Luy · Health reports 2014 · cross-sectional ecological study · n=45 countries

Gender gaps--Life expectancy and proportion of life in poor health.

Level 4 - case-series / case-control

Cross-sectional ecological analysis of national aggregate data (by design analogy, Oxford CEBM level 4).

PubMed 25517936 · record verified 2026-08-26

What was done

Using healthy life expectancy estimates from the Global Burden of Disease Study 2010, the author examined the relationship between total length of life and health status among men and women across 45 more-developed countries. Health status was measured as the proportion of total life expectancy spent in poor health to evaluate gender differences in health relative to longevity.

What was found

Life expectancy at birth was positively associated with the proportion of life spent in poor health for both men and women. Countries with a larger female excess in life expectancy also exhibited a larger female excess in the proportion of life spent in poor health. The abstract reports directional associations but provides no specific numerical values, correlation coefficients, or effect sizes.

Why it matters

This study provides an ecological framework suggesting that the female health-mortality paradox—where women experience worse health despite living longer—may be directly driven by the fact that greater longevity increases the fraction of life lived with chronic or disabling conditions.

Limits

The analysis relies on aggregate, country-level data from 45 developed nations rather than individual-level longitudinal tracking, introducing potential ecological fallacy. The abstract does not report specific statistical estimates, confidence intervals, or underlying causes of disability, and findings may not generalize to low- or middle-income countries.

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