APH 2002, 60, 341-362:

Differences in health expectancy indicators in Belgium by region.

H. Van Oyen, N. Bossuyt, P. Deboosere, S. Gadeyne, J. Tafforeau

Keywords: health expectancy, healthy life expectancy, disability free life expectancy, mental health expectancy, equity,
                Belgium, region

Objective: The purpose of the paper is to compare the health status of the population of the Flemish and the Walloon Region of Belgium using a set of health expectancy indicators: the Healthy Life Expectancy (HLE), the Disability Free Life Expectancy (DFLE) and the Mental Life Expectancy (MLE).

Methods: The Sullivan method was used to calculate the health expectancies combining data of the 1997 health interview survey with the National Mortality Database. The information on subjective health (WHO-Europe instrument) and mental well-being (GHQ-12) was obtained through the self-administrated questionnaire. The instrument to measure disability (WHO-Europe instrument) was part of the face-to-face interview of the 1997 health interview survey. The variance on the differences in the health expectancies was estimated in order to make statistical inference.

Results: Among men at age 25 year, the difference observed between the two regions is more than two years in life expectancy (LEFlem: 50.4 year vs LEWall: 48.1 year) and in disability free life expectancy (DFLEFlem: 39.1 year vs DFLEWall: 37.0 year). The differences are even greater, respectively 4.4 years and 5.3 years, for the mental life expectancy (MLEFlem: 38.6 year vs MLEWall:: 34.2 year) and for the healthy life expectancy (HLEFlem: 39.5 year vs HLEWall: 34.2 year). In women at age 25 years the life expectancy and all 3 health expectancy indicators are greater in the Flemish region. The differences are respectively 1.1 years (LEFlem: 56.1 year vs LEWall: 55.0 year) and 3.8 years (DFLEFlem: 40.4 year vs DFLEWall: 36.6 year), 6.3 years (MLEFlem: 39.1 year vs MLEWall: 32.8 year); HLEFlem: 39.8 year vs HLEWall: 33.5 year). All these differences were statistically significant.

Conclusions:  Overall, compared to the Walloon region, people living in the Flemish region not only live longer but also tend to be healthier while doing so: they live more years in good perceived health, more years without functional limitations and more years in good mental wellbeing. Not only socio-economic differences but especially differences in life style (among others smoking, leisure time physical activity, nutritional habits) may be potential factors causing the described differences.