Search

Background In 2005, the European Union (EU) started to use a disability-free life expectancy, known as Healthy Life Years (HLY), to monitor progress in the strategic European policies such as the 2000 Lisbon strategy. HLY are based on the underlying measure: the Global Activity Limitation Indicator (GALI). Twelve years after its implementation, this study aims to assess its current use in EU Member States and the European Commission. Methods In March 2017, a questionnaire was sent to 28 Member states and the European Commission. The questionnaire inquired how the GALI and HLY are used to set policy targets, in which surveys the GALI has been introduced since 2005, how the GALI and HLY are presented, and what the capacity in each country is to investigate the GALI and HLY. Results The survey was answered by 22 Member States and by the Commission. HLY are often used to set targets and develop strategies in health such as national health plans. Analysis of HLY has even led to policy change. In some countries, HLY have become the main indicator for health, gaining more importance than life expectancy. More recently, the GALI and HLY have also been used for policy targets outside the health sector such as in the area of pension and retirement age or in the context of sustainable development. Regarding surveys, the GALI is mostly obtained from the EU-SILC, SHARE and EHIS, but is also increasingly introduced in national surveys. National health reporting systems usually present HLY on their national statistics websites. Most countries have up to three specialists working on the GALI and HLY, which has been consistent through time. Others have increased their capacity over various institutions. Conclusion HLY is an indicator that is systematically used to monitor health developments in most EU countries. The SHARE, EU-SILC and EHIS are commonly used to assess HLY through the GALI. The results are then described in reports and presented on national statistics websites and used in different policy settings. Expertise to analyse the GALI and HLY is available in most countries. Electronic supplementary material The online version of this article (10.1186/s13690-018-0279-z) contains supplementary material, which is available to authorized users.

Background The objective of this paper is to provide analytical research that supported the European Commission in setting the global target of additional two healthy life years (HLY) at birth by 2020 in the EU on average, within the European Innovation Partnership on Active and Healthy Ageing (the EIP on AHA). It produces a straightforward analysis of HLY projections that helped the European Commission set a firm, politically sound, target. In order to reach that goal, policy makers need to commit to redefining health priorities and goals and developing and implementing relevant strategies and programmes. Methods The study computes a simple simulation of the HLY at birth based on three demographic scenarios: compression of morbidity, expansion of morbidity and an intermediary scenario, the dynamic equilibrium, given the expected 2.1 year gain in male and 1.6 in female life expectancy (LE) by 2020. Data on HLY and projections of life expectancy were obtained from Eurostat and 2008 was taken as a baseline. For consistency and given data gaps, EU27 average values of HLY were calculated. Results In the EU27 as a whole, the difference between LE and HLY in 2008 was nearly 15 years for men and 20 years for women. The developments of healthy life expectancies across the EU Member States (MSs) are even more diverse that makes it difficult to model any robust EU level trends. Under compression of morbidity, life expectancy and HLY would increase by 2020 on average by 2.1 and 2.0 years for men and by 1.6 and 1.4 years for women respectively. The expected years with disability would remain unchanged while the HLY/LE ratio would improve leading to a 0.5% gain for both genders. Under expansion of morbidity, life expectancy would increase by 2.1 years for men and 1.4 years for women by 2020, while HLY would remain unchanged and the expected years with disability would increase by 2.1 years and 1.6 years in women. This would imply the deterioration of the HLY/LE ratio for both men and women generating a 2.2% and 1.4% loss of health for men and women accordingly. Under dynamic equilibrium, the HLY would increase but to a lesser extent as the rise in life expectancy. The HLY would increase by 1.6 and 1.2 years for men and women respectively. HLY/LE ratio would remain unchanged for both men (+0.1%) and women. The study shows that the first scenario would reduce the HLY gap between the EU MSs by 1.4 years in men and 1.2 years in women, the second would generate no change, while the third one would reduce the gap by 0.9 years in men and increase it by 0.7 years in women. Conclusions The results of the study triggered the political decision of setting the global target of 2 additional HLY for the European Innovation Partnership on Active and Healthy Ageing to be achieved by 2020. It is a ‘grand’ goal but can be achieved. Statistics clearly show that EU countries characterise very different levels of health progress, with a gap of 2 decades and diverging trends. With this in mind, the EU HLY target should be complemented by national HLY targets for men and women, set by MSs.