An assessment of population health in Hong Kong : life expectancy, life disparity, and health expectancies

Abstract

Over the last several decades, Hong Kong has witnessed substantial improvements in life expectancy. Previous studies have well discussed population health in Hong Kong. However, in-depth analyses of life expectancy and other health indicators are currently inadequate. Therefore, the aims of this thesis are as follows: 1) to reveal the mechanism of the growth in life expectancy; 2) to investigate the gender gap in life expectancy; 3) to identify the variation in lifespans; 4) to examine the trends in health expectancies; and 5) to assess the impact of suicide on life expectancy. First, Arriaga’s decomposition method has been used to quantify the contributions of mortality change by age group and causes of death to the changes in life expectancy in Hong Kong from 1986 to 2015. The results demonstrate the major contributions of the decline in mortality among the older population and the improvements in mortality from chronic diseases. The concern is the negative contribution of pneumonia among older population, particularly those at advanced ages. Second, although Hong Kong has made significant progress in promoting life expectancy, there remain differences in life expectancy between males and females. The comparison with Japan shows that the gender gap in life expectancy varies across the two societies, despite similar levels of life expectancy. Further decomposition analyses attribute the differences between Hong Kong and Japan to mortality changes between males and females among the old population aged 60-84. Third, apart from celebrating the achievement in prolonging longevity, another important question is “whether the increasing length of life is enjoyed equally”, referring specifically to life disparity. In this thesis, both life expectancy and life disparity in Hong Kong have been investigated and compared with Japan. The results show that although Hong Kong has achieved a higher level of life expectancy, life disparity in Hong Kong is still greater than Japan over the period 1977-2016. Fourth, with the use of the Sullivan’s method, this thesis has examined the trends in health expectancies among population aged 50 years and older in Hong Kong in 2007-2016. The results show that in spite of the marked improvement in life expectancy in Hong Kong, the increase in life expectancy in good self-perceived health was much smaller, while chronic disease-free life expectancy and impairment-free life expectancy even declined for both genders, which suggests that people in Hong Kong live longer but not healthier. Finally, this thesis has evaluated the contribution of a specific cause of death, namely suicide, to life expectancy in Hong Kong. The age-incidence decomposition reveals the important influence of suicide on life expectancy and emphasizes the major impact of the incidence component. Therefore, understanding the contribution pattern of suicide and developing effective strategies for suicide intervention would contribute positively to the life expectancy in Hong Kong. This thesis considers life expectancy and other health indicators by analyzing life disparity and health expectancies, thus presenting a more comprehensive assessment of population health in Hong Kong, which could provide practical information for implementing health-related public policies.