The prevalence of disability is measured by a general question on activity limitations known as the GALI question (Global Activity Limitation Instrument): To what extent have you been limited for at least six months, due to a health problem, in the usual activities people do?
In 2009, men in the 27 European countries could expect 61.3 healthy life years (HLY), representing almost 80% of their 76.7 years life expectancy at birth; women could expect 62 HLY, 75% of their 82.6 years life expectancy at birth, according to the latest figures released by the French Ministry of Health. In 2010, Sweden showed the longest life expectancy (79.6 years) for men in the EU but Lithuania presented the shortest (68 years), a gap of almost 12 years.
Swedish men also have the most HLYs (71.7 years) with men in the Slovak Republic having the least (52.3 years), a gap of almost 20 HLYs. Sweden also has the highest number of years lived without disability (HLY/LE) in 2010 with 90% of life expectancy without limitations in usual activities. Men in the Slovak Republic on the other hand spend the lowest proportion without disability (73%) -- a difference of 17%. This suggests that, for men, the longer the life expectancy the greater the proportion lived without disability. In the short period 2008-2010 and despite its low life expectancy and HLY for men, Lithuania experienced the largest gain in HLY -- almost three years -- whilst the Netherlands saw the largest decline (a loss of 1.3 years). Thus there is also a tendency for health expectancies in Europe to converge, since the gap between Lithuania and the Netherlands fell by more than four HLY in just three years.
Better health outcomes for women
In 2010, France and Spain have the longest life expectancy (85.3 years) for women in the European Union, but for Bulgaria the shortest (77.4 years), a gap of nearly eight years. In 2010 Malta has the highest HLY (71.6 years) for women and the Slovak Republic the lowest (52.1 years), the gap being the same as for men, at almost 20 years. However, for women in 2010, it is in Bulgaria that the proportion of years lived without disability (HLY/LE) reaches its maximum with 87% of life spent free of activity limitation.
This contrasts with the Slovak Republic where women spend the shortest proportion (66%), a difference of 21 points. The results for Bulgaria show that a short life expectancy combined with a low prevalence of activity limitation leads to a large proportion of life expectancy apparently free of disability. In the short time period 2008-2010, it is again Lithuania that experienced the largest gain in HLY in women (2.4 years), confirming the observation made for men, whilst Finland saw the largest decline (a loss of 1.7 years). As in men, women’s health expectancies show some convergence.
Men and women differ
Whilst the gap in life expectancy between men and women is around six years (5.9 years) in the European Union in 2009, the gap in HLY is less than one year (0.7 years). Thus the proportion of years lived without disability is five percentage points lower for women compared to men (75% vs. 80%). In 2010, Lithuania has the largest gap in life expectancy (LE) between men and women (10.9 years) and Sweden the smallest (4 years). Lithuania has also the largest gap in HLY (4.6 years) and the Slovak Republic the least (0.2 years).
When these two measures are looked at in combination, Portugal has the largest gap in the proportion of years free of disability (HLY/LE) between men and women at almost 9% and Bulgaria the smallest gap at around 3%. However, in all European countries women live longer than men and spend a greater proportion of their lives with disabilities. Differences in HLY between men and women are much smaller than differences in life expectancy and, in seven cases out of 27, men experience slightly more HLY than women.
This is indeed the case in 2009 for Belgium, Denmark, Italy, the Netherlands, Portugal, Spain and Sweden, a significant number of western European countries. France, which has the longest female life expectancy in 2009, occupies the 10th place in terms of HLY, illustrating a case where long life does not coincide with a low report of activity limitation. French men occupy respectively the eighth place (out of 27 Member states) in terms of life expectancy and 11th place for HLY with respect to 2009 values.