office for national statistics university of leeds, 21-23 march 2007 domenica rasulo

Office for National StatisticsOffice for National Statistics

University of Leeds, 21-23 March 2007University of Leeds, 21-23 March 2007

Domenica RasuloDomenica Rasulo

Hosting research instituteHosting research institute

CASS Business SchoolCASS Business School

Faculty of Actuarial Science and InsuranceFaculty of Actuarial Science and Insurance

City UniversityCity University

MENTORS:MENTORS:

Prof. Les Mayhew Prof. Les Mayhew

Dr. Ben RickayzenDr. Ben Rickayzen

MENTOR at ONS:MENTOR at ONS:

Dr. M. Bajekal Dr. M. Bajekal

12 months part-time fellowship (start date: 1 April 2007).12 months part-time fellowship (start date: 1 April 2007).

The DFLE provides the number of expected years of life The DFLE provides the number of expected years of life

without limiting illness affecting normal daily activities.without limiting illness affecting normal daily activities.

It is computed using period life tables and disability-free It is computed using period life tables and disability-free

rate fromrate from

surveys (Sullivan 1971):surveys (Sullivan 1971):

Disability-free life expectancy (DFLE)Disability-free life expectancy (DFLE)

For each age band, the number of survivors – For each age band, the number of survivors –

provided by period life tables provided by period life tables –– is multiplied by the is multiplied by the

disability-free rate to obtain the number of survivors disability-free rate to obtain the number of survivors

free-of disability.free-of disability.

tt t+nt+n

ΔΔt,t+nt,t+n disability-free life expectancy disability-free life expectancy

ΔΔ disability rates disability rates

ΔΔ causes of disability causes of disability

ΔΔ mortality rates mortality rates

Change in DFLE: Underlying factorsChange in DFLE: Underlying factors

A recent study has provided a method to disentangle A recent study has provided a method to disentangle

these effects (these effects (Nusselder & Looman 2004Nusselder & Looman 2004).).

This method has not been applied in UK yet.This method has not been applied in UK yet.

Changes in DFLE in Great Britain and Changes in DFLE in Great Britain and England between 1991 and 2001. England between 1991 and 2001.

Great Britain England Indices

Males Females Males Females

AT BIRTH

Disability-free life expectancy1991 59.1 61.6 59.4 61.8


Difference 1.4 1.1 1.4 1.1

AT AGE 65



Difference 0.9 0.8 0.9 0.8

Source: Office for National Statistics.

Research proposalResearch proposal

Quantify the change in disability rate underlying the change Quantify the change in disability rate underlying the change

in DFLE observed in England in the period 1991-2001.in DFLE observed in England in the period 1991-2001.

Identify the causes of disability most responsible for the Identify the causes of disability most responsible for the

change in DFLE.change in DFLE.

Identify the age bands whose change in causes of disability Identify the age bands whose change in causes of disability

most contributed to the change in DFLE.most contributed to the change in DFLE.

DataData

Number of deaths by cause, age and sex and population at Number of deaths by cause, age and sex and population at

risk forrisk for

each year in the period 1991-2001 (each year in the period 1991-2001 (Office for National Office for National

StatisticsStatistics))..

The Health Survey for England from 1991 to 2001 which The Health Survey for England from 1991 to 2001 which

includes includes

questions on limiting-long term illness and causes of illness questions on limiting-long term illness and causes of illness

for eachfor each

year.year.The General Household Survey for the available years in the The General Household Survey for the available years in the

decade (i.e., 1991-1996, 2001) to validate findings based on decade (i.e., 1991-1996, 2001) to validate findings based on

HsfE.HsfE.

MethodsMethods

Cause-specific death rates and cause-specific disability rates Cause-specific death rates and cause-specific disability rates

from 1991from 1991

to 2001 (ICD10 used as reference).to 2001 (ICD10 used as reference).

Disability-free life expectancy from 1991 to 2001. Disability-free life expectancy from 1991 to 2001.

Nusselder & Looman’s method (2004) to investigate the change in DFLE:Nusselder & Looman’s method (2004) to investigate the change in DFLE:

The method decomposes a difference in DFLE in the effect of mortalityThe method decomposes a difference in DFLE in the effect of mortality

and disability. and disability.

The effects of mortality and disability are further decomposed by causes The effects of mortality and disability are further decomposed by causes

of death and disability. of death and disability.

Comparison of the results using the HsfE and the GHS.Comparison of the results using the HsfE and the GHS.

Policy relevancePolicy relevance

Research findings will help to understand:Research findings will help to understand:

The relationship between an ageing population and the demand for The relationship between an ageing population and the demand for

healthhealth

care.care.

Whether the increase of DFLE will increase the pressure on health Whether the increase of DFLE will increase the pressure on health

andand

social care system.social care system.

Which causes of disability have mostly contributed to the change in DFLEWhich causes of disability have mostly contributed to the change in DFLE

in the period 1991-2001 and these results may facilitate priority-setting inin the period 1991-2001 and these results may facilitate priority-setting in

health.health.

NetworkingNetworking

The fellowship will enable skills to be transferred from The fellowship will enable skills to be transferred from

academia to government departments. academia to government departments.

Seminars will be organised at the Office for National Seminars will be organised at the Office for National

Statistics to meet the wider community of government Statistics to meet the wider community of government

departments (DWP, DH, GAD). departments (DWP, DH, GAD).

Networking opportunities will be expanded by participation Networking opportunities will be expanded by participation

at conferences in 2007 and 2008 (e.g., BSPS, REVES, at conferences in 2007 and 2008 (e.g., BSPS, REVES,

European Population Conference). European Population Conference).

office for national statistics university of leeds, 21-23 march 2007 domenica rasulo

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