A VARIED PATTERN OF CHANGE OF THE SEX DIFFERENTIAL IN SURVIVAL IN THE G7 COUNTRIES

2005 ◽  
Vol 38 (3) ◽  
pp. 391-401 ◽  
Author(s):  
FRANK TROVATO ◽  
NILS B. HEYEN

Over the course of the 20th century the sex differential in life expectancy at birth in the industrialized countries has widened considerably in favour of women. Starting in the early 1970s, the beginning of a reversal in the long-term pattern of this differential has been noted in some high-income countries. This study documents a sustained pattern of narrowing of this measure into the later part of the 1990s for six of the populations that comprise the G7 countries: Canada, France, Germany, Italy, England and Wales (as representative of the United Kingdom) and USA. For Japan, a persistence of widening sex differences in survival is noted. The sex differences in life expectancy are decomposed over roughly three decades (early 1970s to late 1990s) from the point of view of four major cause-of-death categories: circulatory diseases, cancers, accidents/violence/suicide, and ‘other’ (residual) causes. In the six countries where the sex gap has narrowed, this has resulted primarily from reduced sex differences in circulatory disease mortality, and secondarily from reduced differences in male and female death rates due to accidents, violence and suicide combined. In some of the countries sex differentials in cancer mortality have been converging lately, and this has also contributed to a narrowing of the difference in life expectancy. In Japan, males have been less successful in reducing their survival disadvantage in relation to Japanese women with regard to circulatory disease and cancer; and in the case of accidents/violence/suicide, male death rates increased during the 1990s. These trends explain the divergent pattern of the sex difference in life expectation in Japan as compared with the other G7 nations.

2009 ◽  
Vol 1 (4) ◽  
pp. 270 ◽  
Author(s):  
Peter Sandiford

INTRODUCTION: Men’s health is of increasing concern to policy makers worldwide. Although women generally live significantly longer than men, the difference in life expectancy in many countries is now narrowing. AIM: To document the trend in sex differences in New Zealand (NZ) life expectancy at birth (LEB) over the last decades and to determine disease patterns which account for it. METHODS: Decomposition of sex differences in LEB by age and cause for the periods 1980–82, 1985–87, 1990–92,1995–97, 2000–02, and 2005–06, using registered deaths and model life tables. RESULTS: Sex differences in LEB increased from 1951 to peak in 1976 before narrowing again. In 2006 they reached almost exactly the level they were at 55 years earlier. Changes in relative mortality from ischaemic heart disease (IHD) and to a lesser extent accidents, respiratory disease and other circulatory causes, brought about the recent decline in gender survival disparities. IHD continues to be a significant cause of gender inequality, but cancers have now become a major component of the sex difference in LEB. DISCUSSION: NZ’s experience mirrors closely that of other developed countries in pattern, timing and the age–cause composition of the trend in gender survival disparities. Thus differences in the timing of taking up smoking, found to explain a substantial portion of the trend elsewhere, were probably also important in NZ, but improvements in medical outcomes for smokers also must have played a significant role. Primary care practitioners will continue to reduce gender survival disparities by working to ensure a high uptake of services such as screening for colorectal cancer, one of many diseases responsible for lower male life expectancy. KEYWORDS: Health status disparities; sex factors; health transition; men’s health; life expectancy; women’s health


2020 ◽  
Author(s):  
Bogdan Wojtyniak ◽  
Jakub Stokwiszewski

Our study, availing the new, agreed by the OECD and Eurostat, lists of preventable and treatable causes of death, seeks to quantify the contribution of avoidable causes to premature mortality and its dynamics in Poland and Central European countries – Czechia, Hungary, Lithuania and Slovenia, in comparison with Sweden serving as a benchmark country in 1999–2017. We calculated age standardised death rates for the broad groups of avoidable causes and more specific ones, which comprised preventable and treatable cancer and diseases of the circulatory system (DCS), preventable injuries and alcohol-related diseases. Deaths from not avoidable causes were also analysed. The analysis of time trends in the death rates and calculation of the Average Annual Percent Change (AAPC) for the overall trend were performed with joint-point models. The contribution of changes in mortality from avoidable causes to increase life expectancy during 1999–2017 and contribution of the difference in mortality from these causes to the difference in life expectancy between five countries and Sweden were based on the decomposition of temporary life expectancy between birth and age 75 [e(0-75)]. For the calculation of life expectancy, we used the classic Chiang method and the decomposition of life expectancy by the death causes and age was conducted with the Arriaga method. The AAPC of death rates from avoidable causes in 1999–2017 was similar in all the countries but Lithuania, where the decline started later. The decline in the death rates from not avoidable causes is much slower than the rates from avoidable causes. Mortality from treatable causes was decreasing faster than from preventable causes in most populations. In 1999–2017, the average rate of mortality decline for preventable cancer was greater among men than among women, while for treatable cancer the sex-related differences were much smaller and in favour of women. As for preventable and treatable death from DCS, their decrease was faster among women than men in all the countries but Sweden. Improvements in mortality from causes that could be avoided through prevention or treatment made substantial positive contributions to the overall change in life expectancy in all the countries. The differences in temporary life expectancy e(0-75) between the analysed Central European countries and Sweden were much smaller in 2017 than in 1999, due to the reduction of the gap in mortality from avoidable causes. Our results show that among men, and to a lesser extent among women, mortality from preventable causes contributes more than mortality from causes that can be effectively treated to shorter life expectancy in the countries of Central Europe than in Sweden. This indicates that in reducing the health gap between the inhabitants of Central Europe and Western Europe, the healthcare system should consider disease prevention even to a greater extent than just treating them.


2001 ◽  
Vol 28 (1) ◽  
pp. 89 ◽  
Author(s):  
Frank Trovato ◽  
N. M. Lalu

A number of industrialized nations have recently experienced some degrees of constriction in their long-standing sex differentials in life expectancy at birth. In this study we examine this phenomenon in the context of Canada’s regions between 1971 and 1991: Atlantic (Newfoundland, Nova Scotia, New Brunswick, Prince Edward Island); Quebec, Ontario, and the West (Manitoba, Saskatchewan, Alberta, British Columbia, Yukon and Northwest Territories). Decomposition analysis based on multiple decrement life tables is applied to address three questions: (1) Are there regional differentials in the degree of narrowing in the sex gap in life expectancy? (2) What is the relative contribution of major causes of death to observed sex differences in average length of life within and across regions? (3) How do the contributions of cause-of-death components vary across regions to either widen or narrow the sex gap in survival? It is shown that the magnitude of the sex gap is not uniform across the regions, though the differences are not large. The most important contributors to a narrowing of the sex gap in life expectancy are heart disease and external types of mortality (i.e., accidents, violence, and suicide), followed by lung cancer and other types of chronic conditions. In substantive terms these results indicate that over time men have been making sufficient gains in these causes of death as to narrow some of the gender gap in overall survival. Regions show similarity in these effects.


2011 ◽  
Vol 43 (3) ◽  
pp. 353-367 ◽  
Author(s):  
FRANK TROVATO ◽  
DAVID ODYNAK

SummaryA growing body of research often indicates that immigrant populations in Western countries enjoy a lower level of mortality in relation to their native-born host populations. In this literature, sex differences in mortality are often reported but substantive analyses of the differences are generally lacking. The present investigation looks at sex differences in life expectancy with specific reference to immigrant and Canadian-born populations in Canada during 1971 and 2001. For these two populations, sex differences in expectation of life at birth are decomposed into cause-of-death components. Immigrants in Canada have a higher life expectancy than their Canadian-born counterparts. In absolute terms, immigrant females enjoy the highest life expectancy. Inrelativeterms, however, immigrant men show a larger longevity advantage, as their expectation of life at birth exceeds that of Canadian-born men by a wider margin than do foreign-born females in relation to Canadian-born females. It is also found that immigrants have a smaller sex differential in life expectancy as compared with the Canadian born. Decomposition analysis shows this is a function of immigrants having smaller sex differences in death rates from heart disease and cancer. Factors thought to underlie these differentials between immigrants and the Canadian born are discussed and suggestions for further research are given.


2021 ◽  
Author(s):  
Anna Kankaanpää ◽  
Asko Tolvanen ◽  
Pirkko Saikkonen ◽  
Aino Heikkinen ◽  
Eija K. Laakkonen ◽  
...  

ABSTRACTBackgroundThe sex gap in life expectancy has been narrowing in Finland over the past four to five decades; however, on average, women still live longer than men. Epigenetic clocks are markers for biological aging that predict lifespan. In this study, we examined the mediating role of lifestyle factors on the association between sex and biological aging in younger and older adults.MethodsOur sample included same-sex younger and older twins (21-42-y, n = 1110; 50-76-y, n = 763) and younger opposite-sex twins (21-30-y, n = 302). Blood-based DNA methylation (DNAm) was used to compute epigenetic age acceleration by four epigenetic clocks as a measure of biological aging. Path modelling was used to study whether the association between sex and biological aging is mediated through lifestyle-related factors, i.e. education, body mass index, smoking, alcohol use, and physical activity.FindingsIn comparison to women, men were biologically older and, in general, they had unhealthier life habits. The effect of sex on biological aging was partly mediated by smoking, but only in older twins. Sex was directly associated with biological aging and the association was stronger in older twins.InterpretationPreviously reported sex differences in lifespan are also evident in biological aging. Declining smoking prevalence among men is a plausible explanation for the narrowing of the difference in life expectancy between the sexes. Data generated by the epigenetic clocks may help in estimating the effects of lifestyle and environmental factors on aging and in predicting aging in future generations.


Author(s):  
Karin Modig ◽  
Marcus Ebeling

Objectives: Mortality from Covid-19 is monitored in detail both within as well as between countries with different strategies against the virus. However, death counts and relative risks based on crude numbers can be misleading. Instead, age specific death rates should be used for comparability. Given the difficulty of ascertainment of Covid-19 specific deaths, excess all-cause mortality is currently more appropriate for comparisons. By estimating age- and sex-specific death rates we aim to get more accurate estimates of the excess mortality attributed to Covid-19, as well as the difference between men and women in Sweden. Design: We make use of Swedish register data about total weekly deaths, total population at risk, and estimate age- and sex-specific weekly death rates for 2020 and the 5 previous years. The data is provided by Statistics Sweden. Results: From the first week of April and onwards, the death rates at all ages above 60 are higher than those in previous years in Sweden. Persons above age 80 are dis-proportionally more affected, and men suffer higher levels of excess mortality than women at all ages with 75% higher death rates for males and 50% higher for females. Current excess mortality corresponds to a decline in remaining life expectancy of 3 years for men and 2 years for women. Conclusion: The Covid-19 pandemic has so far had a clear and consistent effect on total mortality in Sweden, with male death rates being comparably more affected. What consequences the pandemic will eventually have on mortality and life expectancy will depend on the progression of the pandemic, the extent that some of the deaths would have occurred in the absence of the pandemic, only somewhat later, the consequences for other health conditions, as well as the health care sector at large.


Risks ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 109
Author(s):  
Marius Pascariu ◽  
Ugofilippo Basellini ◽  
José Aburto ◽  
Vladimir Canudas-Romo

The prediction of human longevity levels in the future by direct forecasting of life expectancy offers numerous advantages, compared to methods based on extrapolation of age-specific death rates. However, the reconstruction of accurate life tables starting from a given level of life expectancy at birth, or any other age, is not straightforward. Model life tables have been extensively used for estimating age patterns of mortality in poor-data countries. We propose a new model inspired by indirect estimation techniques applied in demography, which can be used to estimate full life tables at any point in time, based on a given value of life expectancy at birth. Our model relies on the existing high correlations between levels of life expectancy and death rates across ages. The methods presented in this paper are implemented in a publicly available R package.


2020 ◽  
Vol 35 (9) ◽  
pp. 835-841
Author(s):  
Fanny Janssen

Abstract This article provides a detailed and overarching illustration of the contribution of smoking to sex differences in life expectancy at birth (e0) in Europe, focusing on changes over time and differences between both European countries and European regions. For this purpose, the sex difference in e0 for 31 European countries over the 1950–2014 period was decomposed into a smoking- and a non-smoking-related part, using all-cause mortality data and indirectly estimated smoking-attributable mortality rates by age and sex, and a formal decomposition analysis. It was found that smoking-attributable mortality contributed, on average, 3 years (43.5%) to the 7-year life expectancy difference between women and men in 2014. This contribution, was largest in 1995, at 5.2 out of 9.0 years, and subsequently declined in parallel with the average sex difference in life expectancy. The average contribution of smoking-attributable mortality was especially large in North-Western Europe around 1975; in Southern Europe around 1985; and in Eastern Europe around 1990–1995, when smoking-attributable mortality reached maximum levels among men, but was still low among women. The observed parallel decline from 1995 onwards in the sex differences in e0 and the absolute contribution of smoking to this sex difference suggests that this recent decline in the sex difference in e0 can be almost fully explained by historical changes in sex differences in smoking, and, consequently, smoking-attributable mortality. In line with the progression of the smoking epidemic, the sex differences in life expectancy in Europe are expected to further decline in the future.


Author(s):  
Anna Kankaanpää ◽  
Asko Tolvanen ◽  
Pirkko Saikkonen ◽  
Aino Heikkinen ◽  
Eija K Laakkonen ◽  
...  

Abstract Background The sex gap in life expectancy has been narrowing in Finland over the past four to five decades; however, on average, women still live longer than men. Epigenetic clocks are markers for biological aging that predict lifespan. In this study, we examined the mediating role of lifestyle factors on the association between sex and biological aging in younger and older adults. Methods Our sample consists of younger and older twins (21‒42-y, n = 1477; 50‒76-y, n = 763) including 151 complete younger opposite-sex twin pairs (21‒30-y). Blood-based DNA methylation (DNAm) was used to compute epigenetic age acceleration by four epigenetic clocks as a measure of biological aging. Path modelling was used to study whether the association between sex and biological aging is mediated through lifestyle-related factors, i.e. education, body mass index, smoking, alcohol use, and physical activity. Results In comparison to women, men were biologically older and, in general, they had unhealthier life habits. The effect of sex on biological aging was partly mediated by body mass index and, in older twins, by smoking. Sex was directly associated with biological aging and the association was stronger in older twins. Conclusions Previously reported sex differences in lifespan are also evident in biological aging. Declining smoking prevalence among men is a plausible explanation for the narrowing of the difference in life expectancy between the sexes. Data generated by the epigenetic clocks may help in estimating the effects of lifestyle and environmental factors on aging and in predicting aging in future generations.


2020 ◽  
Vol 73 (5) ◽  
pp. 937-942
Author(s):  
Tetiana S. Gruzieva ◽  
Nataliia V. Hrechyshkina ◽  
Mykhаilo D. Diachuk ◽  
Vasyl A. Dufynets

The aim: identifying the characteristics and trends of inequalities in the health of the population to substantiate the educational content of the curriculum for the training of Master in Public Health. Materials and methods: Bibliographic, sociological, medical-statistical and information-analytical methods were used in the study. Ukraine’s healthcare institutions were the scientific base of the study. The data on the average life expectancy, morbidity, mortality, satisfaction of medical needs of different groups of the population for revealing the social gradient are analyzed. Documents on strategies to reduce health inequalities have been examined. Results: Health inequalities between WHO countries have been identified, including a difference in the average life expectancy at birth of 17.1 years in premature mortality due to differences in the levels of economic development of countries. The inequality in the prevalence of diseases and the difference in the satisfaction of specific medical needs among the first and tenth decile population of Ukraine were determined. The prevalence of diseases of the genitourinary system in the population older than 60 years with low rates by 27.3% was higher than the figure among financially insured persons. The incidence of ocular pathology among adults with different income levels varied 1.8 times. The provisions of the WHO strategic documents on reducing health inequalities and its protection and on developing the public health system are analyzed. We justify the necessity of expanding the coverage of the problems of reducing disparities in health and health care in the course of training of the Master in Public Health. A modern curriculum “Social Medicine, Public Health” has been developed with the inclusion of inequalities in public health and appropriate educational and methodological support. Conclusion: The strategic goal of reducing inequalities in public health and its care requires integrating these issues into a modern master’s in public health program. The curriculum developed covers various aspects of health inequalities and health care, including the identification and assessment of disparities, the clarification of causes, the identification of counter-measures. Created educational and methodological support allows acquiring theoretical knowledge and practical skills that form the necessary competencies of professionals in the context of overcoming inequalities in health.


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