Multistate healthy life expectancy decomposition (MultiLED)
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| Project Summary

Title: Multistate Healthy Life Expectancy Decomposition
Acronym: MultiLED
Principal Investigator: Timothy Riffe
Funder: La Caixa Foundation
Grant Identifier: SR22-00502
Total funded amount: 99999.46€
Dates: 01/12/2022 - 31/05/2025
Summary: This project will develop, describe, test, and apply a method to decompose differences in summary measures calculated from multistate models reliably. We will apply the approach to multistate estimates of healthy life expectancy (HLE) in Spain to explain trends and inequalities in HLE in terms of health and mortality transitions.
Methods: We will estimate health and mortality transitions for the Spanish population using EU-SILC and SHARE data and use these to calculate healthy and unhealthy life expectancy using multistate models. The proposed decomposition method will then be used to explain changes and gaps in healthy life expectancy.
Expected results: Decomposition results will indicate the absolute and relative importance of mortality differences and critical transitions such as the onset and recovery from disability.
Social relevance: These results will help quantify the relative importance of life-saving versus prevention and recovery on healthy life years. Such information aids in framing policies aimed at closing gaps and continuing health improvement for the whole population.
Scientific value: For social scientists using multistate models to estimate working life expectancy, partnership expectancies, or healthy life expectancy, our proposed decomposition method will allow research into some of the most compelling questions in social science: what transitions determine trends and what transitions create gender, class, geographical, and other inequalities?
| Main Collaborators
- Tim Riffe (PI), Ikerbasque & UPV/EHU University of the Basque Country
- Rustam Tursun-zade, UPV/EHU University of the Basque Country
- Mauricio Gonzalez-Forero, University of St Andrews (United Kingdom)
- Francisco Villavicencio, Universitat de Barcelona School of Economics (Barcelona)
- Margherita Moretti, Helsinki Institute for Demography and Population Health (Finland)
- Tianyu Shen, Australian National University (Australia)
- Shubhankar Sharma, Helsinki Institute for Demography and Population Health (Finland)
- Angelo Lorenti, Max Planck Institute for Demographic Research (Germany)
- Sergi Trias Llimos, Centre d'Estudis Demogràfics (Barcelona)
| Project Outputs
Meetings & conferences organization
- EAPS HMMWG 2024 annual meeting (Bilbao, Sept 25-27 2024). For more information: https://www.ehu.eus/en/web/opik/hmmwg-annual-meeting
Scientific Papers
- Margherita Moretti, Tim Riffe, and Angelo Lorenti (2025). Multistate analysis and decomposition of disability-free life expectancy trends in Italy 2004-2019. Population Studies. DOI: https://doi.org/10.1080/00324728.2025.2475435
- Tim Riffe, Iñaki Permanyer, Rustam Tursun-zade, Magdalena Muszynska-Spielauer (2024). The joint distribution of years lived in good and poor health. Population Health Metrics. Vol. 22 (1). DOI: https://doi.org/10.1186/s12963-024-00354-w
- Tim Riffe, Francisco Villvicencio, Mauricio Gonzalez-Forero (2024, in review). Sensitivity and decomposition of multistate healthy life expectancy. MPIDR Working Paper WP-2024-14 https://dx.doi.org/10.4054/MPIDR-WP-2024-014
- Tim Riffe, Rustam Tursun-zade, SergiTrias-Llimós (2024, in revision) Arriaga meets Kitagawa. Life Expectancy decomposition with population subgroups. MPIDR Working Paper WP-2024-29 https://dx.doi.org/10.4054/MPIDR-WP-2024-029
- Tianyu Shen, Tim Riffe, Collin Payne, and Vladimir Canudas Romo (2023). Decomposition of Differences in Health Expectancies from Multistate Life Table. Demography. DOI: https://doi.org/10.1215/00703370-11058373
Papers in preparation
- Tim Riffe, Mauricio Gonzalez-Forero. Attrition-based sensitivity for multistate models of health with large state spaces
- Tim Riffe, Rustam Tursun-zade. Decomposing a Sullivan expectancy: An indirect incidence-based approach.
- Tim Riffe, Rustam Tursun-zade, Amaia Bacigalupe, Ainhoa Alustiza: Disentangling the gender paradox in health and mortality in Spain (2011 - 2021)
- Margherita Moretti, Tim Riffe, Kaarina Korhonen, Alyson van Raalte, Pekka Martikainen. Demographic and social drivers of widowhood expectancy evolution over three decades in Finland
- Shubhankar Sharma, Tim Riffe, Pekka Martikainen, Mikko Myrskylä, Margherita Moretti. Decomposing the change in cardiovascular disease-free life expectancy in Finland by gender and education (2000-04 and 2016-20): A multistate decomposition based on total population register data
- Shubhankar Sharma, Tim Riffe, Pekka Martikainen, Mikko Myrskylä, Margherita Moretti. Decomposing the gender disparity in cardiovascular health: A register-based multistate analysis
- Adrian Kunz, Adrien Remund, Tim Riffe, Karsten Hank. How does Healthy Life Expectancy differ between Migrants and Natives?
Presentations in different events
- Shubhankar Sharma (2025, Jan 13) Cardiovascular-disease free life expectancy (HLE): decomposing the changes (project 2) and gender disparities (project 3), faculty seminar. University of Helsinki, Finland.
- Tim Riffe (2025, Jan 28, invited) “The limits of Sullivan inputs, and what to do about them”, Laboratory on Longevity and Ageing (LoLA) network, online.
- Tim Riffe (2024, Sept 25-27) EAPS Health, Morbidity, and Mortality Working Group meeting. “DemoDecomp: An R package of generalized demoposition methods”. Bilbao, Spain.
- Tim Riffe (2024, June 12-15) EPC meeting “Decomposing a Sullivan expectancy: An indirect incidence-based approach”. Edinburgh, UK.
- Tim Riffe (2024, May 22-24) REVES annual meeting. “Decomposing a Sullivan expectancy: An indirect incidence-based approach”. Bogotá, Colombia.
- Tim Riffe (2024, May 22-24) REVES annual meeting. “Arriaga meets Kitagawa: life expectancy decompositions including population subgroups”. Bogotá, Colombia.
- Tim Riffe (2024, April 17-20) PAA Annual Meeting “Decomposing a Sullivan expectancy: An indirect incidence-based approach”. Columbus, USA.
- Margherita Moretti (2024, November 6-8) 2nd Annual MaxHel Center Meeting. Rostock, Germany.
- Margherita Moretti (2024, September 25) EAPS Health, Morbidity, Mortality working group annual meeting. Bilbao, Basque Country.
- Margherita Moretti (2024, August 20-21) “Evolution over three decades of widowhood lifespan in Finland and its gender and educational inequalities” New horizons for health equity research workshop. Stockholm, Sweden.
- Margherita Moretti (2024, June 12-15) “Evolution over three decades of widowhood lifespan in Finland and its gender and educational inequalities” European Population Conference EPC. Edinburgh, United Kingdom.
- Tianyu Shen (2024, March 27, invited) “Decomposing the Difference in Healthy Life Expectancy From Multistate Life Table”. Formal Demography Working Group. online.
- Tim Riffe (2023, Sept 28, invited) Uncertainty in healthy life years, CPoP Seminar Series, Odense, Denmark
- Tim Riffe (2023, Sept 26, invited) Uncertainty in healthy life years, MPIDR Population Health Lab Talk, Rostock, Germany.
- Tianyu Shen (2023, April 13) “Decomposing the Difference in Healthy Life Expectancy From Multistate Life Table” PAA annual meeting, New Orleans, USA.
- Tim Riffe (2023, March 7, invited) “Uncertainty in healthy life years” Population and Health Research Group Seminar Series University of St. Andrews, UK.
- Tim Riffe (2022, August 30 - Sept 2, invited) “Decomposing differences in multistate indices: Compositional reflections” Climbing Mortality Models workshop, Misurina, Italy
- Tim Riffe (2023, Sept 20-22) “Sensitivity and decomposition of multistate healthy life expectancy” (poster) EAPS Health, Morbidity, and Mortality Working Group meeting. Budapest, Hungary.
- Tim Riffe (2023, May 24-26) “Sensitivity and decomposition of multistate healthy life expectancy” (poster) REVES Meeting. Padua, Italy.
- Tianyu Shen (2023, April 12-15) “Decomposing the Difference in Healthy Life Expectancy From Multistate Life Table” (poster) PAA Annual Meeting, New Orleans, USA.
- Margherita Moretti (2023, February 2) “Multistate analysis and decomposition of disability-free life expectancy trends at mid-to-older ages in Italy, 2004–19”
- Giornate di Studio sulla Popolazione – Popdays (SIS-AISP) (Rome, Italy)
- Margherita Moretti (2023, April 12-15) “A Multistate Analysis and Decomposition of Disability-Free Life Expectancy Trends in Italy, 2004–2019” (poster) PAA Annual Meeting, New Orleans, USA.
- Margherita Moretti (2023, Jan 31) “Multistate analysis and decomposition of disability-free life expectancy trends at mid-to-older ages in Italy, 2004–19”. Workshop LoLA (Rome, Italy)