Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
Potential Years of Life Lost (PYLL)
Definition
Potential years of life lost (PYLL) is an indicator of early death (before age 75), which gives greater
weight to deaths occurring at a younger age than to those at later ages. PYLL emphasizes the loss to
society of the potential contribution that younger individuals can make. By emphasizing the loss of
life at an early age, PYLL focuses attention on the need to deal with the major causes of early deaths,
such as injury, in order to improve health status. For example, the death of a 50–year–old contributes
‘one death’ to premature mortality, but ‘25 years’ to PYLL; whereas the death of a 70–year–old also
contributes ‘one death’ to premature mortality, but only ‘five years’ to PYLL.
In this report, PYLL is the average annual number of potential years of life lost for deaths up to age 74,
per 1,000 residents from birth to age 74. For each death, the PYLL value is calculated as: PYLL = 75 – age
at death. This indicator has some similarity to premature mortality and life expectancy, but PYLL is more
sensitive to deaths at younger ages. Rates were calculated for four 5–year periods and a final four–year
period and were age– and sex–adjusted to the Manitoba population in the last time period.
NOTE: in other MCHP reports, PYLL has also been analysed as the potential years of life lost for deaths
from age one to 74 per 1,000 residents aged one to 74. Analyses of PYLL excluding the births occurring
during the first year of life are available on request from the lead author (P. Martens). There is little
overall change in trends or in measures of inequality, but the PYLL rates are around 10–15% lower.
Time Periods Average annual rate per 1,000
T1: 1984–1988 75.15
T2: 1989–1993 68.56
T3: 1994–1998 67.98
T4: 1999–2003 62.50
T5: 2004–2007 60.53
Key findings: Potential Years of Life Lost (PYLL)
Manitoba overall rates:
• From the first time period T1 (1984–1988) to the last time period T5 (2004–2007), the PYLL (potential
years of life lost among residents dying before the age of 75, per 1,000 residents 74 and under)
dropped from 75.15 to 60.53 years per 1,000 provincially.
Rates by neighbourhood income quintile over time:
Rural:
• From T1 to T5, the PYLL of rural neighbourhood income quintile groups R3 to R5 decreased steadily,
whereas the PYLL of R2 remained unchanged except for a jump in T3 (1994–1998). In the lowest rural
neighbourhood income quintile (R1), there was a drop from T1 to T2 (1989–1993) but thereafter the
rate increased slightly.
Manitoba Centre for Health Policy 31