Factors explaining the geographical differences in Disability Free Life Expectancy in Spain

Objective study the geographical variations in Disability Free Life Expecta ncy (DFLE) at birth (DFLEb) and at 65 years (DFLE65) in Spain and to identi fy the main factors that explain these variations. Design-Ecological study with the 50 provinces of Spain as the units of anal ysis. Sullivan's method is used to calculate DFLE for each province based o n information from the death registry and the survey on disabilities, impai rments and handicaps. Information on the independent variables-socioeconomi c level, factors related with the health system and risk factors-was taken from various sources. Main outcome measure-Simple correlation coefficients were obtained between each dependent variable (DFLEb and DLFE65) and the independent variables. T wo multiple linear regression models were fit to obtain the best set of fac tors that explain the geographical distribution of DFLEb and DLFE65. Results-Both DFLEb and DLFE65 vary widely among provinces. The multiple lin ear regression analysis shows that the illiteracy rate, the percentage of t he unemployed and the percentage of smokers in the population were the main factors associated with the geographical variation of DFLE. The models exp lained approximately 40% of the variance for DFLEb and 30% for DLFE65. Conclusions-The results obtained show the influence of education, the unemp loyment rate and smoking on the geographical differences of DFLE. The DFLE indicators are shown to be valid for use in health policy.