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Gender differences in healthy life years within the EU: an exploration of the "health-survival" paradox

Lookup NU author(s): Emerita Professor Carol Jagger



To evaluated the female-male health-survival paradox by estimating the contribution of women's mortality advantage versus women's disability disadvantage. Disability prevalence was measured from the 2006 Survey on Income and Living Conditions in 25 European countries. Disability prevalence was applied to life tables to estimate healthy life years (HLY) at age 15. Gender differences in HLY were split into two parts: that due to gender inequality in mortality and that due to gender inequality in disability. The relationship between women's mortality advantage or disability disadvantage and the level of population health between countries was analysed using random-effects meta-regression. Women's mortality advantage contributes to more HLY in women; women's higher prevalence of disability reduces the difference in HLY. In populations with high life expectancy women's advantage in HLY was small or even a men's advantage was found. In populations with lower life expectancy, the hardship among men is already evident at young ages. The results suggest that the health-survival paradox is a function of the level of population health, dependent on modifiable factors.

Publication metadata

Author(s): Van Oyen H, Nusselder W, Jagger C, Kolip P, Cambois E, Robine JM

Publication type: Article

Publication status: Published

Journal: International Journal of Public Health

Year: 2013

Volume: 58

Issue: 1

Pages: 143-155

Print publication date: 22/05/2012

Date deposited: 03/04/2013

ISSN (print): 1661-8556

ISSN (electronic): 1661-8564

Publisher: Birkhäuser Basel


DOI: 10.1007/s00038-012-0361-1


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Funder referenceFunder name
2006 109European Public Health Programme (EHLEIS)