Summary Measures of Population Health: Healthy Life Expectancy in India in the Context of Sustainable Development

Ensuring healthy lives and promoting well-being for all were recognized as an integral part of the United Nations 2030 Agenda for Sustainable Development. The present increase in life expectancy is primarily explained by the mortality reductions from chronic diseases at older ages. Therefore, debates arise on whether longer life means better health and if mortality indicators are enough to measure health. These considerations led to the development of Summary Measures of Population Health (SMPH) which combines both morbidity and mortality data to show the health status of a population as a single numerical index. In this context, we presented a brief history of the development of SMPH to understand how the nonfatal health outcomes have gained due recognition in measuring health. As healthy life expectancy (HLE) is one of the most popular and widely used SMPH, we estimated the healthy life expectancy of India using the Sullivan method based on the World Health Survey data (2003). We compared healthy life expectancies derived from self-rated general health, self-reported activity limitations, and self-reported functional limitations (involving social, psychological, and physical domains of health). In addition, we calculated the morbidity-free life expectancy (MFLE) of the males and females in India using the data of the National Sample Survey, round 75, conducted in 2017–2018. We found that healthy life expectancies, measured by all three aspects of health, were higher among males. In contrast, morbidity-free life expectancies based on the age-specific prevalence rate of ailing persons were higher among women. It reflects that MFLE differs from HLE as the latter includes much broader aspects of health. Therefore, researchers should carefully choose the appropriate health indicators for assessing health. As India is experiencing population ageing with substantial regional variation and the burden of noncommunicable diseases has already exceeded the burden of infectious diseases, we should use SMPH to assess population health in India. In our opinion, healthy life expectancy is a good indicator for evaluating population health in the context of SDG 3.