Key Social Determinants to Narrow the Gap between Health-adjusted Life Expectancy and Life Expectancy in Megacities.

Jun Yan XI; Yuan Yuan Chen; Yu Qin Zhang; Ao Luo; Zhi Cheng DU; Bo Heng Liang; Hang Dong; Xiao Lin; Peng Zhe Qin; Yuan Tao Hao

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Key Social Determinants to Narrow the Gap between Health-adjusted Life Expectancy and Life Expectancy in Megacities.

Author: Jun Yan XI ¹ ; Yuan Yuan CHEN ² ; Yu Qin ZHANG ¹ ; Ao LUO ³ ; Zhi Cheng DU ¹ ; Bo Heng LIANG ² ; Hang DONG ² ; Xiao LIN ¹ ; Peng Zhe QIN ² ; Yuan Tao HAO ^{4
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Author Information

1. Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
2. Department of Chronic Non-communicable Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, Guangdong, China.
3. Institute for Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China.
4. Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
5. Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing 100191, China
6. Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
7. Center for Health Information Research, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
Publication Type:Journal Article
Keywords: Generalized principal component analysis; Health-adjusted life expectancy; Megacities; Quality of life; Social determinants; Temporal trend; Urban expansion
MeSH: Cities; Health Status; Humans; Infant, Newborn; Life Expectancy; Quality of Life; Social Determinants of Health
From: Biomedical and Environmental Sciences 2022;35(9):773-781
CountryChina
Language:English
Abstract: OBJECTIVE:Improvement in the quality of life is reflected in the narrowing of the gap between health-adjusted life expectancy (HALE) and life expectancy (LE). The effect of megacity expansion on narrowing the gap is rarely reported. This study aimed to disclose this potential relationship.
METHODS:Annual life tables were constructed from identified death records and population counts from multiple administrative sources in Guangzhou, China, from 2010 to 2020. Joinpoint regression was used to evaluate the temporal trend. Generalized principal component analysis and multilevel models were applied to examine the county-level association between the gap and social determinants.
RESULTS:Although LE and HALE in megacities are increasing steadily, their gap is widening. Socio-economic and health services are guaranteed to narrow this gap. Increasing personal wealth, a growing number of newborns and healthy immigrants, high urbanization, and healthy aging have helped in narrowing this gap.
CONCLUSION:In megacities, parallel LE and HALE growth should be highly considered to narrow their gap. Multiple social determinants need to be integrated as a whole to formulate public health plans.