Emmanuelle Cambois

Institut national d'études démographiques, Lutetia Parisorum, Île-de-France, France

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Publications (44)93.7 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Smoking is the single most important health threat yet there is no consistency as to whether non-smokers experience a compression of years lived with disability compared to (ex-)smokers. The objectives of the manuscript are (1) to assess the effect of smoking on the average years lived without disability (Disability Free Life Expectancy (DFLE)) and with disability (Disability Life Expectancy (DLE)) and (2) to estimate the extent to which these effects are due to better survival or reduced disability in never smokers.
    BMC Public Health 07/2014; 14(1):723. · 2.08 Impact Factor
  • Armelle Andro, Emmanuelle Cambois, Marie Lesclingand
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    ABSTRACT: Female genital mutilation (FGM) concerns an estimated half a million women in Europe. The studies based in countries where migrant women have settled highlight the need for more accurate information on FGM health consequences, in a European health care context. Excision and Handicap (ExH) is a multi-centric survey based on case-control methodology and conducted in France to assess the long-term consequences of FGM, sampling both FGM and non-FGM adult women. The interviews were conducted in 74 mother-and-child health centres and hospital departments providing gynaecological and family planning services in five French regions. The two groups were compared on health indicators (self-perceived health, illnesses, symptoms) and functioning indicators (daily, sexual and reproductive life) for cases (n = 678) and controls (n = 1706). Multivariate logistic models highlighted FGM-related health problems. Among women living in France, FGM was significantly associated with poor health indicators: gynaecological and urinary infections (OR = 2.0), sleep disorders (OR = 1.4), intense pain (OR = 1.5), difficulties in daily life (OR = 1.5) and in sexual life (OR = 1.7) or tearing during childbirth (OR = 1.6). Our results suggest that, even in a favourable healthcare context, FGM exposes women to long-term health problems, including in areas neglected in previous research. They confirm the need to establish recommendations to help physicians understand these women's needs.
    Social Science [?] Medicine 02/2014; 106C:177-184. · 2.73 Impact Factor
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    ABSTRACT: BACKGROUND: The European Innovation Partnership on Active and Healthy Ageing seeks an increase of two healthy life years (HLY) at birth in the EU27 for the next 10 years. We assess the feasibility of doing so between 2010 and 2020 and the differential impact among countries by applying different scenarios to current trends in HLY. METHODS: Data comprised HLY and life expectancy (LE) at birth 2004-09 from Eurostat. We estimated HLY in 2010 in each country by multiplying the Eurostat projections of LE in 2010 by the ratio HLY/LE obtained either from country and sex-specific linear regression models of HLY/LE on year (seven countries retaining same HLY question) or extrapolating the average of HLY/LE in 2008 and 2009 to 2010 (20 countries and EU27). The first scenario continued these trends with three other scenarios exploring different HLY gap reductions between 2010 and 2020. RESULTS: The estimated gap in HLY in 2010 was 17.5 years (men) and 18.9 years (women). Assuming current trends continue, EU27 HLY increased by 1.4 years (men) and 0.9 years (women), below the European Innovation Partnership on Active and Healthy Ageing target, with the HLY gap between countries increasing to 18.3 years (men) and 19.5 years (women). To eliminate the HLY gap in 20 years, the EU27 must gain 4.4 HLY (men) and 4.8 HLY (women) in the next decade, which, for some countries, is substantially more than what the current trends suggest. CONCLUSION: Global targets for HLY move attention from inter-country differences and, alongside the current economic crisis, may contribute to increase health inequalities.
    The European Journal of Public Health 03/2013; · 2.52 Impact Factor
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    ABSTRACT: BACKGROUND: Life expectancy has been increasing during the last century within the European Union (EU). To measure progress in population health it is no longer sufficient to focus on the duration of life but quality of life should be considered. Healthy Life Years (HLY) allow estimating the quality of the remaining years that a person is expected to live, in terms of being free of long-standing activity limitation. The Joint Action on Healthy Life Years (JA: EHLEIS) is a joint action of European Member States (MS) and the European Union aiming at analysing trends, patterns and differences in HLY, as well as in other Summary Measures of Population Health (SMPH) indicators, across the European member states. METHODS: The JA: EHLEIS consolidates existing information on life and health expectancy by maximising the European comparability; by analysing trends in HLY within the EU; by analysing the evolution of the differences in HLY between Member States; and by identifying both macro-level as micro-level determinants of the inequalities in HLY. The JA: EHLEIS works in collaboration with the USA, Japan and OECD on the development of new SMPHs to be used globally. To strengthen the utility of the HLY for policy-making, annual meetings with policy-makers are planned. RESULTS: The information system allows the estimation of a set of health indicators (morbidity and disability prevalence, life and health expectancies) for Europe, Member States and shortly their regional levels. An annual country report on HLY in the national languages is available. The JA: EHLEIS is developing statistical attribution and decomposition tools which will be helpful to determine the impact of specific diseases, life styles or other determinants on differences in HLY. Through a set of international workshops the JA: EHLEIS aims to develop a blueprint for an international harmonized Summary Measure of Population Health. CONCLUSION: The JA: EHLEIS objectives are to monitor progress towards the headline target of the Europe 2020 strategy of increasing HLY by 2 years by 2020 and to support policy development by identifying the main determinants of active and healthy ageing in Europe.
    Archives of Public Health 02/2013; 71(1):2.
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    ABSTRACT: BACKGROUND:Increases in life expectancy make it important to remain healthy for as long as possible. Our objective was to examine the extent to which healthy behaviours in midlife, separately and in combination, predict successful aging. METHODS:We used a prospective cohort design involving 5100 men and women aged 42-63 years. Participants were free of cancer, coronary artery disease and stroke when their health behaviours were assessed in 1991-1994 as part of the Whitehall II study. We defined healthy behaviours as never smoking, moderate alcohol consumption, physical activity (≥ 2.5 h/wk moderate physical activity or ≥ 1 h/wk vigorous physical activity), and eating fruits and vegetables daily. We defined successful aging, measured over a median 16.3-year follow-up, as good cognitive, physical, respiratory and cardiovascular functioning, in addition to the absence of disability, mental health problems and chronic disease (coronary artery disease, stroke, cancer and diabetes). RESULTS:At the end of follow-up, 549 participants had died and 953 qualified as aging successfully. Compared with participants who engaged in no healthy behaviours, participants engaging in all 4 healthy behaviours had 3.3 times greater odds of successful aging (95% confidence interval [CI] 2.1-5.1). The association with successful aging was linear, with the odds ratio (OR) per increment of healthy behaviour being 1.3 (95% CI 1.2-1.4; population-attributable risk for 1-4 v. 0 healthy behaviours 47%). When missing data were considered in the analysis, the results were similar to those of our main analysis. INTERPRETATION:Although individual healthy behaviours are moderately associated with successful aging, their combined impact is substantial. We did not investigate the mechanisms underlying these associations, but we saw clear evidence of the importance of healthy behaviours for successful aging.
    Canadian Medical Association Journal 10/2012; · 6.47 Impact Factor
  • Emmanuelle Cambois, Audrey Blachier, Jean-Marie Robine
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    ABSTRACT: OBJECTIVES: The study presents new disability-free life expectancies (DFLE) estimates for France and discusses recent trends in the framework of the three 'health and aging' theories of compression, dynamic equilibrium and expansion of disability. The objectives are to update information for France and to compare two methods to analyse recent trends. METHODS: DFLE at ages 50, 65 and in the 50-65 age group are computed for several disability dimensions, using data from five French surveys over the 2000s. Owing to scarce time series, we used two methods to assess trends and consolidate our conclusions: (i) decomposition of the DFLE changes using the available time series; (ii) linear regression using all the available estimates, classified by disability dimensions. RESULTS: Trends in DFLE(65) prolonged the dynamic equilibrium of the previous decades: increasing life expectancy with functional limitations but not with activity restrictions. Meanwhile, partial DFLE50-65 has decreased for various disability dimensions, including some activity restrictions, especially for women. CONCLUSION: France has recently experienced an unexpected expansion of disability in mid-adulthood while it is still on a trend of dynamic equilibrium at older ages. The study highlights the importance of monitoring trends in DFLE for various disability dimensions and broadens the scope of interest to the mid-adulthood.
    The European Journal of Public Health 10/2012; · 2.52 Impact Factor
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    ABSTRACT: OBJECTIVES: To evaluated the female-male health-survival paradox by estimating the contribution of women's mortality advantage versus women's disability disadvantage. METHODS: Disability prevalence was measured from the 2006 Survey on Income and Living Conditions in 25 European countries. Disability prevalence was applied to life tables to estimate healthy life years (HLY) at age 15. Gender differences in HLY were split into two parts: that due to gender inequality in mortality and that due to gender inequality in disability. The relationship between women's mortality advantage or disability disadvantage and the level of population health between countries was analysed using random-effects meta-regression. RESULTS: Women's mortality advantage contributes to more HLY in women; women's higher prevalence of disability reduces the difference in HLY. In populations with high life expectancy women's advantage in HLY was small or even a men's advantage was found. In populations with lower life expectancy, the hardship among men is already evident at young ages. CONCLUSIONS: The results suggest that the health-survival paradox is a function of the level of population health, dependent on modifiable factors.
    International Journal of Public Health 05/2012; · 1.99 Impact Factor
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    Emmanuelle Cambois, Florence Jusot
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    ABSTRACT: Recent research shows that adverse experiences, such as economic hardships or exclusion, contribute to deterioration of health status. However, individuals currently experiencing adverse experiences are excluded from conventional health surveys, which, in addition, often focus on current social situation but rarely address past adverse experiences. This research explores the role of such experiences on health and related social inequalities based on a new set of ad hoc questions included in a regular health survey. In 2004, the National Health, Health Care and Insurance Survey included three questions on lifelong adverse experiences (LAE): financial difficulties, housing difficulties due to financial hardship, isolation. Logistic regressions were used to analyse associations between LAE, current socio-economic status (SES) (education, occupation, income) and health status (self-perceived health, activity limitation, chronic morbidity), on a sample of 4308 men and women aged ≥35 years. LAE were reported by 20% of the sample. They were more frequent in low SES groups but concerned >10% of the highest income group. LAE increased the risk of poor self-perceived health, diseases and activity limitations, even after controlling for current SES [odds ratio (OR) > 2]. LAE experienced only during childhood are also linked to health. LAE account for up to 32% of the OR of activity limitations associated with the lowest quintile among women and 26% among men. LAE contribute to the social health gradient and explain variability within social groups. It is useful to take lifetime social factors into account when monitoring health inequalities.
    The European Journal of Public Health 10/2011; 21(5):667-73. · 2.52 Impact Factor
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    ABSTRACT: Life expectancy gaps between Eastern and Western Europe are well reported with even larger variations in healthy life years (HLY). To compare European countries with respect to a wide range of health expectancies based on more specific measures that cover the disablement process in order to better understand previous inequalities. Health expectancies at age 50 by gender and country using Sullivan's method were calculated from the Survey of Health and Retirement in Europe Wave 2, conducted in 2006 in 13 countries, including two from Eastern Europe (Poland, the Czech Republic). Health measures included co-morbidity, physical functional limitations (PFL), activity restriction, difficulty with instrumental and basic activities of daily living (ADL), and self-perceived health. Cluster analysis was performed to compare countries with respect to life expectancy at age 50 (LE50) and health expectancies at age 50 for men and women. In 2006 the gaps in LE50 between countries were 6.1 years for men and 4.1 years for women. Poland consistently had the lowest health expectancies, however measured, and Switzerland the greatest. Polish women aged 50 could expect 7.4 years fewer free of PFL, 6.2 years fewer HLY, 5.5 years less without ADL restriction and 9.5 years less in good self-perceived health than the main group of countries (Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden). Substantial inequalities between countries were evident on all health expectancies. However, these differed across the disablement process which could indicate environmental, technological, healthcare or other factors that may delay progression from disease to disability.
    Journal of epidemiology and community health 04/2011; 65(11):1030-5. · 3.04 Impact Factor
  • Emmanuelle Cambois, Caroline Laborde
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    ABSTRACT: Mortality differentials between French occupations and occupational classes are large and widening. But considerable inequalities also exist within occupational classes by career history. Changes in the labour market and occupational pathways in recent decades -notably among women -have altered the composition of occupational classes and their average mortality levels. This article analyses the changes in mortality differentials between occupational classes by studying occupational mobility and associated mortality using data from the permanent demographic sample (Échantillon démographique permanent, EDP), a long-term sample representative of the French population at different dates. Analysis of mortality in 1975 (EDP75) and 1999 (EDP99) by occupational class and past occupational moves shows that mortality has declined for all classes but in different ways, causing a slight widening of differentials for both sexes. Within occupational classes, differentials by past moves increased in the EDP99 for men and were now observed in all classes for women. Changes in the composition of occupational classes and in excess mortality associated with certain moves has contributed to this increase in inequalities between occupational classes. This finding highlights the importance of interpreting changes in mortality differentials in the light of sociodemographic developments. Les inégalités de mortalité entre les professions et catégories socioprofessionnelles françaises (PCS) sont importantes et en augmentation. Mais il existe aussi de larges inégalités de mortalité au sein des PCS selon la nature des carrières passées. Les transformations du marché du travail et des parcours professionnels dans les dernières décennies, notamment pour les femmes, modifient la composition des PCS et leur niveau moyen de mortalité. Cet article analyse l'évolution des inégalités de mortalité entre les PCS à travers l'étude des mobilités professionnelles et de la mortalité associée, en utilisant les données de l'Échantillon démographique permanent (EDP), un échantillon suivi et représentatif de la population française à différentes dates. L'étude de la mortalité en 1975 (EDP75) et en 1999 (EDP99), selon les PCS et les mobilités professionnelles passées, montre que la mortalité a baissé pour toutes les PCS mais de façon différente, aboutissant à un léger creusement des écarts pour les deux sexes. Au sein des PCS, les écarts selon les mobilités passées sont renforcés dans TEDP99 pour les hommes et se généralisent pour les femmes. La modification de la composition des PCS et l'évolution de la surmortalité associée à certaines mobilités a contribué à cette augmentation des inégalités entre PCS. Interpréter l'évolution des inégalités de mortalité à la lumière des changements sociodémographiques s'avère donc particulièrement important. Las desigualdades de mortalidad entre las profesiones y categorías socio-profesionales francesas (PCS) son importantes y están todavía aumentando. Pero existen también amplias diferencias de mortalidad dentro de las PCS según la naturaleza de la carrera pasada. Las transformaciones del mercado del trabajo y de los recorridos socio-profesionales en las ultimas décadas, particularmente en las mujeres, han modificado la composición de las PCS y su nivel medio de mortalidad. Este articulo analiza la evolución de las desigualdades de mortalidad entre las PCS a través del estudio de la movilidad profesional y de la mortalidad asociada, utilizando los datos del Echantillon démographique permanent (EDP) , es decir un panel observado en continuo y representativo de la población francesa en diferentes fechas. El estudio de la mortalidad en 1975 (EDP1975) y en 1999 (EDP99), según la PCS y la movilidad profesional pasada, muestra que la mortalidad ha disminuido en todas las PCS pero de manera diferente, abocando a un ligero ahondamiento de las diferencias tanto en los hombres como en las mujeres. En el EDP99, dentro de las PCS, las diferencias según la movilidad pasada se refuerzan en los hombres y se generalizan en las mujeres. La modificación de la composición de las PCS y la evolución del exceso de mortalidad asociado a ciertas movilidades han contribuido al aumento de las diferencias entre las PCS. Interpretar la evolución de las desigualdades de mortalidad a la luz de los cambios socio-demográficos se revela pues particularmente importante.
    Population (English Edition 2002-) 01/2011; 66(2).
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    ABSTRACT: Increasing life expectancy (LE) raises expectations for social participation at later ages. We computed health expectancies (HE) to assess the (un)equal chances of social/work participation after age 50 in the context of France in 2003. We considered five HEs, covering various health situations which can jeopardize participation, and focused on both older ages and the pre-retirement period. HEs reveal large inequalities for both sexes in the chances of remaining healthy after retirement, and also of reaching retirement age in good health and without disability, especially in low-qualified occupations. These results challenge the policy expectation of an overall increase in social participation at later ages.
    Demographic Research 01/2011; 25(12):407-436. · 1.20 Impact Factor
  • Emmanuelle Cambois, Caroline Laborde
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    ABSTRACT: Les inégalités de mortalité entre les professions et catégories socioprofessionnelles françaises (PCS) sont importantes et en augmentation. Mais il existe aussi de larges inégalités de mortalité au sein des PCS selon la nature des carrières passées. Les transformations du marché du travail et des parcours professionnels dans les dernières décennies, notamment pour les femmes, modifient la composition des PCS et leur niveau moyen de mortalité. Cet article analyse l'évolution des inégalités de mortalité entre les PCS à travers l'étude des mobilités professionnelles et de la mortalité associée, en utilisant les données de l'Échantillon démographique permanent (EDP), un échantillon suivi et représentatif de la population française à différentes dates. L'étude de la mortalité en 1975 (EDP75) et en 1999 (EDP99), selon les PCS et les mobilités professionnelles passées, montre que la mortalité a baissé pour toutes les PCS mais de façon différente, aboutissant à un léger creusement des écarts pour les deux sexes. Au sein des PCS, les écarts selon les mobilités passées sont renforcés dans TEDP99 pour les hommes et se généralisent pour les femmes. La modification de la composition des PCS et l'évolution de la surmortalité associée à certaines mobilités a contribué à cette augmentation des inégalités entre PCS. Interpréter l'évolution des inégalités de mortalité à la lumière des changements sociodémographiques s'avère donc particulièrement important. Mortality differentials between French occupations and occupational classes are large and widening. But considerable inequalities also exist within occupational classes by career history. Changes in the labour market and occupational pathways in recent decades -notably among women - have altered the composition of occupational classes and their average mortality levels. This article analyses the changes in mortality differentials between occupational classes by studying occupational mobility and associated mortality using data from the Permanent Demographic Sample (Échantillon Démographique Permanent: EDP), a long-term sample representative of the French population at different dates. Analysis of mortality in 1975 (EDP75) and 1999 (EDP99) by occupational class and past occupational moves shows that mortality has declined for all classes but in different ways, causing a slight widening of differentials for both sexes. Within occupational classes, differentials by past moves increased in the EDP99 for men and were now observed in all classes for women. Changes in the composition of occupational classes and in excess mortality associated with certain moves has contributed to this increase in inequalities between occupational classes. This finding highlights the importance of interpreting changes in mortality differentials in the light of sociodemographic developments. Las desigualdades de mortalidad entre las profesiones y categorías socio-profesionales francesas (PCS) son importantes y están todavía aumentando. Pero existen también amplias diferencias de mortalidad dentro de las PCS según la naturaleza de la carrera pasada. Las transformaciones del mercado del trabajo y de los recorridos socio-profesionales en las ultimas décadas, particularmente en las mujeres, han modificado la composición de las PCS y su nivel medio de mortalidad. Este articulo analiza la evolución de las desigualdades de mortalidad entre las PCS a través del estudio de la movilidad profesional y de la mortalidad asociada, utilizando los datos del Echantillon démographique permanent (EDP), es decir un panel observado en continuo y representativo de la población francesa en diferentes fechas. El estudio de la mortalidad en 1975 (EDP1975) y en 1999 (EDP99), según la PCS y la movilidad profesional pasada, muestra que la mortalidad ha disminuido en todas las PCS pero de manera diferente, abocando a un ligero ahondamiento de las diferencias tanto en los hombres como en las mujeres. En el EDP99, dentro de las PCS, las diferencias según la movilidad pasada se refuerzan en los hombres y se generalizan en las mujeres. La modificación de la composición de las PCS y la evolución del exceso de mortalidad asociado a ciertas movilidades han contribuido al aumento de las diferencias entre las PCS. Interpretar la evolución de las desigualdades de mortalidad a la luz de los cambios socio-demográficos se revela pues particularmente importante.
    Population (French Edition) 01/2011; 66(2). · 0.33 Impact Factor
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    ABSTRACT: This work aims to validate and increase understanding of the Global Activity Limitation Index (GALI), an activity limitation measure from which the new structural indicator Healthy Life Years is generated. Data from the Survey of Health and Retirement in Europe, covering 11 European countries and 27,340 individuals older than 50 years, was used to investigate how the GALI was associated with other existing measures of function and disability and whether the GALI was consistent or reflected different levels of health in different countries. The GALI was significantly associated with the two subjective measures of activities of daily living score and instrumental activities of daily living (IADL) score, and the two objective measures of maximum grip strength and walking speed (P<0.001 in all cases). The GALI did not differ significantly between countries in terms of how it reflected three of the health measures, with the exception being IADL. The GALI appears to satisfactorily reflect levels of function and disability as assessed by long-standing objective and subjective measures, both across Europe and in a similar way between countries.
    Journal of clinical epidemiology 02/2010; 63(8):892-9. · 5.33 Impact Factor
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    Thomas Barnay, emmanuelle cambois, jean-marie robine
    Retraite et Societe 01/2010; 59:pp 194-205..
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    ABSTRACT: Women generally live longer than men, but women’s longer lives are not necessarily healthy lives. The aim of this article is to describe the pattern of gender differences in expected years with and without activity limitations across 25 EU countries and to explore the association between gender differences and macro-level factors. We applied to the Eurostat life table’s data from the Statistics of Income and Living Conditions Survey to estimate gender differences in life expectancy with and without activity limitations at age 50 for 2005. We studied the relationship between the gender differences and structural indicators using meta-regression techniques. Differences in years with activity limitations between genders were associated with the life expectancy (LE) and the size of the gender difference in LE. Gender difference in years with activity limitations were larger as the gross domestic product, the expenditure on elderly care and the indicator of life-long learning decreased, and as the inequality in income distribution increased. There was evidence of disparity in the associations between the more established EU countries (EU15) and the newer EU10 countries. Among the EU15, gender differences were positively associated with income inequality, the proportion of the population with a low education and the men’s mean exit age from labour force. Among the EU10, inequalities were smaller with increasing expenditure in elderly care, with decreasing poverty risk and with decreasing employment rate of older people. The association between structural indicators and the gender gap in years with activity limitations suggests that gender differences can be reduced. KeywordsGender inequality-Health expectancy-Life expectancy-Healthy life years-Global Activity Limitation Index
    European Journal of Ageing 01/2010; 7(4):229-237. · 1.27 Impact Factor
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    Emmanuelle Cambois, Florence Jusot
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    ABSTRACT: Conventional health surveys focus on current health and social context but rarely address past experiences of hardship or exclusion. However, recent research shows how such experiences contribute to health status and social inequalities. In order to analyse in routine statistics the impact of lifelong adverse experiences (LAE) on various health indicators, a new set of questions on financial difficulties, housing difficulties due to financial hardship and isolation was introduced in the 2004 French National health, health care and insurance survey (ESPS 2004). Logistic regressions were used to analyze associations between LAE, current socioeconomic status (SES) (education, occupation, income) and health (self-perceived health, activity limitation, chronic morbidity), on a sample of 4308 men and women aged 35 years and older. In our population, LAE were reported by 1 person out of 5. Although more frequent in low SES groups, they concerned above 10% of the highest incomes. For both sexes, LAE are significantly linked to poor self-perceived health, diseases and activity limitations, even controlling for SES (OR>2) and even in the highest income group. This pattern remains significant for LAE experienced only during childhood. The questions successfully identified in a conventional survey people exposed to health problems in relation to past experiences. LAE contribute to the social health gradient and explain variability within social groups. These questions will be useful to monitor health inequalities, for instance by further analyzing LAE related health determinants such as risk factors, exposition and care use.
    01/2010;
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    ABSTRACT: The Minimum European Health Module (MEHM) consists of 3 global questions concerning 3 health domains: self-perceived health, chronic conditions and long-term activity limitation. The objective of this paper is to evaluate the reliability of the MEHM. Participants of the Belgian Food Consumption Survey were interviewed twice: 170 individuals were selected for the MEHM reliability evaluation. For each of the 3 questions Pearson and Kappa coefficients were estimated. Analyses were stratified by gender, age, education, language and time between the interviews. The Pearson correlations are between 0.73 and 0.81. The Kappa estimates are good or excellent: 0.74 (self-perceived health), 0.77 (chronic conditions) and 0.68 (activity limitation). Also stratified analyses indicated in general an acceptable reliability. The MEHM has an acceptable reliability.
    International Journal of Public Health 03/2009; 54(2):55-60. · 1.99 Impact Factor
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    ABSTRACT: Although life expectancy in the European Union (EU) is increasing, whether most of these extra years are spent in good health is unclear. This information would be crucial to both contain health-care costs and increase labour-force participation for older people. We investigated inequalities in life expectancies and healthy life years (HLYs) at 50 years of age for the 25 countries in the EU in 2005 and the potential for increasing the proportion of older people in the labour force. We calculated life expectancies and HLYs at 50 years of age by sex and country by the Sullivan method, which was applied to Eurostat life tables and age-specific prevalence of activity limitation from the 2005 statistics of living and income conditions survey. We investigated differences between countries through meta-regression techniques, with structural and sustainable indicators for every country. In 2005, an average 50-year-old man in the 25 EU countries could expect to live until 67.3 years free of activity limitation, and a woman to 68.1 years. HLYs at 50 years for both men and women varied more between countries than did life expectancy (HLY range for men: from 9.1 years in Estonia to 23.6 years in Denmark; for women: from 10.4 years in Estonia to 24.1 years in Denmark). Gross domestic product and expenditure on elderly care were both positively associated with HLYs at 50 years in men and women (p<0.039 for both indicators and sexes); however, in men alone, long-term unemployment was negatively associated (p=0.023) and life-long learning positively associated (p=0.021) with HLYs at 50 years of age. Substantial inequalities in HLYs at 50 years exist within EU countries. Our findings suggest that, without major improvements in population health, the target of increasing participation of older people into the labour force will be difficult to meet in all 25 EU countries. EU Public Health Programme.
    The Lancet 11/2008; 372(9656):2124-31. · 39.06 Impact Factor
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    ABSTRACT: Disability-free life expectancy estimates (DFLE) are summary measures to monitor whether a longer life expectancy (LE) is associated with better health or whether additional years of life are years of poor health or disability. Disability is a generic term defined as the impact of disease or injury on the functioning of individuals. It covers various situations from the rather common functional limitations to restrictions in daily activities and finally dependency. Disentangling these dimensions is essential to monitor future needs of care and assistance; but this is not always feasible since surveys do not systematically cover a large range of disability dimensions in their questionnaires. This study aims to cover different disability dimensions by using data from different French population surveys. We computed ten disability-free life expectancies, based on both specific and generic disability indicators from four population health surveys, in order to describe and compare trends and patterns for France over the 1980s and the 1990s. We used the Sullivan method to combine prevalence of disability and life tables. In 2000, two thirds of total LE at age 65 are years with physical or sensory functional limitations and 10% are years with restrictions in personal care activities. Trends in DFLE over the two last decades seem to have remained stable for moderate levels of disability and to have increased for more severe levels of disability or activity restrictions. We found that patterns are consistent from one survey to the other when comparing indicators reflecting similar disability situations.
    European Journal of Ageing 01/2008; 5(4):287-298. · 1.27 Impact Factor
  • E. Cambois, C. Laborde, J.-M. Robine
    Revue D Epidemiologie Et De Sante Publique - REV EPIDEMIOL SANTE PUBL. 01/2008; 56(6).

Publication Stats

499 Citations
93.70 Total Impact Points

Institutions

  • 2004–2014
    • Institut national d'études démographiques
      Lutetia Parisorum, Île-de-France, France
  • 2010–2013
    • Newcastle University
      • Institute for Ageing and Health
      Newcastle upon Tyne, ENG, United Kingdom
  • 2009–2012
    • Belgian Scientific Institute for Public Health
      Bruxelles, Brussels Capital Region, Belgium
  • 2004–2011
    • Max Planck Institute for Demographic Research
      Rostock, Mecklenburg-Vorpommern, Germany
  • 2008–2010
    • University of Leicester
      • Department of Health Sciences
      Leicester, ENG, United Kingdom
  • 1999–2001
    • Institut du Cancer de Montpellier Val d'Aurelle
      Montpelhièr, Languedoc-Roussillon, France