Living a long, healthy and happy life is, probably, one of the dreams of most people. Basic indicators of quality of life, such as longevity, health and happiness interact with each other, but differently for men and women at different points over the course of their life cycle. Specifically, happiness is one of the life assessment indicators that enable us to summarise people’s quality of life as they subjectively perceive it. In addition to their state of health, happiness is explained by different factors such as, for example, following a certain lifestyle, work, civil status (whether people are married or living with a partner and when they do so), children or their social environment, among others.

To understand how the citizens of a population live and, in short, to improve their quality of life, objective and subjective measures need to be combined in order to develop an integrated indicator on quality of life. Unlike objective measures (such as socioeconomic level, life expectancy or recorded state of health), subjective measures provide personal appreciations and help to better understand people’s general state of wellbeing, which reflects to what point their vital needs are being satisfied.

The general interest in measuring a population’s quality of life from the perspective of public health has, in recent decades, led to consideration of whether the increase in people’s longevity (improvement in survival) is accompanied by a deterioration in their health. Even so, special interest currently exists in exploring not only the relationship between survival and people’s health but also the subjective evaluation that they make of their lives. At this point their evaluation of happiness intervenes. The years of life that an individual can expect to live happily is a new form of empirically measuring the useful life of people with a subjective quality of life indicator, as it includes how long (total duration) and for how many of these years people will live in happiness. Like the indicator on healthy life expectancy, the happy life expectancy summarises the quality of life for a population by combining data on life duration and a subjective measure of quality of life.

Empirical evidence shows that in developed countries life expectancy is high and continuing to increase (during the 20th century the average rate of increase was three months per year). On a global scale, countries with low or medium incomes recorded reductions in mortality among younger ages, whereas in countries with high incomes, the greater life expectancy is explained above all by the reduction in mortality rates among the population of advanced age (Mathers et al., 2015).

One of the results most repeated in scientific literature is the greater longevity of women if compared with that of men from the same generation. Table 1 shows the current life expectancy at birth and at age 50 years in five European countries with a high level of income. Average life expectancy at birth for men varies between 78.1 years in Germany and 80.6 in Italy and Sweden, while for women it varies between 83.0 years in Germany and 85.8 years in Spain. Men aged 50 years can expect to live from 29.9 to 32.2 years longer, and women from 34.2 to 36.7 years. Spanish and Italian women have a relatively long life expectancy at both times of life (at birth and at the age of 50). It is worth highlighting that the longer lives in the countries of southern Europe in comparison with those of the north is generally a reflection of the characteristics of Mediterranean countries; for example, a healthier eating pattern (Mediterranean diet) or healthier lifestyle habits with regard to tobacco consumption (smoking is less frequent among elderly women in southern Europe than among those in northern Europe).

The size of the gender gap in life expectancy at birth and at age 50 is substantial and varies between countries. The differences between men and women range between 3 and 6 years at birth and are slightly smaller between people aged 50 years (between 2.8 and 5.1 years, respectively). Therefore, we see that in all countries, women live longer than men and that gender differences are maintained. It is important to highlight, however, that the dimension of gender differences in life expectancy varies substantially between countries when broken down by state of health or socioeconomic status (education level or professional category). For example, graph 1 shows the life expectancy and the healthy life expectancy at age 50 years for men and women, and it is observed precisely that gender differences in healthy life expectancy are less evident. In the current study, the Global Activity Limitation Indicator (GALI) is used to define good health using the response to the question: “For at least the last 6 months, to what extent have you been limited because of a health problem in activities people usually do?” If the respondents answer that they have experienced no limitation, it is assumed that they enjoy good health; if, on the contrary, they manifest having suffered some limitation (which may be severe or not severe), they are assumed to be suffering from poor health.

As can be observed in graph 1, the fact that the populations of developed countries have longer lives does not necessarily mean that they live in conditions of good health. Furthermore, there is no clear international evidence on whether these additional years of life are lived with high levels of happiness.

In general, high levels of happiness have a positive influence on longevity, and happier people live more years (Koopmans et al., 2010). Being happy is associated with low levels of chronic illness, of high blood pressure and of stress. Furthermore, the context and the environment also have an influence on happiness. For example, individuals who live in greener neighbourhoods and who perceive their area to be safer and more functional present higher levels of happiness. Social capital, measured directly through GDP per capita and generalised social confidence in the organisational context, and indirectly through the index of public perception of corruption in governments and companies, is one of the main factors that helps us explain why some countries are happier than others (Bjørnskov, 2003). That said, and as indicated by the latest World Happiness Report (Helliwell et al., 2018), other indicators exist that help to explain the different levels of happiness between countries: healthy life expectancy, social relations, personal freedom and monetary generosity towards those most in need.

Graph 2 shows the happiness ranking in six European countries based on data from the Gallup World Poll international survey between 2015 and 2017. This survey defines happiness by asking respondents to evaluate the quality of their lives on a scale of 0 to 10. Among the countries selected, Sweden ranks first in the happiness classification, followed by Germany, France and Spain, while Italy occupies the last position. The difference in scores on the scale from 0 to 10 between Sweden and Italy is nearly a point and a half. In all countries, GDP per capita, social support and healthy life expectancy explain more than 50% of the happiness scores. The perception of corruption is an important variable when explaining differences in happiness between countries; however, it varies substantially and is more relevant for citizens from the centre and north of Europe than for those of the south. Even so, and as can be seen in graph 2, additional factors exist that affect life evaluation (the “Others” epigraph) that are not analysed here and that could probably help us to better understand the differences between countries.

To analyse in greater depth and better understand what people’s quality of life is like, it is necessary to combine objective health indicators (mortality) and subjective ones (perception of life satisfaction) in different social groups.

At present, there are numerous publications available that explain the differences in survival and healthy life expectancy between men and women, but studies analysing gender differences in life expectancy based on a subjective indicator of wellbeing are much thinner on the ground. Solé-Auró et al.(2018), in their analysis, use data from the fourth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE). The total sample contains information on 56,984 people in 16 European countries. Life happiness is measured  on a scale that runs from 0 (completely dissatisfied with life) to 10 (completely satisfied with life). High levels of happiness are defined by aggregating all answers that obtain a high score (from 8 to 10 on the scale).

Graph 3 presents the total life expectancy, life expectancy with good health and years of life with high levels of happiness at age 50 years for men and women. In addition to observing a higher survival rate for women in all cases, we see that countries in which life expectancy is higher are not those in which people live for longer happily. In fact, the number of years lived happily varies substantially between countries and it is revealing to know how those years of additional life are lived with regard to happiness. In the case of Spanish or French women, it is observed that, even though they have one of the highest life expectancies, the proportion of happy years is lower than in other countries. In contrast, Swedish men have one of the highest life expectancies, and they live through most of their years with a high level of happiness. As other studies indicate, gender differences in health and happiness are not closely related. For example, in Spain, France and Italy, life expectancy at age 50 is high, but they are also the countries with the highest number of years lived with low levels of happiness.

Graph 4 shows the proportion of remaining years of happy life expectancy at age 50 years for men and women. Men have more years of happy life expectancy than women, in all countries. Therefore, in comparison with men, women not only live more years in a worse state of health, but also with less happiness. In Spain, for example, men aged 50 years are expected to live 63% of their remaining life expectancy time with high levels of happiness; for women, in contrast, this percentage falls to 57% (in absolute values, this difference would mean a year and a half). This result (women live longer but with less happiness) could be explained by contextual differences between countries, such as gender equality, socioeconomic differences (for example, in education: in some countries women have a lower educational level) or overall levels of participation in the labour market (also lower in the case of women).

This study provides empirical evidence regarding an interesting and relevant aspect of health research for advanced societies, in which life expectancy is high and continues to increase. In particular, it reveals how both men and women live their lives in relation to happiness in different countries in the European Union (Solé-Auró et al., 2018). Women, in comparison with men, not only have greater longevity, but they live for more years in a state of less happiness. Furthermore, it has been seen that countries with the highest life expectancy are not necessarily the countries with the greatest happiness. Moreover, countries in which gender differences in life expectancy are high (the cases of Spain and France) are not the countries that present the highest gender differences in the perception of happiness (other countries such as Germany and Sweden present much greater differences). The results of the gender differences between countries can be explained by different individual and contextual factors.

Among the individual factors, the greater life expectancy of women with less happiness in some countries could be due to women’s poorer state of health. But it is also possible that women experience a double burden at younger ages: caring for their family and doing housework, and at more advanced ages, looking after their partners, who are generally elderly, and/or after their parents. In contrast, they have a lower probability of being cared for at home, and it is more probable that they live alone or have lost their partner. Therefore, in some countries, the greater longevity of women, but lived in a greater proportion of years with less happiness, would be due to the fact that they have more functional problems, difficulties in doing everyday life activities and also symptoms of depression, indicators that are generally spread out over time if compared with the lethal illnesses suffered by men (Crimmins et al., 2011).

Among the contextual factors, the differences between countries are explained by gender inequality, differences in pay between men and women, social support for elderly people (availability of home or residential care services), socioeconomic differences and women’s presence in the labour market (Van Oyen et al., 2010; Bambra et al., 2009).

This article has been adapted from this study:

SOLÉ-AURÓ, A.,D. JASILIONIS, P. LI and A. OKSUZYAN (2018):"Do women in Europe live longer and happier lives than men?", European Journal of Public Health, 28(5).
 

More bibliographic references:

BJØRNSKOV, C. (2003): "The happy few: cross-country evidence on social capital and life satisfaction", KYLOS, 56(1).

BAMBRA, C., D.P. POPE, V. SWAMI, D.L. STAINSTREET, A.-J. ROSKAM, A.E. KUNST and A. SCOTT-SAMUEL(2009): "Gender, health inequalities and welfare state regimes: a cross-national study of thirteen European countries", Journal of Epidemiology and Community Health,63.

CRIMMINS, E.M., J.K. KIM and A. SOLÉ-AURÓ (2011): "Gender differences in health: results from SHARE, ELSA and HRS", The European Journal of Public Health, 21.

HELLIWELL, J.F., R. LAYARD and J. SACHS(2018): World Happiness Report 2018, Nueva York: Sustainable Development Solutions Network.

KOOPMANS, T.A., J.M. GELEIJNSE, F.G. ZITMAN and E.J.GILTAY (2010): "Effects of happiness and all-cause mortality during 15 years of follow-up: The Arnhem Elderly Study", Journal of Happiness Studies, 11(1).

MATHERS, C.D., G.A. STEVENS, T. BOERMA and R.A. WHITE (2015): «Causes of international increases in older age life expectancy», The Lancet, 385(9967).

VAN OYEN, H., B. COX, C. JAGGER, E. CAMBOIS, W. NUSSELDER, C. GILLES and J.-M. ROBINE (2010): "Gender gaps in life expectancy and expected years with activity limitations at age 50 in the European Union: associations with macro-level structural indicators", European Journal of Ageing, 7.