Background The indicator Healthy Life Year (HLY) is currently a standard summary measure of population health that expresses the number of remaining years spent without disability at a particular age. Social inequalities in HLY are widely documented on the national and European levels. In previous studies, HLY by socioeconomic status (SES) in Belgium were estimated using the follow-up mortality of the national census. However, as there has been no census planned since 2001, other approaches have to be identified. Objectives This presentation explores an alternative method to estimate and update HLY by SES (as defined by educational level) using the follow-up mortality of a representative population survey. Methods To estimate HLY by SES using the Sullivan method, two types of data are required: disability information by SES and mortality rates by SES. Based on a number of criteria, two surveys were chosen: The Health Interview Survey (HIS) and the Survey on Income and Living Conditions (SILC). Mortality was based on a 6-years mortality follow up for the HIS and a 5-years follow up for the SILC. Disability was defined by the Global Activity Limitation Indicator instrument (GALI) that is worded as follows: "For at least the last 6 months, have you been limited because of a health problem in activities people usually do?". ResultsMortality rates by SES were comparable in the HIS and the SILC, but the disability rates by SES were systematically higher in the SILC leading to systematically higher HLY in the HIS. For instance, life expectancy at 25 years for men with the lowest educational achievement is almost 50 years in the HIS and the SILC. Concerning HLY for the same group, it is 35 years in the HIS compared with 28 years in the SILC. Statistically significant inequalities in HLY were detected in both surveys. For instance, the difference in HLY between men in the highest and lowest educational group is almost 7 years in the HIS and 14 years in the SILC. ConclusionBoth the HIS and the SILC are good alternative to the census for estimating HLY by SES. However, the estimates are not interchangeable between these two surveys. To monitor HLY by SES in Belgium, we recommend the use of the SILC as it is a yearly survey and is the survey used to monitor the HLY at the European level.
