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Decomposition of Differentials in Health Expectancies From Multistate Life Tables: A Research Note
Tianyu Shen1, Tim Riffe2,3,4, Collin F Payne1,5
1School of Demography, Australian National University, Canberra, Australia.
Demography
|November 17, 2023
Summary
A new derivative-based method decomposes differences in healthy life expectancy (HLE). Sex gaps in HLE are mainly due to differing transition rates between disability states, not initial health status.
Area of Science:
- Demography
- Biostatistics
- Epidemiology
Background:
- Multistate modeling is crucial for calculating healthy life expectancy (HLE).
- Existing methods lack analytical approaches to decompose summary measure differentials.
- Decomposition is vital for understanding factors influencing HLE disparities.
Purpose of the Study:
- To introduce a novel derivative-based analytical method for decomposing differentials in health expectancies.
- To identify the contributions of initial health structure and transition rates to these differentials.
- To apply the method to understand the sex differential in disability-free life expectancy.
Main Methods:
- Developed a derivative-based analytical framework for multistate models.
- Applied the method to U.S. Health and Retirement Study data on activities of daily living.
- Decomposed the sex differential in disability-free life expectancy (HLE).
Main Results:
- The proposed method successfully decomposes HLE differentials into two components.
- Sex differences in HLE are primarily driven by variations in transition rates between disability states.
- Initial health distribution differences contribute less to the observed sex gap in HLE.
Conclusions:
- The derivative-based method provides a robust way to analyze HLE differentials.
- Transition rates, not initial health structure, are the main drivers of the sex gap in HLE.
- This methodology is applicable across various fields analyzing state-specific life expectancies.
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