Sickness or health: Healthy life split along gender, education lines

Australians are living and working longer than ever, but the number of healthy years they’re enjoying with this added longevity isn’t shared equally between the sexes, or by those who finished school before Year 12.

A paper recently published in The Lancet Public Health from the Ageing Futures Institute at the University of New South Wales shows an increase in longevity in Australia. Other data in the publication reveal detail about “healthy years”.

Men, and those with higher levels of education, worked about 2 years longer in good health. For women and those with lower education, the years of healthy life expectancy have gone backwards.

The report, led by statistician Dr Kim Kiely who is now based at The University of Wollongong, compared representative cohorts of people aged 50-100 who participated in the Household Income and Labour Dynamics in Australia survey (HILDA). Those cohorts were measured over decade long periods – the first from 2001-2010 and the second from 2011-2020.

Men added an extra 11 months of healthy life between the cohorts, while women lost a month. Similarly those of any gender who had completed year 12 added about 10 months to their healthy life expectancy, while the same amount of time was lost by those who hadn’t.

“Everyone’s increasing their working life expectancy, so the years they’re expected to be working,” Kiely says. “What is different is how long they’re expected to be living in good health: women and people with low education didn’t have an improvement in healthy life expectancy.

“Everyone’s also living longer than ever before, but for women, those extra years seem to be years of poor health.  People with lower education – they end up going backwards, they’re losing years of healthy life.”

Australia’s working life trends are similar to those in Europe and the UK, though this research suggests the Australian labour force works longer in poor health than their antipodean counterparts.

Kiely says the findings are important considerations for policymakers pondering questions of retirement and pension ages: the demands of some labour may not be evenly spread when it comes to considering health implications.

“We have a pension age that has been rising steadily over the past couple of decades – it’s not rising anymore – but there is a strong expectation for people to be working longer,” Kiely says. “And if that is the case, then we need opportunities for work for mature age, older adults, and those work opportunities have to be suitable for their capacity to work.

“We do need to address things like age and gender discrimination in the workforce. And we need to think about how we support people who are unable to work before they reach the pension age.”

Kiely is extending his research into how the nature of work in Australia influences these high-level findings. He hopes this can explain why gender and education influence healthy working years.

Further drilling down into other subgroups is important, say Dr Marty Lynch and Dr Ross Wilkie from Keele University, UK. They investigated healthy working life expectancy as part of Britain’s Independent State Pension Age Review last year. They too found Briton were working longer, but not at a rate that keeps pace with the national pension age.

In a Lancet editorial accompanying the Australian research, they point out that the HILDA data evaluation only shows changes in average ages on gender and education lines.

“The extent of HWLE [Healthy Working Life Expectancy] inequalities between subpopulations with multiple specific characteristics are likely to be even wider and will also indicate targets and interventions to increase the number of years that people can be healthy and in work,” they say.

The impact of socioeconomic status on life expectancy and disease burden was recently highlighted in a large-scale review of Australia’s 30-year health data.

It found while Australians have added 6 years to their life expectancy since 1990, those with lower socioeconomic backgrounds had a higher risk of death-causing disease.