HEALTH EXPECTANCY IN RUSSIAN FEDERATION: GENDER DIFFERENCES AND CROSS-COUNTRY COMPARISONS Ramonov Alexander, post-graduate student, Higher School of Economics, Russia

2 HEALTH SUMMARY MEASURES T( x) DFLE T( x) DALE DALE – Disability Adjusted Life Expectancy DFLE – Disability Free Life Expectancy DALYs – Disability Adjusted Life Years HALE – Health Adjusted Life Expectancy Tx = A + B = T(x) DFLE + T(x) DALE DALE = T(x) DALE / l(x) DFLE = T(x) DFLE / l(x) f – DALE weighting function 1.HEALTHY LIFE EXPECTANCY DALYs = C + g(B) [Murray, Lopez, 1996] C (years of life lost due to excess mortality) = T(x) MODEL - T(x) B - years of life lost due to morbidity g – DALYs weighting function 2.BURDEN OF BAD HEALTH

3 HEALTH SUMMARY MEASURES CONTRIBUTION AND METHODOLOGY  Healthy life expectancy in Russian Federation was estimated: - Andreev, shkolnikov, McKee [Andreev et all., 2003 ]. Data: RLMS, WVS, Self-perceived health indicator. - WHO estimates for 199 countries including Russia in 2002 and 2007[Mathers et all, 2000] - Komarov et all – 1997, handicap free life expectancy estimates. - Martin Bobak [Bobak et all., 2004]: Healthy life expectancy in Russia and Sweden, cross-country comparisons using self rated health and disability indicators  Contribution: - HALE estimates were made using different health indicators and 2 national representative surveys for the same year (2004). Cross-sectional study. - Data: 1) Life table indicators (life table statistics for 2004). 2) RLMS (13 wave, 2004, sample size = individuals 3) GGS, (1 st wave, Sample size = individuals).

4 HEALTH SUMMARY MEASURES METHODOLOGY Health indicators in RLMS and GGS Self-rated health Chronic diseases How is your health in general? «Very good» + «Good» + «Average» = «Good health» «Very bad» + «Bad» = «Bad health» GGS: Do you have any chronic diseases? Heart chronic disease Lung chronic disease Liver chronic disease Spine chronic disease Other chronic diseases RLMS: variable was created from: Methods: Sullivan’s health expectancy Healthy life expectancy decomposition [Andreev, Shkolnikov,Begun, 2002] Monte-Carlo simulations for 95% confidence intervals estimates

5 HEALTH SUMMARY MEASURES DESCRIPTIVES How is your health in general? SampleMalesFemales RLMS, N = GGS, N = RLMS, N = 5579 GGS, N = 4223 RLMS, N = 7062 GGS, N = 7038 Very good1,82,82,64,71,21,5 Good34,828,642,036,429,123,6 Fair50,552,146,646,953,555,5 Bad10,614,57,110,613,317,0 Very Bad1,92,01,11,42,4 Presence/absence of chronic diseases SampleMalesFemales RLMS, N = GGS, N = RLMS, N = 5579 GGS, N = 4223 RLMS, N = 7062 GGS, N = 7038 Yes 44,839,237,630,950,444,6 No 55,260,662,468,949,655,2

6 HEALTH SUMMARY MEASURES DESCRIPTIVES Share of respondents rating their health as poor and having chronic diseases among males (estimates from GGS and RLMS data 2004), males

7 HEALTH SUMMARY MEASURES DESCRIPTIVES Share of respondents rating their health as poor and having chronic diseases among males (estimates from GGS and RLMS data 2004), females

8 HEALTH SUMMARY MEASURES HALE (SELF-RATED HEALTH) Healthy Life Expectancy among Russian males and females estimated using data on self- rated health, RLMS and GGS surveys data, 2004

9 HEALTH SUMMARY MEASURES HALE (CHRONIC MORBIDITY) Healthy Life Expectancy among Russian males and females estimated using data on chronic morbidity, RLMS and GGS surveys data, 2004

10 HEALTH SUMMARY MEASURES CROSS-COUNTRY COMPARISONS LE e(x) and HALE H(x) of Russian, Western and Eastern European countries male and females aged 50

11 HEALTH SUMMARY MEASURES Female-male difference in e(30) = 11,8years Female-male difference in eH(30) = 5,5 years HALE DECOMPOSITION (SELF-RATED HEALTH)

12 HEALTH SUMMARY MEASURES HALE DECOMPOSITION (CHRONIC MORBIDITY) Female-male difference in e(30) = 11,8years Female-male difference in eH(30) = -0,74 years