Secular trends of life expectancy and disability-free life expectancy at age 65 and associated gender and area-level socioeconomic inequalities in Hong Kong: a serial cross-sectional study between 2007 and 2020.

Chung, Gary Ka-Ki, Marmot, Michael ORCID: 0000-0002-2431-6419, Ho, Irene Yuk-Ying, Chan, Siu-Ming ORCID: 0000-0003-0580-289X, Lai, Eric Tsz-Chun ORCID: 0000-0002-1229-9471, Wong, Samuel Yeung-Shan, Yeoh, Eng-Kiong, Woo, Jean and Chung, Roger Yat-Nork (2023) Secular trends of life expectancy and disability-free life expectancy at age 65 and associated gender and area-level socioeconomic inequalities in Hong Kong: a serial cross-sectional study between 2007 and 2020. The Lancet regional health. Western Pacific, 41. 100909-.

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Abstract

<h4>Background</h4>Despite Hong Kong's world leading longevity, little is known about its associated disability burden and social patterning. Hence, this study assessed the gender-specific secular trends and area-level inequalities in life expectancy (LE) and disability-free life expectancy (DFLE) at age 65 in Hong Kong.<h4>Methods</h4>Population structure, death records, and disability data in 2007, 2013, and 2020 were retrieved from the Census and Statistics Department to estimate LE and DFLE using the Sullivan Method. District-based sociodemographic indicators were used to compare LE and DFLE across 18 districts of Hong Kong in 2013.<h4>Findings</h4>Between 2007 and 2020, LE at age 65 increased by 3.7 years (from 18.3 to 22.0) in men and by 2.1 years (from 22.7 to 24.8) in women. By contrast, DFLE increased more slowly, by 1.8 years (from 14.6 to 16.3) in men and by only 0.1 year (from 16.4 to 16.5) in women, leading to a substantial increase in proportion of life spent with disability. Results from multiple linear regression using district-based data in 2013 showed a similar extent of associations of education with LE and DFLE (mean year difference: 0.81 [95% CI: 0.14, 1.48] and 0.68 [0.10, 1.27], respectively, per 10% increase in average education level), while female gender was more strongly associated with LE (4.44 [3.56, 5.31]) than with DFLE (2.00 [1.18, 2.82]).<h4>Interpretation</h4>Expansion of disability burden and male-female health-survival paradox hold true in Hong Kong. Unlike Western countries with a stronger socioeconomic patterning of DFLE, the extent of area-level socioeconomic inequalities in LE and DFLE appears to be more comparable in Hong Kong.<h4>Funding</h4>Health and Medical Research Fund (Ref. no.: 19202031) by the Health Bureau of Hong Kong.

Item Type:	Article
Uncontrolled Keywords:	Disability-free life expectancy, Gender, Hong Kong, Inequality, Life expectancy, Older adults, Socioeconomic factor, Trend
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	09 Apr 2024 09:53
Last Modified:	09 Apr 2024 13:52
DOI:	10.1016/j.lanwpc.2023.100909
Open Access URL:	https://doi.org/10.1016/j.lanwpc.2023.100909
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3180206