Correlates of healthy life expectancy in low- and lower-middle-income countries

Islam, Md. Shariful, Mondal, Md Nazrul Islam, Tareque, Md. Ismail, Rahman, Md. Aminur, Hoque, Md. Nazrul, Ahmed, Md. Munsur and Khan, Hafiz T.A. ORCID: (2018) Correlates of healthy life expectancy in low- and lower-middle-income countries. BMC Public Health, 18 (1). pp. 476-487.

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Background: Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middleincome countries.
Methods: In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE,
demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations
Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives.
Results: The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure,
economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related
millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and
achieving a level of health-related MDGs were found to be the most influential factors.
Conclusion: To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

Item Type: Article
Identifier: 10.1186/s12889-018-5377-x
Additional Information: © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Keywords: Healthy life expectancy, Low- and lower-middle-income countries, Quality of life, Correlates of healthy life expectancy
Subjects: Medicine and health > Health promotion and public health
Medicine and health
Depositing User: Hafiz T.A. Khan
Date Deposited: 09 Mar 2018 05:58
Last Modified: 06 Feb 2024 15:56


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