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

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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Author(s)

  • Gary Ka-ki Chung
  • Michael Marmot
  • Irene Yuk-Ying Ho
  • Eric Tsz-Chun Lai
  • Samuel Yeung-Shan Wong
  • Eng-kiong Yeoh
  • Jean Woo
  • Roger Yat Nork Chung

Detail(s)

Original languageEnglish
Article number100909
Journal / PublicationThe Lancet Regional Health - Western Pacific
Volume41
Online published22 Sept 2023
Publication statusPublished - Dec 2023

Link(s)

Abstract

Background 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.
Methods 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.
Findings 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]).
Interpretation 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.
Funding Health and Medical Research Fund (Ref. no.: 19202031) by the Health Bureau of Hong Kong.
© 2023 The Author(s). Published by Elsevier Ltd.

Research Area(s)

  • Disability-free life expectancy, life expectancy, Hong Kong, Socioeconomic factor, Trend, Gender, Inequality, Older adults

Citation Format(s)

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; Ho, Irene Yuk-Ying et al.
In: The Lancet Regional Health - Western Pacific, Vol. 41, 100909, 12.2023.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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