Walking difficulties in Europe: gender and regional inequalities in prevalence and healthy life expectancy

The aim of this study was to assess the prevalence of walking difficulties across European countries and to examine gender and regional inequalities in healthy life expectancy without walking difficulties.

Data were obtained from the third wave of the European Health Interview Survey (EHIS-3), conducted between 2018 and 2020, involving over 305,000 respondents. Walking difficulties were defined as any self-reported difficulty walking 500 metres without aids. Age-standardised prevalence rates were calculated using the 2013 European standard population. Life expectancy (LE) and healthy life expectancy without walking difficulties (HLE) were estimated using abridged life tables and the Sullivan method. Analyses were conducted separately for women and men and summarised at country and regional levels.

Across Europe, walking difficulties were more prevalent among women (11.3%) than men (8.9%). Pronounced geographical inequalities were observed, with the lowest prevalence and highest HLE in Western and Northern Europe and the highest burden in Eastern and parts of Southern Europe. Although women have a higher LE, they spend a greater proportion of their lives with mobility limitations, confirming the health-survival paradox. Substantial between-country differences were evident in both absolute and relative years lived with mobility limitations.

Marked gender and regional inequalities in mobility persist across Europe. These findings provide important evidence to support targeted public health policies and preventive strategies aimed at reducing the burden of physical limitations and promoting healthy ageing.