The apparent discrepancy between social inequality in disability-free and quality-adjusted life expectancy

Disability-free and healthy life expectancy yield larger estimated magnitudes of health inequality than quality-adjusted life expectancy. This is due to their binary scaling, which implicitly assigns a HRQOL value of zero (as bad as death) to disability or non-good health. A simple adjustment to narrow both ends of the binary scale renders the two approaches more comparable.

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Publication Details

Journal
Value in Health
Published
2026-02-01
DOI
https://doi.org/10.1016/j.jval.2026.01.026
Primary Topic
Health Systems, Economic Evaluations, Quality of Life
Type
article
Field-Weighted Citation Impact
0.00
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article

The apparent discrepancy between social inequality in disability-free and quality-adjusted life expectancy

Ieva Skarda, Richard Cookson, James Lomas
Value in Health
Health Systems, Economic Evaluations, Quality of Life
article

The apparent discrepancy between social inequality in disability-free and quality-adjusted life expectancy

Ieva Skarda, Richard Cookson, James Lomas
article en

Abstract

Disability-free and healthy life expectancy yield larger estimated magnitudes of health inequality than quality-adjusted life expectancy. This is due to their binary scaling, which implicitly assigns a HRQOL value of zero (as bad as death) to disability or non-good health. A simple adjustment to narrow both ends of the binary scale renders the two approaches more comparable.

Value in Health
University of York (GB)
Reduced inequalities
Openalex Percentile: Top 61%
Health Systems, Economic Evaluations, Quality of Life
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The apparent discrepancy between social inequality in disability-free and quality-adjusted life expectancy — Ieva Skarda, Richard Cookson, et al. · Value in Health (2026) | TGRS Research Map | TGRS