Socioeconomic status, comorbidity, activity limitation, and healthy life expectancy in older men and women: a 6-year follow-up study in Japan

This study aimed to explore the structural contributions of socioeconomic status (SES), comorbidity, and activity limitation to the healthy life expectancy (HALE) of Japanese suburban elderly. A questionnaire survey was distributed to all residents aged 65 years and older in Tama City, Tokyo, in 2001; a follow-up study was conducted in 2004; and individual vital status data from the municipal residents' registry were tracked until 2007. In all, 7,905 respondents were included for analysis. Data analysis was performed by structural equation modeling (SEM). The data were well fit by the models, and HALE was found to be well explained by SES, comorbidity, and activity limitation (R (2) = .59 for men and R (2) = .71 for women). In conclusion, elderly people with higher SES were more likely to live longer with good self-rated health, via living with less chronic diseases and better performance in daily living activities, especially for elderly women.

[Average and healthy life expectancies and self-rated health in the European country]

AIM

When considering the health of elderly individuals, extending a healthy lifespan as well as the average life expectancy has been discussed. In general, life expectancy is determined by biological health, socioeconomic factor, and social disparities. However, the effects of fatal diseases, such as cancer, socioeconomic factor, and self-rated health on the average life expectancy and healthy life expectancy have not been fully elucidated.

METHODS

In the present study, a multiple regression analysis was used to clarify the relationships between the lifespan and socio-economic conditions, such as the GDP, GiNi index, age-adjusted mortality from cancer, suicide rate and self-rated health in 27 European countries.

RESULTS

According to the multiple regression analysis, the average life expectancy was significantly correlated with mortality from cancer (β=-0.816, P=0.001), whereas the healthy life expectancy was significantly correlated with self-rated health (β=0.759, p=0.001) in males. In females, the average life expectancy was significantly correlated with mortality from cancer (β=-0.470, p=0.004), whereas the healthy life expectancy was significantly correlated with self-rated health (β=0.605, p=0.001).

CONCLUSIONS

These findings indicate that there is a significant correlation between cancer and life expectancy. Meanwhile, self-rated health is an important factor for increasing the longevity of a healthy life expectancy.