Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.

Life expectancy in Spain is among the highest in the world. Nevertheless, we do not know if improvements in health conditions at older ages have followed postponements of death. Previous studies in Spain show a stable trend in years lived in ill health in the past. In this paper we investigate chang...

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Main Authors: Pilar Zueras, Elisenda Rentería
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0240923
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spelling doaj-ace6cb55b4344a328899851ffba6a6c92021-03-23T05:31:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011511e024092310.1371/journal.pone.0240923Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.Pilar ZuerasElisenda RenteríaLife expectancy in Spain is among the highest in the world. Nevertheless, we do not know if improvements in health conditions at older ages have followed postponements of death. Previous studies in Spain show a stable trend in years lived in ill health in the past. In this paper we investigate changes between 2006, 2012 and 2017 in life expectancy with and without disease at age 65 in Spain and, for the first time, in Spanish regions, which have autonomous powers of health planning, public health and healthcare. Results show that, at the country level, disease-free life expectancy reduced between 2006 and 2017 in Spain. This was explained by an expansion of most diseases except for some cardiovascular and respiratory chronic conditions. However, at the regional level the evolution was different, especially regarding each disease and sex. First, regional differences reduced between 2006 and 2012 but largely widened in 2017, suggesting that not all regions had the same ability to recover after the 2008 financial crisis that caused government cuts to health services. Second, regional analysis also highlighted diverging trends by sex. While men experienced expansion of morbidity in most regions, women experienced a compression in about half of them, ending up with women showing higher disease-free life expectancies than men in 9 out of the 17 regions considered. This study, then, calls attention to the importance of focusing the analysis of health surveillance to more disaggregated levels, more in accordance with the level of health management, as regional trends showed heterogeneity in the prevalence of diseases and different progresses in the relationship between sexes.https://doi.org/10.1371/journal.pone.0240923
collection DOAJ
language English
format Article
sources DOAJ
author Pilar Zueras
Elisenda Rentería
spellingShingle Pilar Zueras
Elisenda Rentería
Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.
PLoS ONE
author_facet Pilar Zueras
Elisenda Rentería
author_sort Pilar Zueras
title Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.
title_short Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.
title_full Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.
title_fullStr Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.
title_full_unstemmed Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.
title_sort trends in disease-free life expectancy at age 65 in spain: diverging patterns by sex, region and disease.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2020-01-01
description Life expectancy in Spain is among the highest in the world. Nevertheless, we do not know if improvements in health conditions at older ages have followed postponements of death. Previous studies in Spain show a stable trend in years lived in ill health in the past. In this paper we investigate changes between 2006, 2012 and 2017 in life expectancy with and without disease at age 65 in Spain and, for the first time, in Spanish regions, which have autonomous powers of health planning, public health and healthcare. Results show that, at the country level, disease-free life expectancy reduced between 2006 and 2017 in Spain. This was explained by an expansion of most diseases except for some cardiovascular and respiratory chronic conditions. However, at the regional level the evolution was different, especially regarding each disease and sex. First, regional differences reduced between 2006 and 2012 but largely widened in 2017, suggesting that not all regions had the same ability to recover after the 2008 financial crisis that caused government cuts to health services. Second, regional analysis also highlighted diverging trends by sex. While men experienced expansion of morbidity in most regions, women experienced a compression in about half of them, ending up with women showing higher disease-free life expectancies than men in 9 out of the 17 regions considered. This study, then, calls attention to the importance of focusing the analysis of health surveillance to more disaggregated levels, more in accordance with the level of health management, as regional trends showed heterogeneity in the prevalence of diseases and different progresses in the relationship between sexes.
url https://doi.org/10.1371/journal.pone.0240923
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