Health expectancies and health policies in the UK

<p>Over the last decade there has been increasing recognition by policy makers in the UK as elsewhere, that the achievement of longer length of life ought to be accompanied by improvement in the amount of healthy life. For example:

<p><p><p>'The transformation [in length of life] has been profound. ... But major health problems remain. People may be living longer but many still die prematurely or have the quality of their lives especially in their later years, impaired by avoidable ill health' (Introduction to Health of the Nation).

<p><p><p>Health of the Nation (1991) constituted proposals for English health strategy up to the year 2000, together with sets of health targets, and is document which continues to guide forward thinking in England. The core of its approach is stated as:

<p><p><p>'The aim of a strategy is simple: it is to improve the span of healthy life' (op cit, para. 2.5).

<p><p><p>The measurement of health expectancies are thus highly salient to this objective.

<p><p><p>There have been several strands in development of measures of health expectancies. QALYs or quality adjusted life years, has been a publicly funded programme in the UK for 10 years or more, and has established international links through the EuroQol survey. A methodological concern of this approach has been with the relative valuations to be given to different health states, from full health to death and maybe worse (Kind, 1992). 'Healthy life expectancy' is a closely related topic which has been funded on a pilot basis in England over the last 18 months (Bone et al, 1995a). Here the methodological emphasis has been on the construction of measures using prevalence and incidence data on health combined with separate mortality statistics, and on how to achieve comparisons.