Finland has established its first population-level reference values for measuring how long people can expect to live with the ability to work, care for others, manage household responsibilities and participate in everyday life. The findings introduce Finnish benchmarks for functional capacity and work ability, while also supporting a new measure known as Productivity-Adjusted Life Expectancy, or PALE. Unlike conventional life expectancy, which counts years lived regardless of health status, PALE estimates the number of years people can expect to live while maintaining productive functioning, including both paid employment and unpaid activities. The results, published in Social Science & Medicine, are part of an international effort to create comparable measures of the wider social consequences of disease and disability.
The study is based on data from 3,644 Finnish adults aged 20 to 79 who participated in a population survey during the summer of 2024. The sample was designed to represent Finland’s adult population geographically and demographically, allowing the researchers to estimate national-level norms rather than relying on clinical groups or narrowly defined occupational populations. These norms are important because the consequences of illness vary considerably with age, sex, employment status and daily responsibilities. A reduction in the ability to work may be the most visible effect of a disease in an employed person, but the same condition can also limit cooking, cleaning, childcare, caregiving, volunteering or other unpaid activities that sustain households and communities.
To capture these effects, the researchers created a weighted productivity index ranging from 0 to 1. A value of 1 represents full functioning and work ability, while 0 represents complete inability to perform daily activities or work because of health-related limitations. The index is intended to express the average proportion of full productive capacity that remains available to an individual. Thus, a coefficient of 0.80 indicates that a person is functioning at approximately 80 percent of the level expected in the absence of illness or other health conditions. The measure combines information about everyday functioning and work ability rather than treating productivity as synonymous with paid employment alone.
Across the Finnish adult population, the average weighted productivity index was 0.77. The estimated value was 0.78 among men and 0.76 among women. These figures do not mean that every person in the population operates at precisely that level, nor do they represent a direct measure of economic output. Instead, they are population averages that summarize the effects of health-related limitations across a wide range of activities. Their value lies in providing a standardized baseline against which researchers can compare specific diseases, demographic groups or policy interventions. A study of chronic pain, depression, cardiovascular disease or musculoskeletal disorders, for example, could use age- and sex-specific Finnish norms to estimate how far affected individuals fall below expected population functioning.
The researchers argue that conventional health-economic evaluations often give disproportionate attention to paid employment because wages, absenteeism and reduced labor-force participation are relatively easy to quantify. Unpaid work is more difficult to price, even though it is essential to the functioning of families and society. Household labor, informal caregiving and other unpaid contributions can represent thousands of hours of activity over a lifetime, yet they are generally excluded from measures such as gross domestic product. By incorporating these activities into the productivity framework, the Finnish approach attempts to make health-related losses more visible. A person who leaves paid employment but continues to provide substantial care at home may experience a major change in work ability without becoming economically inactive in any meaningful social sense.
The study’s most striking result concerns Productivity-Adjusted Life Expectancy. Finnish life tables indicate that a 20-year-old man can expect to live to approximately 80 years of age, while a 20-year-old woman can expect to live to approximately 85. When those projected years are adjusted for the loss of functioning and productivity associated with health problems, the estimates fall to 42.9 years for men and 46.1 years for women. PALE therefore does not predict the age at which an individual will die. Instead, it estimates the equivalent number of years a person can expect to live with full or unrestricted functioning after accounting for partial limitations across the life course.
Technically, the measure can be understood as a health-adjusted accumulation of future life years. Each period of expected survival is weighted by the corresponding level of functioning and productivity in the population. A year lived with a productivity coefficient of 1 contributes a full year to PALE, while a year lived at a coefficient of 0.5 contributes approximately half a year. The calculation links survey-derived functional information with life-expectancy estimates, producing a single summary measure that reflects both mortality and morbidity. This approach is related to other health-adjusted life-expectancy measures, but its distinctive feature is the explicit inclusion of productive participation in paid and unpaid roles.
The difference between ordinary life expectancy and PALE illustrates why survival alone can provide an incomplete picture of population health. Medical advances may extend life while leaving people with chronic conditions, disability or reduced capacity to participate in daily activities. Conversely, prevention, rehabilitation and effective treatment may improve functioning even when they have a smaller immediate effect on mortality. PALE is designed to detect that distinction. It could help policymakers ask not only whether people are living longer, but also whether additional years are being lived with the ability to work, care for others and manage independent daily life.
Finnish norm values may also support comparisons across countries. Similar population-level reference values have previously been reported in Australia and Canada, and the researchers hope that standardized methods will eventually make it possible to compare the broader societal burden of illness internationally. Such comparisons require caution because countries differ in health systems, employment patterns, retirement ages, household structures and cultural expectations surrounding unpaid work. Nevertheless, common metrics can help identify whether apparent differences in disease burden reflect actual health disparities, differences in labor-market participation or contrasting ways of measuring productivity. The age- and sex-specific Finnish values are intended to provide a stable reference point for future studies rather than a universal standard that ignores national context.
The researchers say the new framework could be used to estimate the economic and social burden of diseases, evaluate health and welfare policies, compare population groups and measure the effectiveness of interventions aimed at preserving functioning. It may also help quantify losses that are invisible in conventional economic statistics, particularly among older adults, people with chronic conditions and those whose main contributions occur outside formal employment. The data were collected through the PREWELL consortium, an initiative focused on promoting positive mental wellbeing among high-risk adults through capabilities, gamification and digital intervention, with funding from the Next Generation EU programme. By placing Finnish life expectancy alongside functional capacity and productivity, the study offers a new way to describe population health: not simply how many years people live, but how many years they can expect to remain able to participate fully in the activities that keep society running.
Subject of Research: People
News Publication Date: 20-Aug-2026
Web References: https://doi.org/10.1016/j.socscimed.2026.119723; https://uefconnect.uef.fi/en/prewell/
References: Social Science & Medicine, DOI: 10.1016/j.socscimed.2026.119723
Keywords: Productivity-Adjusted Life Expectancy, PALE, life expectancy, functional capacity, work ability, Finland, population health, health economics, unpaid work, caregiving, productivity, chronic disease, health policy, Social Science & Medicine
