Life span and disability in Sweden and Russia
http://www.100md.com
《英国医生杂志》
EDITOR—We are pleased by the consistency of our results with those of Andreev et al1; the fact that the two studies used entirely independent data (and partly different outcomes) on ill health supports the validity of both results.
The primary interest of our paper was the difference between Russia and Sweden. In this aspect, our results are consistent with the healthy life expectancy project, which shows, for both sexes, a difference in healthy life expectancy at birth of about 20 years between the two countries.2 Differences between men and women were not a focus of our study, mainly because reporting by women of worse health than men is well known and our data are, in this respect, similar to those of other studies.
As McKee et al point out, our data do not show a major sex difference in disability free survival (and healthy life expectancy). This is because Russian women live longer than men but spend more of their lives with disability. We agree that a large number of elderly Russian women who are widowed or in poor health often live in difficult social circumstances. Papers such as the one by Andreev et al and ours may help to draw attention to it.
Martin Bobak, reader
m.bobak@ucl.ac.uk
Michael Marmot, director
International Centre for Health and Society, University College London, London WC1E 6BY
Competing interests: None declared.
References
Andreev EM, McKee M, Shkolnikov VM. Health expectancy in Russia: a new perspective on the health divide in Europe. Bull WHO 2003;81: 778-88.
World Health Organization. Healthy life expectancy. The world health report 2001. www3.who.int/whosis/hale/hale.cfm?path=whosis,hale&language=english (accessed 1 Oct 2004).
The primary interest of our paper was the difference between Russia and Sweden. In this aspect, our results are consistent with the healthy life expectancy project, which shows, for both sexes, a difference in healthy life expectancy at birth of about 20 years between the two countries.2 Differences between men and women were not a focus of our study, mainly because reporting by women of worse health than men is well known and our data are, in this respect, similar to those of other studies.
As McKee et al point out, our data do not show a major sex difference in disability free survival (and healthy life expectancy). This is because Russian women live longer than men but spend more of their lives with disability. We agree that a large number of elderly Russian women who are widowed or in poor health often live in difficult social circumstances. Papers such as the one by Andreev et al and ours may help to draw attention to it.
Martin Bobak, reader
m.bobak@ucl.ac.uk
Michael Marmot, director
International Centre for Health and Society, University College London, London WC1E 6BY
Competing interests: None declared.
References
Andreev EM, McKee M, Shkolnikov VM. Health expectancy in Russia: a new perspective on the health divide in Europe. Bull WHO 2003;81: 778-88.
World Health Organization. Healthy life expectancy. The world health report 2001. www3.who.int/whosis/hale/hale.cfm?path=whosis,hale&language=english (accessed 1 Oct 2004).