The Healthy Life Years (HLY) indicator, also known as disability-free life expectancy (DFLE) or Sullivan's Index, is a European structural indicator computed by Eurostat. It is one of the summary measures of population health, known as health expectancies, composite measures of health that combine mortality and morbidity data to represent overall population health on a single indicator. HLY measures the number of remaining years that a person is expected to live at a certain age without the disability.
History
The European Union has decided to include a small set of health expectancies among its European Community Health Indicators (ECHI) to provide synthetic measures of disability, chronic morbidity, and perceived health. Therefore the Minimum European Health Module (MEHM), composed of 3 general questions covering these dimensions, has been introduced into the Eurostat EU-Statistics on Income and Living Conditions Survey (EU-SILC) to improve the comparability of health expectancies between countries. In addition life expectancy without long term activity limitation, based on the disability question, was selected in 2004 to be one of the structural indicators to be examined every year, during the European Spring Council for assessing the EU strategic goals (Lisbon Strategy) under the name of “Healthy Life Years” (HLY). Furthermore the European Union is co-funding a Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (CHRODIS-JA). This aims to promote and facilitate a process of exchange and transfer of good practices between European countries and regions, addressing chronic conditions, with a specific focus on health promotion and prevention of chronic conditions, multi-morbidity and diabetes.
Detailed information on the Health Expectancies in Europe are available from the EurOhex Advanced research on European health expectancies while latest Healthy Life Years values can be found on the general public website devoted to the Healthy Life Years.
Context
The dramatic increase in the life expectancy in the most developed countries in general and in the countries of the European Union in particular represents one of the most significant achievements of recent decades. The further challenge confronts the European Community: "increasing life expectancy must be by the increase of its part spent in "good" health".
In this context, the classical mortality indicators are no longer sufficient to monitor the health status of the populations of the European countries. The availability of health expectancy indicators dividing life expectancy into life spent in different states of health is useful to health authorities in the field of public health and health policies provided that these indicators allow comparisons over time, between geographic areas and between socio-economic groups. As the post-war generation reaches the retirement age, the pace of ageing increases dramatically, with the profound societal effects. HLY is an important indicator which is based on the following assumptions: Many studies focus on such measures as physical impairment or disability in functional tasks or presence of a specific chronic disease. Self-assessed health, being much more global and subjective in nature, can incorporate a variety of aspects of health including cognitive and emotional as well as physical status, and therefore provide insights into the needs of an ageing society. Therefore, self-assessed health measures as HLY may be a particularly important indicator of the potential demand for health services and long-term care needs. The two components of the calculation of the HLY are life tables and self-perceived disability assessed by health surveys. From 1995 to 2001, data from the Eurostat European Community Household Panel (ECHP) survey have been used for the EU-15 Member States. Its successor, the Eurostat EU-SILC has been used from 2005 onwards for the EU-25 and then 27 Member States. The analysis of the healthy life years values disclose significant inequalities in between the European countries.