Healthy life expectancy and its trends among Brazilian older adults from 2003 to 2019: an observational study using PNAD and PNS data
- 1Health Sciences Center, Federal University of Rio Grande do Norte
Abstract
Introduction: Population longevity is a relatively recent phenomenon in Latin America. In Brazil, the region’s largest and most populous country, studies examining healthy life expectancy (HLE) are scarce. Hence, this repeated/serial cross-sectional study aimed to analyze healthy life expectancy (HLE) and its trends among Brazilian older adults at national and regional levels from 2003 to 2019. The analysis used data on functional disability, self-rated health, and multimorbidity from the Brazilian National Household Sample Survey (PNAD) and National Health Survey (PNS), 2013 and 2019, both conducted by the Brazilian Institute of Geography and Statistics (IBGE).
Methods: The PNAD and PNS employed a three-stage cluster probability sampling design. The territorial divisions and sectoral networks established for the 2000 (PNAD 2003 and 2008) and 2010 (PNS 2013 and 2019) population censuses served as the primary and secondary sampling units, respectively. Health indicators were analyzed by estimating prevalence, stratified by sex, age group, and geographic region, with 95% confidence intervals, while accounting for the complex sampling design, sample weights, and design effects. Life expectancy (LE), disability-free life expectancy (DFLE), multimorbidity-free life expectancy (MFLE), and life expectancy with good self-rated health (GSR-LE) were calculated using Sullivan’s method and compared by sex for 2003 and 2019. The data used were secondary and publicly available; therefore, approval from an ethics committee was not required. The variables analyzed were sex, geographic region, self-rated health, functional disability, and multimorbidity.
Results: Among Brazilian older adults, HLE (0.57%), DFLE (11.94%), MFLE (13.70%), and GSR-LE (18.91%) increased. Although women experienced a greater increase in LE, their gains in HLE were slightly lower than those of men across all analyzed dimensions, both nationally and across all geographic regions. Men showed an absolute compression of multimorbidity and a relative compression of LE with functional disability and poor self-rated health.
Conclusion: These sex-based discrepancies reinforce the gender health survival paradox, highlighting the potential relationship between the findings and genetic, behavioral, and cultural factors, which could guide the formulation of public health policies.
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BibTeX
@article{cesario2026healthy,
title = {{Healthy life expectancy and its trends among Brazilian older adults from 2003 to 2019: an observational study using PNAD and PNS data}},
author = {Vanovya Alves Claudino Cesário and Kenio Costa Lima},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1797715},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1797715/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Healthy life expectancy and its trends among Brazilian older adults from 2003 to 2019: an observational study using PNAD and PNS data
AU - Vanovya Alves Claudino Cesário
AU - Kenio Costa Lima
PY - 2026
DA - 2026/10/19
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1797715
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1797715/full
AB - Introduction: Population longevity is a relatively recent phenomenon in Latin America. In Brazil, the region’s largest and most populous country, studies examining healthy life expectancy (HLE) are scarce. Hence, this repeated/serial cross-sectional study aimed to analyze healthy life expectancy (HLE) and its trends among Brazilian older adults at national and regional levels from 2003 to 2019. The analysis used data on functional disability, self-rated health, and multimorbidity from the Brazilian National Household Sample Survey (PNAD) and National Health Survey (PNS), 2013 and 2019, both conducted by the Brazilian Institute of Geography and Statistics (IBGE). Methods: The PNAD and PNS employed a three-stage cluster probability sampling design. The territorial divisions and sectoral networks established for the 2000 (PNAD 2003 and 2008) and 2010 (PNS 2013 and 2019) population censuses served as the primary and secondary sampling units, respectively. Health indicators were analyzed by estimating prevalence, stratified by sex, age group, and geographic region, with 95% confidence intervals, while accounting for the complex sampling design, sample weights, and design effects. Life expectancy (LE), disability-free life expectancy (DFLE), multimorbidity-free life expectancy (MFLE), and life expectancy with good self-rated health (GSR-LE) were calculated using Sullivan’s method and compared by sex for 2003 and 2019. The data used were secondary and publicly available; therefore, approval from an ethics committee was not required. The variables analyzed were sex, geographic region, self-rated health, functional disability, and multimorbidity. Results: Among Brazilian older adults, HLE (0.57%), DFLE (11.94%), MFLE (13.70%), and GSR-LE (18.91%) increased. Although women experienced a greater increase in LE, their gains in HLE were slightly lower than those of men across all analyzed dimensions, both nationally and across all geographic regions. Men showed an absolute compression of multimorbidity and a relative compression of LE with functional disability and poor self-rated health. Conclusion: These sex-based discrepancies reinforce the gender health survival paradox, highlighting the potential relationship between the findings and genetic, behavioral, and cultural factors, which could guide the formulation of public health policies.
SN - 2296-2565
ER -