J Korean Med Sci.  2024 Feb;39(6):e46. 10.3346/jkms.2024.39.e46.

Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database

• Jung YS
• Kim YE
• Ock M
• Yoon SJ

• KMID: 2553302
• DOI: http://doi.org/10.3346/jkms.2024.39.e46

Abstract

Background
Healthy life expectancy is a well-recognized indicator for establishing health policy goals used in Korea’s Health Plan. This study aimed to explore Koreans’ healthy life expectancy and its gender, income, and regional disparities from 2008 to 2020.
Methods
This study was conducted on the entire population covered by health insurance and medical aid program in Korea. The incidence-based “years lived with disability” for 260 disease groups by gender, income level, and region was calculated employing the methodology developed in the Korean National Burden of Disease Study, and it was used as the number of healthy years lost to calculate health-adjusted life expectancy (HALE).
Results
Koreans’ HALE increased from 68.89 years in 2008 to 71.82 years in 2020. Although the gender disparity in HALE had been decreasing, it increased to 4.55 years in 2020. As of 2020, 5.90 years out of 8.67 years of the income disparity (Q5–Q1) in HALE were due to the disparity between Q1 and Q2, the low-income groups. Income and regional disparities in HALE exhibited an increasing trend, and these disparities were higher in men than in women.
Conclusion
A subgroup with a low health level was identified through the HALE results, and it was confirmed that improving the health level of this population can reduce health inequalities and improve health at the national level. Further exploration of the HALE calculation methodology may help in the development of effective policies such as prioritizing interventions for health risk factors.

Keyword

Health-Adjusted Life Expectancy; Health Equality; Years Lived with Disability; Income; Region

Figure

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  Fig. 1 Income-wise HALE for men and women in Korea (2008–2020) (unit: years). (A) Income-wise HALE for men (B) Income-wise HALE for women.HALE = health-adjusted life expectancy.

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  Fig. 2 Regional HALE in Korea in 2020 (unit: years). (A) Regional quintile division according to regional HALE. (B) Regional median division according to national HALE (71.82 years).HALE = health-adjusted life expectancy.

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  Fig. 3 Trends in regional disparities (95th and 5th percentile) in HALE in Korea (2008–2020) (unit: years).HALE = health-adjusted life expectancy.

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