title: Rational expectations? An explorative study of subjective survival probabilities and lifestyle across Europe.
abstract: BACKGROUND
  Subjective survival probabilities (SSPs) are considered relevant in relation to lifestyle as lifestyle improvements may improve health and lower mortality risk.
  
  
  OBJECTIVE
  To study individuals' SSP in a population of elderly (i.e. 60 years and older) from 15 European countries.
  
  
  METHODS
  Data from the second wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Individuals were asked about their chances to live up to age [T] or more. These SSPs were related to general characteristics, health and lifestyle. In addition, cross-country comparisons were made. The validity of the probabilistic elicitation format used for collecting SSPs was also addressed.
  
  
  RESULTS
  The average subjective probability of surviving the next 9-15 years was around 57%. Mean SSPs varied significantly across age, with lower means at higher ages. Cross-country comparisons showed lowest mean in the Czech Republic (42%) and the highest in Denmark (64%). SSPs correlated with socio-demographic, socio-economic and also strongly with (objective) health characteristics except for obesity. Smokers reported significantly lower SSPs compared to non-smokers, but no difference was found between non-smokers and quitters. Excessive alcohol consumers reported significantly higher SSPs than moderate consumers and abstainers, but this only held for female excessive drinkers. Physical inactivity was negatively associated with SSPs, but this relation was attenuated at higher ages. In this context, important cross-country differences were found.
  
  
  CONCLUSIONS
  Subjective survival probabilities are informative and relevant in relation to lifestyle decisions and can be validly obtained in elder people. The results from this study provide interesting implications for health policy, health communication strategies and future research.
authors.affiliation: Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: David R
authors.initials: DR
authors.lastname: Rappange
authors.affiliation: Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Werner B F
authors.initials: WB
authors.lastname: Brouwer
authors.affiliation: Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van Exel
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D002908:Chronic Disease; D005060:Europe / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012111:Residence Characteristics; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors
keywords: Europe; elderly; health; lifestyle; subjective survival probabilities