title: Gender differences in healthy life years within the EU: an exploration of the "health-survival" paradox.
abstract: OBJECTIVE
  To evaluated the female-male health-survival paradox by estimating the contribution of women's mortality advantage versus women's disability disadvantage.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  The results suggest that the health-survival paradox is a function of the level of population health, dependent on modifiable factors.
authors.affiliation: Directorate of Public Health and Surveillance, Scientific Institute of Public Health, J. Wytsmanstraat 14, 1050 Brussels, Belgium. herman.vanoyen@wiv-isp.be
authors.forename: Herman
authors.initials: H
authors.lastname: Van Oyen
authors.forename: Wilma
authors.initials: W
authors.lastname: Nusselder
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.forename: Petra
authors.initials: P
authors.lastname: Kolip
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Cambois
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Robine
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015995:Prevalence; D012737:Sex Factors; D015996:Survival Rate; D016387:Women's Health; D055815:Young Adult