Disability Free Life Expectancy (2011) in Goa: Some Implications For Health Policy Dr. M.S. Kulkarni Associate Professor in Statistics & Demography Goa Medical College, Bambolim-Goa

Introduction : India is presently experiencing health transition with more burden due to non communicable diseases and also increase in life expectancy Life expectancy is the number of years that a person of a particular age can expected to survive under existing mortality rates. Focus on indicators of the quality of life lived (life spent in a healthy state) rather than on the quantity (life expectancy). Disability Free Life Expectancy (DFLE) is the extension of life expectancy proposed by Sullivan (1971). DFLE is an important summary measure of population health status combining longevity with functional health status.

DFLE represents the expected number of years of remaining disability-free life a member of the life table cohort Population ageing & growth in numbers of the very old, LE increases will necessarily mean better population health overall. Health expectancies such as disability-free life expectancy (DFLE) are useful for monitoring trends and inequalities in population health.

Objectives : To calculate the life expectancy and disability free life expectancy for the state of Goa To find the differentials in life expectancy and disability free life expectancy by gender.

Material and methods: The data for present study includes all the registered deaths in the state of Goa for the year 2011 was collected from Annual Reports of Registered Births & Deaths (RBD), Department of Planning & Statistics, Panaji, Goa. Age and sex-specific disabled persons and population of Goa was collected from 2011 census. The Life expectancy was calculated by Reed- Merrill and Greville Abridge life table method and Disability free life expectancy was calculated by Sullivan’s method.

Material and methods: To calculate life expectancy age & sex specific mortality was calculated . Disability free life expectancy was calculated by Sullivan’s method, which utilizes the mortality data from a period life table and the disability prevalence data from a cross sectional survey. Disability free life expectancy was calculated by Sullivan’s method LE = ΣLx/lx Lx= No. of years lived in (x, x+n) DFLE= Σ(1-px)Lx/lx lx = Survivor aged x px = Prob. of disability in (x, x+n)

Background Characteristics Population (2011) 14.58 lakh Sex ratio - 973 Females / 1000 Males CBR – 15.08 LB /1000 Popln, CDR – 7.8 Deaths /1000 Popln IMR – 8.55 Infant deaths /1000 live births Disability Rate – 2. 26 %

Life expectancy at age x Life Expectancy Goa (2011) : Combined Population   Dx Px Mx nQx lx ndx nLx Tx ex Age group (Years) Deaths Population Death rate Prob of dying between ages x to x+n Number surviving to age x Number dying between ages x to x+n person-years lived between ages x to x+n Total No. of person-years lived above age x Life expectancy at age x 0-4 224 1,01,203 0.002 0.011 1,00,000 1,101.0752 4,97,464.8 74,58,966 74.6 5-14 68 2,16,957 0.000 0.003 98,899 309.5676 9,87,689.0 69,61,501 70.4 15-24 328 2,44,620 0.001 0.013 98,589 1,314.5354 9,80,370.9 59,73,812 60.6 25-34 529 2,58,485 0.020 97,275 1,973.7952 9,64,454.5 49,93,441 51.3 35-44 826 2,34,810 0.004 0.035 95,301 3,303.5949 9,39,124.9 40,28,986 42.3 45-54 1199 1,71,328 0.007 0.068 91,997 6,254.1581 8,93,671.7 30,89,862 33.6 55-65 1623 1,26,657 0.122 85,743 10,425.0619 8,13,559.5 21,96,190 25.6 65-70 1061 41,019 0.026 75,318 9,187.7202 3,55,203.7 13,82,630 18.4 70+ 4085 63,466 0.064 1.000 66,130 66,130.4915 10,27,426.6 10,27,427 15.5

Disability Free Life Expectancy Goa (2011) : Combined Population Age group Prob Disability (1-p)Lx Tx' DFLE 0-4 0.010 492648 7239494 72.4 5-14 0.014 973408 6746847 68.2 15-24 0.015 965190 5773439 58.6 25-34 0.021 944418 4808249 49.4 35-44 0.019 921527 3863831 40.5 45-54 0.027 869417 2942304 32.0 55-65 0.033 786325 2072888 24.2 65-70 0.032 343981 1286563 17.1 70+ 0.083 942582 14.3

Life expectancy at age x Life Expectancy Goa (2011) : Male   Dx Px Mx nQx lx ndx nLx Tx ex Age group (Years) Deaths Population Death rate Prob of dying between ages x to x+n Number surviving to age x Number dying between ages x to x+n person-years lived between ages x to x+n Total No. of person-years lived above age x Life expectancy at age x 0-4 148 52,017 0.003 0.014 1,00,000 1,413 4,96,745 70,39,050 70.4 5-14 45 1,12,089 0.000 0.004 98,587 395 9,84,207 65,42,306 66.4 15-24 237 1,30,691 0.002 0.018 98,192 1,767 9,74,490 55,58,099 56.6 25-34 421 1,31,215 0.032 96,424 3,053 9,51,414 45,83,609 47.5 35-44 650 1,19,045 0.005 0.053 93,372 4,984 9,12,763 36,32,195 38.9 45-54 900 86,649 0.010 0.100 88,388 8,796 8,46,870 27,19,432 30.8 55-65 1111 61,121 0.169 79,592 13,439 7,39,345 18,72,562 23.5 65-70 599 19,005 0.147 66,153 9,711 3,08,102 11,33,217 17.1 70+ 1868 27,308 0.068 1.000 56,442 8,25,115 14.6

Disability Free Life Expectancy Goa (2011) : Male Age group Prob Disability (1-p)Lx Tx' DFLE 0-4 0.010 491877 6840857 68.4 5-14 0.014 969976 6348981 64.4 15-24 0.015 959400 5379005 54.8 25-34 0.021 931648 4419605 45.8 35-44 0.019 895420 3487956 37.4 45-54 0.027 823885 2592536 29.3 55-65 0.034 714355 1768651 22.2 65-70 0.035 297319 1054296 15.9 70+ 0.083 756977 13.4

Life expectancy at age x Life Expectancy Goa (2011) : Female   Dx Px Mx nQx lx ndx nLx Tx ex Age group (Years) Deaths Population Death rate Prob of dying between ages x to x+n Number surviving to age x Number dying between ages x to x+n person-years lived between ages x to x+n Total No. of person-years lived above age x Life expectancy at age x 0-4 76 49,186 0.002 0.008 1,00,000 770 4,98,228 79,28,699 79.3 5-14 23 1,04,868 0.000 99,230 217 9,91,388 74,30,471 74.9 15-24 91 1,13,929 0.001 99,013 788 9,86,816 64,39,083 65.0 25-34 108 1,27,270 98,225 831 9,78,756 54,52,266 55.5 35-44 176 1,15,765 0.015 97,394 1,471 9,67,758 44,73,510 45.9 45-54 299 84,679 0.004 0.035 95,923 3,337 9,45,199 35,05,752 36.5 55-65 512 65,536 0.076 92,585 7,003 8,96,396 25,60,554 27.7 65-70 462 22,014 0.021 0.100 85,582 8,563 4,08,021 16,64,158 19.4 70+ 2217 36,158 0.061 1.000 77,019 12,56,137 16.3

Disability Free Life Expectancy Goa (2011) Female Age group Prob Disability (1-p)Lx Tx' DFLE 0-4 0.010 493403 7683506 76.8 5-14 0.014 977054 7190103 72.5 15-24 0.015 971535 6213049 62.8 25-34 0.021 958423 5241514 53.4 35-44 0.019 949624 4283092 44.0 45-54 0.027 919545 3333468 34.8 55-65 0.033 866388 2413923 26.1 65-70 0.032 395129 1547535 18.1 70+ 0.083 1152406 15.0

Summary: Life Expectancy & Disability Free Life Expectancy Life Expectancy at Birth Disability Free Life Expectancy at Birth Life Expectancy at 65 years Disability Free Life Expectancy at 65 years Male 70.4 68.4 (2.0) 17.1 15.9 (1.2) Female 79.3 76.8 (2.5) 19.4 18.1 (1.3) Combined 74.6 72.4 (2.2) 18.4 17.1 (1.3)

Implications of the findings : The life expectancy at birth and at the age of 65 years was more for females compared to males. There is a further need of measuring differentials in DFLE due to other socio-economic characteristics. Increase in life expectancy with higher disability life expectancy requires access to high quality rehabilitation interventions and coverage of social security measures.

Questions Canvassed in Census 2011 Codes