Income disparities in health-adjusted life expectancy for Canadian adults, 1991 to 2001.
BACKGROUND
Health-adjusted life expectancy is a summary measure of population health that combines mortality and morbidity data into a single index. This article profiles differences in health-adjusted life expectancy across income categories for a representative sample of the Canadian population.


METHODS
Mortality data were obtained from the 1991-2001 Canadian census mortality follow-up study, which linked a 15% sample of the 1991 adult non-institutional population with 11 years of death records from the Canadian Mortality Data Base. Information on morbidity was obtained from the Health Utilities Index Mark 3 instrument on the 2000/2001 Canadian Community Health Survey. The Sullivan method was used to compute health-adjusted life expectancy for national deciles of population ranked by income.


RESULTS
For both sexes, and with few exceptions, a nearly linear gradient across income deciles emerged for health-adjusted life expectancy at age 25. Compared with people in higher-income deciles, those in lower-income deciles had fewer years of health-adjusted life expectancy. These disparities were substantially larger than those revealed by life expectancy alone.


CONCLUSIONS
These findings highlight the generally worse health-related quality of life of lower-income groups. The results demonstrate that assessments of socio-economic disparities in health should include the effects of both mortality and morbidity.
McIntosh
Cameron N
CN
Public Safety Canada. Cameron.Mclntosh@ps.sp.gc.ca
Finès
Philippe
P
Wilkins
Russell
R
Wolfson
Michael C
MC
D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012959:Socioeconomic Factors