Prevalence of bad self-rated health and healthy life expectancy in Russia and EU: dynamics, cross-country and cross-survey comparison»
A report by Alexander Ramonov at the regular LCSR seminar
On March 16th Alexander Ramonov (research fellow at the Institute of Demography, HSE) delivered a report on «Prevalence of bad self-rated health and healthy life expectancy in Russia and EU: dynamics, cross-country and cross-survey comparison» at the regular LCSR seminar.
Life expectancy is considered to be one of the main indicators of socio-economic development and is a part of an integral Index of Human Potential Development that is a very popular measure of the level of society’s well-being. Alexander suggests an advanced method of life expectancy measurement that corrects country-level life expectancy scores with the respect to particular average scores for groups with different health quality (including so-called ‘healthy life’ expectancy).
Demographists, sociologists and epidemiologists who try to evaluate average level of population health inevitably face various theoretical and conceptual problems. How is it possible to measure someone’s health? Is the absence of diagnosed illnesses enough to conclude that a person is healthy? One of the most widespread methods of health assessment is individual self-evaluation of their health condition. However, this approach has one significant drawback: in cross-cultural studies subjective health evaluations can be skewed due to the effect of cultural traits of the countries. Traditionally, subjective health is measured through 5-category scale that includes the following categories: ‘excellent’, ‘good’, ‘average’, ‘poor’, and ‘very poor’. In some countries respondents tend to see the world in black and white and access their health in radical categories – either as excellent or very poor. At the same time, in other countries people prefer choosing moderate answers. Therefore, the same evaluation of subjective health in different countries may reflect various health level depending on prevalent response styles in these countries.
Alexander notices that the previous studies revealed that cultural differences among countries influence primarily individual choice between ‘excellent’, ‘good’ or ‘average’ health level. On the contrary, the choice of ‘poor’ and ‘very poor’ health levels indicates that the respondent has serious health problems and might belong to a risk category. The probability of death between two adjacent waves of study for those who have chosen these options is much higher. Thus, Alexander argues that indicators of healthy life expectancy should necessary reflect the share of these responses in different population groups.
The speaker constructs several indices of healthy life expectancy using data from the large cross-cultural surveys: ESS, EU-SILC и ECHP . The data on Russia are provided by RLMS-HSE. Alexander focuses on people who are older than 40 because after this age individuals much more often tend to give negative assessment to their health condition.
According to the results of Alexander’s analysis, the share of people who report poor and very poor health has been consistently decreasing in Europe since 1994 to 2010. The same trends are detected in different surveys that confirms reliability of this inference. Alexander has noted that in the last few years we can observe an improvement in women’s general health, and this trend is more evident in Russia than in the other European countries. From the other hand, Russia and Eastern European countries are characterized by higher male mortal rates and lower female healthy life expectancy. It is also worth noting that, despite overall life expectancy of Russian men is still rather low, their healthy life expectancy is at the same level as in Western Europe.