Health Promotion International, Vol. 17, No. 3, 291,
September 2002
© Oxford University Press 2002
LETTER |
Reply to the Letter to the Editor
Research & Development of Kela (The Social Insurance Institution of Finland) FIN-20720 Turku Finland
Thank you for inviting us to respond to the comment made by Fjalar Finnäs (‘How long do Swedish-speaking Finns live?’). We thank the commentator for his valuable remarks on the calculations of population health expectancy and age structure. We agree that it is inappropriate to conclude about mortality or life expectancy from the average age at death, and we have been fully aware of the different meanings of the latter two measures. Therefore, we calculated and used disability-free life expectancy in our paper. We also wrote: ‘Ever since epidemiological health surveys have been published in Finland, the total mortality rates have favoured the Swedish-speaking minority’ [see (Hyyppä and Mäki, 2001a
)]. Accordingly, the commentator reports that the age-specific death risks for the Swedish speakers are on average markedly (20% for men) lower than the corresponding ones for Finnish speakers in the whole of Finland. He might gain more convincing evidence for the disparity in Ostrobothnia by calculating the age-specific death risks and life expectancies of the language groups in this limited geographic area. Therefore, we have good reasons to argue that the lifetime of the Swedish-speaking Finns is one of the longest known in the world.
We agree, of course, that the differential migration effect can be the main reason for the disparity in the population age pyramids. The higher average age at death depends on the greater proportion of elderly people among the Swedish speakers, which can be due to migration from Ostrobothnia to Sweden. The migration effect on the disparity in health and social capital is intriguing since migrating people are healthier than non-migrating people who stay in their home district (Bentham, 1988). If this is true in Ostrobothnia, it means that less healthy Swedish speakers have stayed at home during the migration period. Since the migration losses of Swedish speakers in southern Finland have been much smaller than in Ostrobothnia, it is interesting to note that in 1996, 3.9% of men and 3.7% of women in the former community, in comparison with 5.0% of men and 4.4% of women in the latter community, were on disability pension before 65 years of age (Hyyppä and Mäki, 2002). Although migration losses attenuate health statistics in the Ostrobothnian Swedish-speaking community, there is a much higher percentage of disability-free and elderly people among the Swedish than among the Finnish speakers in the same region. In another recent study, we showed that after controlling for language, demographic factors (including migration) and several health-related variables, social capital was significantly and independently associated with good self-rated health. Furthermore, we found that after controlling for demographic factors (including migration) and several health-related variables, the Swedish speakers had more social capital than the Finnish speakers in Ostrobothnia (Hyyppä and Mäki, 2001b).
REFERENCES
Bentham, G. (1988) Migration and morbidity: implications for geographic studies of diseases. Social Science and Medicine, 26, 49–54.
Hyyppä, M. T. and Mäki, J. (2001a) Why do Swedish-speaking Finns have longer active life? An area for social capital research. Health Promotion International, 16, 55–64.
Hyyppä, M. T. and Mäki, J. (2001b) Individual-level relationships between social capital and self-rated health in a bilingual community. Preventive Medicine, 32, 148–155.[Web of Science][Medline]
Hyyppä, M. T. and Mäki, J. (2002) Toimivassa kansalaisyhteisässä tarvitaan vähemmän kuntoutusta. (Less rehabilitation is needed in an active civic community.) (In Finnish.) Suomen Lääkärilehti, 56, 3067–3070.
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