

30

40

50


Low Medium High


10

20

30

40

50


Low Medium High


10

20

30

40

50


Low Medium High


Life expectancy by educational attainment 2010 - 2

Years

Life expectancy at age 30 by educational attainment, men 2010 (IT,MT: 2008; RO,SI: 2009)

10

20

30

40

50

CZ EE HU BG RO PL SI MK HR DK FI NO PT MT IT SE

Low Medium High


10

20

30

40

50


Low Medium High


10

20

30

40

50


Low Medium High


10

20

30

40

50


Low Medium High


Life expectancy gaps between men and women 2010

Years

Life expectancy at age 40: women with low education and men with high education, 2010 (IT,MT: 2008; RO,SI: 2009)

20

25

30

35

40

45

BG CZ DK EE IT HU MT PL PT RO SI FI SE NO HR MK

Women, Low educ. Men, High educ.


To summarise …..

An inverse relationship between educational attainment and mortality can be observed: at any age, life expectancy is shorter among persons with the lowest educational attainment and life expectancy increases with educational level.

Large differences in life expectancy by educational attainment can be observed among the Member States, particularly for men.


To summarise …..

Life expectancy for women at a given educational attainment is consistently higher than for men but there are smaller differences between educational attainment groups for women than for men.

However, based on the available data, social gaps between high and low levels have increased between 2007 and 2010 at age 30 for 40% of the countries for men and for 80% for women.

Women present another important ‘mortality advantage’ over men: life expectancy of men with higher education is generally lower than the life expectancy of women with the lowest educational attainment.


Eurostat on line database

http://epp.eurostat.ec.europa.eu/


Next steps

«Regular» production of the indicator. Follow up on census linkage if needed. Wait for results from linkage exercise….


Thank you!

Contact information:

Veronica CorsiniEurostat, Unit F2 – [email protected]

Documents

Findings of the project on measuring Life Expectancy by socio-economic status group