SOCIOECONOMIC INEQUALITIES IN HEALTH EXPECTANCY IN FINLAND AND NORWAYIN THE LATE 1980S

Studies on health inequalities have usually focused either on mortalit y or on morbidity. This concerns national studies as well as internati onal comparisons of health inequalities. This paper seeks to bridge th e gap by applying health expectancy as a synthetic overall measure of health. The purpose of the study is to compare socioeconomic inequalit ies in health expectancy in Finland and Norway in the late 1980s. Addi tionally, the major methodological issues in the use of health expecta ncy in the study of health inequalities are identified. Data on mortal ity by level of education derive from linked national follow-up studie s (1986-1990) of population censuses. Data on the prevalence of morbid ity by level of education derive from nationally representative survey s of the noninstitutionalised adult population in 1985/87. Persons age d 25-74 years were included. Four measures of morbidity were used: lim iting long-standing illness, extremely limiting long-standing illness, functional disabilities and perceived less than good health. The asso ciation between mortality/morbidity and level of education in each 5-y ear age/sex group was determined by a regression-based method. Partial life expectancies and partial health expectancies for ages 25-74 were then calculated by using the mortality quotients and morbidity preval ences predicted by the regression model for those at the top and the b ottom of the educational hierarchy in each 5-year age group, using an application of the method first presented by Sullivan. Although variou s measures of health expectancy were used, the result were consistent. In absolute terms the size of socioeconomic inequalities in health ex pectancy in Finland and Norway is on the same level. In relative terms , however, the size of inequalities in health expectancy is greater in Norway. If one considers premature mortality to be more severe than a ny indicator of morbidity, the mortality-morbidity mix of the health i nequalities is less favourable to Finland, since the size of absolute inequalities in mortality is greater in Finland. Health expectancy mea sures provide a promising measure for assessing and comparing the patt ern and the size of health inequalities. (C) 1998 Elsevier Science Ltd . All rights reserved.