Author: The Korea Institute for Health and Social Affairs (South Korea)
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CHAPTER 1 Introduction CHAPTER 2 Literature review of the methods and results of estimation of healthy life expectancy 1. Mathers et al. (2003) 2. Loukine et al. (2011) 3. Kaplan et al. (2007) 4. van Baal et al. (2006) 5. Manuel et al. (2004) CHAPTER 3 Estimation of life expectancy and health life expectancy 1. Method and result of the analysis of healthy life expectancy 2. Method and result of HALE analysis 3. Health-related Quality of Life 4. Health-adjusted life expectancy CHAPTER 4 Expected effects of obesity control on life expectancy and healthy life expectancy 1. Analysis method 2. Analysis variables CHAPTER 5 Conclusion 1. Results of the estimation of life expectancy and healthy life expectancy 2. Changes in healthy life expectancy depending on variations in incidence rates References Many advanced countries have set out national initiatives for improving their people's health and pursued strategies for nationwide health promotion since the 1980s. Examples of such initiatives include ‘Healthy People' of the US, ’Our Healthier Nation' of the UK, ‘Healthy Japan 21’ of Japan, and ‘Better Health Commission' of Australia. The goals of these plans is to help people have longer healthy lives and eliminate health disparities. South Korea's third national health promotion plan--'National Health Plan 2020' (HP 2020, '11~20)--intends to increase healthy life expectancy for Koreans to 75 by 2020. Healthy life expectancy, a basic health measure of HP 2020 is the number of years a person can expect to live without diseases or injuries, which is a measure of a population's health that focuses on how many years a person might live in a healthy state rather than just how many years they might be expected to live. Such improvement in the quality of life cannot be achieved without a social environment that promotes good health for all. While infectious diseases took up a large portion of the global burden of disease in the past, rapidly increasing chronic diseases account for a larger portion these days. Therefore, it is necessary to increase healthy life expectancy by reducing the burden of chronic diseases through prevention and appropriate management. Of such health risk factors causing chronic illness as smoking, drinking and obesity, this research is about obesity. In the US, the cost of obesity-related diseases accounted for 5.5%--7.8% of the total medical expenditure (as of 1998)1) --while in Canada 2.5% (as of 1999) of the total medical cost is caused by a lack of exercise.2) In Korea, obesity makes up about 6% of the medical cost of adults 20 or older for the national health insurance plan.3) This study intends to estimate the life expectancy and healthy life expectancy of the Korean people, and measure the effects of the control of obesity, a major health risk factor, thereby analyzing the relationship between chronic illness, life expectancy, and healthy life expectancy. Based on the results, this study explores the current state of Koreans' healthy life expectancy (2009) and the effects of obesity control, providing the basis for attaining the goals of Korea's national health promotion plan. This paper is composed of five chapters. Chapter 1 is the introduction, and Chapter 2 reviews existing literature related to healthy life expectancy in to help the reader to understand the indicator. In Chapter 3, Koreans' life expectancy and healthy life expectancy as of 2009 are estimated. First, the number of deaths, population, and life table released by the Korean Statistical Information Service (KOSIS) are used to calculate life expectancy, and then the health-related quality of life data out of the nationwide survey, Korea Health Panel (KHP) is utilized to measure healthy life expectancy. Chapter 4 presents analysis of the effects of obesity control on life expectancy and healthy life expectancy. A multi-state simulation model and the Sullivan method are applied to estimate healthy life expectancy. The Sullivan method, a widely used method to calculate healthy life expectancy, is useful in estimating the average healthy life expectancy of the population, while the multi-state model is good for computing the healthy life expectancy of a specific age group or subgroup with a certain health status (Lee Seung-wook et al., 2007). Next, the Markov Model is used for dynamic analysis of the life expectancy and healthy life expectancy of those with obesity and those of normal weight. Chapter 5 is the conclusion and summarizes the results of the analyses of this study and discusses its limitations and research tasks for the future.