The triple burden of communicable and non-communicable diseases and injuries on sex differences in life expectancy in Ethiopia

Abstract Background Ethiopia has experienced great improvements in life expectancy (LE) at birth over the last three decades. Despite consistent increases in LE for both males and females in Ethiopia, the country has simultaneously witnessed an increasing discrepancy in LE between males and females. Methods This study used Pollard’s actuarial method of decomposing LE to compare age- and cause- specific contributions to changes in sex differences in LE between 1995 and 2015 in Ethiopia. Results Life expectancy at birth in Ethiopia increased for both males and females from 48.28 years and 50.12 years in 1995 to 65.59 years and 69.11 years in 2015, respectively. However, the sex differences in LE at birth also increased from 1.85 years in 1995 to 3.51 years in 2015. Decomposition analysis shows that the higher male mortality was consistently due to injuries and respiratory infections, which contributed to 1.57 out of 1.85 years in 1995 and 1.62 out of 3.51 years in 2015 of the sex differences in LE. Increased male mortality from non-communicable diseases (NCDs) also contributed to the increased difference in LE between males and females over the period, accounting for 0.21 out of 1.85 years and 1.05 out of 3.51 years in 1995 and 2015, respectively. Conclusions While injuries and respiratory infections causing male mortality were the most consistent causes of the sex differences in LE in Ethiopia, morality from NCDs is the main cause of the recent increasing differences in LE between males and females. However, unlike the higher exposure of males to death from injuries due to road traffic injuries or interpersonal violence, to what extent sex differences are caused by the higher male mortality compared to female mortality from respiratory infection diseases is unclear. Similarly, despite Ethiopia’s weak social security system, an explanation for the increased sex differences after the age of 40 years due to either longer female LE or reduced male LE should be further investigated.

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Narrowing sex differences in life expectancy: regional variations, 1971-1991

Canadian Studies in Population ◽

10.25336/p6130b ◽

2001 ◽

Vol 28 (1) ◽

pp. 89 ◽

Cited By ~ 6

Author(s):

Frank Trovato ◽

N. M. Lalu

Keyword(s):

Sex Differences ◽

Life Expectancy ◽

Gender Gap ◽

Prince Edward Island ◽

Causes Of Death ◽

Average Length ◽

Decomposition Analysis ◽

Relative Contribution ◽

Life Expectancy At Birth ◽

Length Of Life

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.

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Changing contribution of smoking to the sex differences in life expectancy in Europe, 1950–2014

European Journal of Epidemiology ◽

10.1007/s10654-020-00602-x ◽

2020 ◽

Vol 35 (9) ◽

pp. 835-841

Author(s):

Fanny Janssen

Keyword(s):

Sex Differences ◽

Life Expectancy ◽

Sex Difference ◽

Western Europe ◽

Decomposition Analysis ◽

European Countries ◽

Attributable Mortality ◽

Mortality Data ◽

Life Expectancy At Birth ◽

Related Part

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.

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

Journal of Biosocial Science ◽

10.1017/s0021932005007212 ◽

2005 ◽

Vol 38 (3) ◽

pp. 391-401 ◽

Cited By ~ 40

Author(s):

FRANK TROVATO ◽

NILS B. HEYEN

Keyword(s):

Sex Differences ◽

Life Expectancy ◽

Point Of View ◽

Industrialized Countries ◽

Circulatory Disease ◽

G7 Countries ◽

Death Rates ◽

The United Kingdom ◽

Life Expectancy At Birth ◽

The Difference

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.

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Decomposition analysis of Spanish life expectancy at birth

Demographic Research ◽

10.4054/demres.2005.13.20 ◽

2005 ◽

Vol 13 ◽

pp. 521-546 ◽

Cited By ~ 19

Author(s):

Rosa Gómez-Redondo ◽

Carl Boe

Keyword(s):

Life Expectancy ◽

Decomposition Analysis ◽

Life Expectancy At Birth

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Mortality from respiratory infections and chronic non-communicable diseases before the COVID-19 pandemic in Cali, Colombia.

Colombia Medica ◽

10.25100/cm.v51i2.4270 ◽

2020 ◽

pp. 1-10

Author(s):

Luis Eduardo Bravo Ocaña ◽

Paola Collazos ◽

Elvia Karina Grillo Ardila ◽

Luz Stella García ◽

Erquinovaldo Millán ◽

...

Keyword(s):

Respiratory Infections ◽

Ventilatory Support ◽

The Elderly ◽

International Classification Of Diseases ◽

Mortality Rates ◽

Communicable Diseases ◽

Noncommunicable Diseases ◽

Non Communicable Diseases ◽

Infected People ◽

Classification Of Diseases

Introduction: The COVID-19 disease pandemic is a health emergency. Older people and those with chronic noncommunicable diseases are more likely to develop serious illnesses, equire ventilatory support, and die from complications. Objective: To establish deaths from respiratory infections and some chronic non-communicable diseases that occurred in Cali, before the SARS-CoV-2 disease pandemic. Methods: During the 2003-2019 period, 207,261 deaths were registered according to the general mortality database of the Municipal Secretary of Health of Cali. Deaths were coded with the International Classification of Diseases and causes of death were grouped according to WHO guidelines. Rates were standardized by age and are expressed per 100,000 people-year. Results: A direct relationship was observed between aging and mortality from respiratory infections and chronic non-communicable diseases. Age-specific mortality rates were highest in those older than 80 years for all diseases evaluated. Seasonal variation was evident in respiratory diseases in the elderly. Comments: Estimates of mortality rates from respiratory infections and chronic non-communicable diseases in Cali provide the baseline that will serve as a comparison to estimate the excess mortality caused by the COVID-19 pandemic. Health authorities and decision makers should be guided by reliable estimates of mortality and of the proportion of infected people who die from SARS-CoV-2 virus infection.

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P3414Differences in total life expectancy and life expectancy with and without non-communicable diseases within the reference range of thyroid function

European Heart Journal ◽

10.1093/eurheartj/ehz745.0288 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Bano ◽

L Chaker ◽

F U S Mattace-Raso ◽

R P Peeters ◽

O H Franco

Keyword(s):

Life Expectancy ◽

Thyroid Function ◽

Communicable Diseases ◽

Reference Ranges ◽

Men And Women ◽

Non Communicable Diseases ◽

Normal Thyroid ◽

Normal Thyroid Function ◽

Total Life Expectancy ◽

The Impact

Abstract Background Variations in thyroid function within the reference ranges are associated with an increased risk of diseases and death. However, the impact of thyroid function on life expectancy (LE) and the number of years lived with and without non-communicable diseases (NCD) remains unknown. Purpose We aimed to investigate the association of thyroid function with total LE and LE with and without NCD among euthyroid subjects. Methods Participants of the Rotterdam Study without known thyroid disease and with thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels within the reference ranges were eligible. NCD were defined as the presence of cardiovascular disease, diabetes mellitus type 2, or cancer. We used multistate life tables to calculate the total LE and LE with and without NCD among TSH and FT4 tertiles, in men and women. LE estimates were obtained using prevalence, incidence rates and hazard ratios for three transitions (healthy to NCD, healthy to death and NCD to death). Analyses were adjusted for sociodemographic and cardiovascular risk factors. Results The mean (standard deviation) age of 7644 participants was 64.5 (9.7) years and 52.2% were women. Over a median follow-up of 8 years, we observed 1396 incident NCD events and 1422 deaths. Compared with those in the lowest tertile, men and women in the highest TSH tertile lived 1.5 (95% confidence interval [CI], 0.8; 2.3) and 1.5 (95% CI, 0.8; 2.2) years longer, respectively; of which 1.4 (95% CI, 0.5; 2.3) and 1.3 (95% CI, 0.3; 2.1) years with NCD. Compared with those in the lowest tertile, the difference in LE for men and women in the highest FT4 tertile was −3.7 (95% CI, −5.1 to −2.2) and −3.3 (95% CI, −4.7; −1.9), respectively; of which −1.8 (95% CI, −3.1 to −0.7) and −2.0 (95% CI, −3.4 to −0.7) years without NCD. Life expectancy in TSH and FT4 tertiles Conclusions There are meaningful differences in total LE, LE with and without NCD within the reference ranges of thyroid function. People with low-normal thyroid function live more years with and without NCD than those with high-normal thyroid function. These findings support a reevaluation of the current reference ranges of thyroid function.

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SEX DIFFERENCES IN LIFE EXPECTANCY IN CANADA: IMMIGRANT AND NATIVE-BORN POPULATIONS

Journal of Biosocial Science ◽

10.1017/s0021932011000010 ◽

2011 ◽

Vol 43 (3) ◽

pp. 353-367 ◽

Cited By ~ 7

Author(s):

FRANK TROVATO ◽

DAVID ODYNAK

Keyword(s):

Sex Differences ◽

Life Expectancy ◽

Decomposition Analysis ◽

Specific Reference ◽

Foreign Born ◽

Death Rates ◽

Immigrant Populations ◽

Growing Body ◽

Immigrant Men ◽

Two Populations

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.

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Socioeconomic factors affecting the longevity of the Japanese population: a study for 1980 and 1985

Journal of Biosocial Science ◽

10.1017/s0021932000020058 ◽

1992 ◽

Vol 24 (4) ◽

pp. 497-504 ◽

Cited By ~ 5

Author(s):

Eiichi Uchida ◽

Shunichi Araki ◽

Katsuyuki Murata

Keyword(s):

Life Expectancy ◽

Socioeconomic Factors ◽

Low Income ◽

Japanese Population ◽

Age Groups ◽

High Income ◽

Factors Affecting ◽

Life Expectancy At Birth ◽

Males And Females

SummaryThe effects of urbanisation, low income and rejuvenation of the population on life expectancy at birth and at 20, 40 and 65 years of age for males and females in Japan were examined twice, in 1980 and 1985. For males, urbanisation was the major factor determining life expectancy at birth and at age 20 years, and low income was the key determinant of decreased life expectancy except at 65 years of age. For females high income was the factor significantly decreasing life expectancy at 65 years of age in 1980, and rejuvenation of the population inversely influenced life expectancy except at birth in 1985. Life expectancy for all age groups in 1985 was significantly longer than in 1980 for both males and females.

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Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China

10.21203/rs.2.20284/v4 ◽

2020 ◽

Author(s):

Hanyi Chen ◽

Yi Zhou ◽

Lianghong Sun ◽

Yichen Chen ◽

Xiaobin Qu ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Life Expectancy ◽

Gender Gap ◽

Causes Of Death ◽

Age Groups ◽

International Classification Of Diseases ◽

Communicable Diseases ◽

Plateau Phase ◽

Non Communicable Diseases ◽

Chronic Respiratory Diseases

Abstract Background To address change in gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change overtime.Methods Retrospective demographic analysis with application of Joinpoint regression to evaluate the temporal trend in GGLE. Causes of death were coded in accordance with International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. Life table technique and decomposition method was used to express changes in GGLE.Results Trend of GGLE in Shanghai experienced two phases ie., a decrease from 8.4 to 4.2 years in the descent phase (1973-1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999-2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0-9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer and diabetes in recent plateau phase.Conclusions Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE and ensure improvement in health and health equity in Shanghai China.

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