Changing mortality patterns in East and West Germany and Poland. I: long term trends (1960-1997)

OBJECTIVES: To examine the long term evolution of mortality in the former German Democratic Republic (GDR) in the period from 1960 and its specific position in health terms compared with the Federal Republic (FRG) in the west and Poland in the east. METHODS: Decomposition of life expectancy by age and cause of death. Differences in life expectancy at birth between the former GDR and the old FRG were decomposed by age using data on all cause mortality for the period 1960 to 1997. Changes in life expectancy over time by cause of death were examined using data for 1974 and 1989 for both parts of Germany and for 1974 and 1988 for Poland. RESULTS: Male life expectancy in the two parts of Germany diverged twice, in the mid-1960s, favouring the GDR, and in the mid-1970s, giving increasing advantage to the FRG, while female life expectancy remained similar until the mid-1970s and began to diverge thereafter. The initial advantage of the GDR was mainly attributable to an improving mortality rate among children compared with that in the west in both sexes. During the 1980s, mortality among men over 15 and women over 40 steadily worsened relative to their western counterparts, although men were doing considerably better than those in Poland who actually experienced deterioration. In the FRG, falling death rates among adults of all ages have contributed substantially to the improvement in life expectancy between 1974 and 1989, largely attributable to falling deaths from cardiovascular disease and from injuries at younger adult ages. In Poland, death rates among male adults have risen at all ages over 35, mostly attributable to worsening death rates from cardiovascular disease and neoplasms while women experienced stagnation. The GDR showed a small worsening among men under 60, counterbalanced by improvements among those over 60, and some improvement in women, attributable to falling deaths from cardiovascular disease among the middle aged and elderly. CONCLUSIONS: This study provides further evidence for the complexity of the east-west mortality differential emerging in the 1960s in Europe, highlighting the intermediate position in health terms the former GDR occupied during much of the communist period. Further research is required to assess the underlying causes for the specific position of the former GDR between east and west.     

The contribution of medical care to changing life expectancy in Germany and Poland

This paper assesses the impact of medical care on changes in mortality in east Germany and Poland before and after the political transition, with west Germany included for comparison. Building upon Rutstein's concept of unnecessary untimely deaths, we calculated the contribution of conditions considered responsive to medical care or health policy to changes in life expectancy between birth and age 75 [e(0-75)] for the periods 1980/1983-1988 and 1991/1992-1996/1997.Temporary life expectancy, between birth and age 75, has been consistently higher in west Germany, intermediate in east Germany and lowest in Poland. Although improving in all three regions between the early 1980s and the late 1990s, the pace of change differed between countries, resulting in a temporary widening of an initial east-west gap by the late 1980s and early 1990s. In the 1980s, in east Germany, 50-60% of the improvement was attributable to declining mortality from conditions responsive to medical care (west Germany: 30-40%). A net positive effect was also observed in Poland, although counterbalanced by deterioration in ischaemic heart disease mortality.In the former communist countries, improvements attributable to medical care in the 1980s were due, largely, to declining infant mortality. In the 1990s, they benefited also adults, specifically those aged 35+ in Poland and 55+ in Germany. A persisting east-west gap in temporary life expectancy in Germany was due, largely, to higher mortality from avoidable conditions in the east, with causes responsive to health policy contributing about half, and medical care 16% (men) to 24% (women) to the differential in 1997.The findings indicate that changes in the health care system related to the political transition were associated with improvements in life expectancy in east Germany and, to a lesser extent, in Poland. Also, differences in the quality of medical care as assessed by the concept of "unnecessary untimely deaths" appear to contribute to a persisting east-west health gap. Especially in Poland and the former German Democratic Republic there remains potential for further progress that would narrow the health gap with the west.     

Changing life expectancy in Romania after the transition

BACKGROUND: While Poland, Hungary, and the Czech Republic have seen impressive gains in life expectancy in the 1990s, Romania has not. In contrast with the other countries, there has been very little research on the causes of the pattern of mortality seen in Romania. OBJECTIVES: To describe the trends in life expectancy at birth in Romania after the political transition in 1989 and to evaluate the contribution of deaths from different causes and different ages to these changes. METHODS: Decomposition of life expectancy by age and cause of death using routine data on mortality for the years 1990, 1996, and 1998; comparison of death rates by age, sex, and cause of death. RESULTS: Romania has experienced an overall decline of 1.71 years of life expectancy at birth from 1990 to 1996 in men and 0.54 years in women. The major contribution to this decline was an increase in mortality from cardiovascular diseases and diseases of the digestive system, in particular cirrhosis, among the middle aged and elderly. The recovery observed in 1998, of 1.12 years in men and 0.89 years in women, was mainly caused by a reduction in deaths from cardiovascular disease in the middle aged and elderly. Infant and early childhood mortality fell throughout the period but there was an increase of approximately 40% in mortality at age 5-9 that was almost entirely attributable to AIDS. CONCLUSION: This is the first Romanian study that describes the evolution of life expectancy after transition. Romania may at last be beginning to follow the path of improving adult mortality seen in the early 1990s in some of its neighbours. It has, however, been unique in eastern Europe in experiencing increasing childhood mortality. This is attributable to an epidemic of paediatric AIDS, consequent on the tragically inappropriate policies adopted in the 1980s.     

Influence of death from circulatory diseases on life expectancy at birth in Japan

This study aims to evaluate the contribution of the change in circulatory diseases mortality to the life expectancy at birth observed during the years 1955-1995 in Japan. We used data on the population and the number of deaths by cause, age, and sex in 1955, 1965, 1975, 1985, and 1995. The contribution of different ages and causes of death to the change in life expectancy were examined with the method developed by Pollard. We found that the reduction in circulatory diseases mortality contributed to the improvements in life expectancy for both sexes during the decade 1975-1985. Much of this was due to the decrease in cerebrovascular disease. In the years 1985-1995, however, the contribution of cerebrovascular disease decreased in both sexes, while that of heart disease grew to become the largest of any single condition. By age, the contribution of all circulatory diseases increased among the elderly in recent years. The contribution of the change in circulatory diseases mortality to the life expectancy at birth has increased in recent years but seems to have reached a plateau. The weight against improvements in life expectancy in middle-aged people has shown little change, so that reducing the mortality rate in middle-aged people is now a major issue.     

2015-2018年乌海市市区居民死因分析

目的 了解2015-2018年乌海市市区居民主要死因及寿命损失，为提出有针对性的疾病预防控制策略提供依据。 方法 整理2015-2018年乌海市市区居民全死因数据，分析死亡率、死因顺位、期望寿命等指标。结果 2015-2018年乌海市市区居民粗死亡率为533.59/10万，标化死亡率为531.61/10万，男性高于女性，随年龄增长死亡率呈升高趋势（〖XC小五号.EPS;P〗=30785.35，P<0.001）。全人群死因前5位依次为循环系统疾病、肿瘤、呼吸系统疾病、损伤和中毒及其他，占全部死亡人数的90.34%；其中循环系统疾病和肿瘤占全部死亡人数的69.33%。2015-2018年乌海市市区居民期望寿命为77.20岁，去循环系统疾病和去肿瘤后期望寿命可分别增加5.44岁和3.33岁。结论 循环系统疾病和肿瘤是乌海市市区居民的两大死因，也是造成居民期望寿命损失最主要的两大疾病，尤其要重点关注肿瘤。     

2016年江西省监测地区居民去死因期望寿命分析

目的 了解各类死因对江西省国家级死因监测地区(以下简称国家点)居民期望寿命的影响,为制定疾病防治策略提供依据。方法 利用2016年江西省国家点全死因登记资料,计算期望寿命、去死因期望寿命及寿命损失年数。结果 2016年江西省国家点居民粗死亡率为570.31/10 万,平均期望寿命78.59岁,女性高于男性5.56岁,城市高于农村1.04岁。导致寿命损失的前4大类疾病是循环系统疾病、恶性肿瘤、呼吸系统疾病和伤害,去除后期望寿命男性可分别增长6.48岁、2.79岁、1.82岁、1.58岁,女性可分别增长8.95岁、1.76岁、1.97岁、0.91岁。循环系统疾病中主要是脑血管病、心脏病,去除后男性分别增长2.57岁、2.11岁,女性分别增长2.97岁、2.82岁,呼吸系统疾病中主要是慢性下呼吸道疾病,去除后男性增长1.32岁,女性增长1.72岁,恶性肿瘤中前2位是肺癌、肝癌,去除后男性分别增长0.82岁、0.64岁,女性分别增长0.35岁、0.23岁。结论 心脑血管疾病、慢性下呼吸道疾病及以肺癌为首的恶性肿瘤等慢性非传染性疾病是造成江西省国家点居民期望寿命减少的主要疾病,需针对不同人群,采取有效的防治策略。     

Change in life expectancy in connection with three large groups of causes of death in Medellín, Colombia, between 1989-1991 and 1994-1996]

OBJECTIVES: To examine changes in life expectancy in Medellin, Colombia, between 1989-1991 y 1994-1996, in connection with four large groups of causes of death commonly employed in studies on the burden of disease: group 1, communicable diseases, perinatal and maternal health problems, and nutritional deficits; group 2, non-communicable diseases; group 3, wounds; group 4, ill-defined causes. The latter were excluded from the analysis because of their ambiguity. METHODS: The calculations were made according to the method described by J. H. Pollard in 1986, with the aid of Microsoft Excel, by using the recommended formulas. The computations were double checked with EPIDAT (version 3.0, unofficial). RESULTS: Between 1989-1991 y 1994-1996, a total gain of 1.93 years in life expectancy was seen in Medellin, with a rise from 62.13 to 64.06 years. The gain was greater in men than in women (2.42 vs. 1.09 years, respectively). The increase noted among females was greatest in the extreme age groups (girls 1 to 4 and women over 54 years of age); in men, it was highest in the middle years (between the ages of 25 and 44). In both sexes, the greatest percentage loss in life expectancy was seen in persons 15 to 19 years of age (23% in men and 4% in women, roughly). In the group comprising communicable diseases, perinatal and maternal health problems, and nutritional deficits, a loss in life expectancy was seen in men (0.04 years), whereas in the group of non-communicable diseases there was a gain in life expectancy in both sexes (0.60 years among men and 0.55 years among women). The greater gain in life expectancy among men was linked to a reduction in mortality from wounds (1.98 years). CONCLUSIONS: If one compares the results obtained in Medellin at the end of the study period with life expectancy at birth in Colombia in 1995, which was 70 years, it is obvious that life expectancy in Medellin is still lagging behind, even though it has risen progressively over the years. This is in keeping with the epidemiological transition the city has experienced, which has been linked with a rise in mortality from degenerative and cardiovascular diseases, chronic respiratory ailments, and diabetes, as well as from diseases resulting from human activity. Nevertheless, this epidemiological transition has been slow in Medellin when compared to Colombia as a whole due to high rates of death from infectious and parasitic diseases, which are more characteristic of the transition in its earlier stages. Despite the fact that mortality from wounds has decreased in Medellin, particularly among young males, it may be worthwhile to reassess the effectiveness of interventions undertaken in recent years to promote peaceful coexistence and tolerance in the community.     

Contributions of mortality changes by age group and selected causes of death to the increase in Japanese life expectancy at birth from 1950 to 2000

The purpose of this study is to analyze contributions of mortality change by age group and selected causes of death to the increase in life expectancy at birth from 1950 to 2000 in Japan, which has the longest longevity in the world. Using mortality data from Japanese vital statistics from 1950 to 2000, we analyzed contributions of mortality change by age group and selected causes of death to the increase in life expectancy at birth by the method of decomposition of changes and calculated age-adjusted death rates for selected causes of death. Gastroenteritis, tuberculosis and pneumonia largely contributed to an increase in life expectancy in childhood and in the young in the 1950s and 1960s. The largest contributing disease changed from tuberculosis and pneumonia in earlier decades to cerebrovascular diseases in the 1970s. The largest contributing age group also shifted to older age groups. Age-adjusted death rate for cerebrovascular diseases in 2000 was one fifth of the 1965 level. Cerebrovascular diseases contributed to an increase in life expectancy at birth of 2.9years in males and 3.1 years in females from 1970 to 2000. In the 1990s, the largest contributing age group, both among males and among females, was the 75–84 age group. Of the selected causes of death, heart diseases other than ischemic heart disease became the largest contributor to the increase in life expectancy at birth. Unlike cerebrovascular diseases, cancer and ischemic heart disease contributed little to change in life expectancy at birth over the past 50years. In conclusion, although mortality from ischemic heart disease has not increased since 1970 and remained low compared with levels in western countries, mortality from cerebrovascular diseases has dramatically decreased since the mid-1960s in Japan. This gave Japan the longest life expectancy at birth in the world. It is necessary to study future trends in life expectancy at birth in Japan.     

2017年开封市居民期望寿命及减寿分析

目的了解2017年开封市居民期望寿命及寿命损失情况。方法收集2017年开封市死亡资料,采用ANACONDA(Analysis of Causes of National Deaths for Action,ANACONDA)软件对死亡数据质量进行评价,通过死亡率、标化死亡率、构成比、死因顺位、期望寿命、潜在减寿年数(Potential Years of Life Lost,PYLL)等指标对居民死亡情况及寿命损失进行描述。结果2017年全市共报告死亡病例25099例,死亡率645.05/10万(标化死亡率577.12/10万),男性死亡率高于女性且差异有统计学意义(χ^2=26.00,P<0.001)。居民平均期望寿命为78.08岁(男性74.90岁,女性81.26岁)。前五位死因依次为:心脏病、脑血管疾病、恶性肿瘤、呼吸系统疾病、损伤与中毒。去除前五位死因后,平均期望寿命增加10.43岁。四类慢性病造成的早死概率为18.32%。2017年开封市1~69岁人群因各种疾病导致128808人年的潜在减寿年数损失,平均减寿年数(Average Years of Life Lost,AYLL)为13.77年。结论慢性病尤其是心脑血管疾病及恶性肿瘤是造成开封市居民寿命损失的主要原因,期望寿命的提高关键在于对循环系统疾病、恶性肿瘤等慢性病的预防和控制。     

南昌市安义县2004～2009年居民死因分析

目的了解南昌市安义县居民的死亡水平、死亡的变化趋势以及死因模式的变化,为疾病的预防与控制提供决策依据。方法采用国际疾病分类ICD-10对死因资料进行编码,应用SPSS13.0软件进行相关统计指标分析。结果2004～2009年安义县居民年均粗死亡率为467.63/10万,标化死亡率为498.52/10万,呈逐年下降趋势。男性标化死亡率(555.82/10万)高于女性(434.67/10万)(χ2=109.511,P=0.000);0～14岁、15～64岁、65岁及以上组年均死亡率分别为53.83/10万,207.11/10万、4 535.71/10万;前5位的主要死因为循环系统疾病、肿瘤、损伤和中毒、呼吸系统疾病以及消化系统疾病。6年年均期望寿命为76.79岁,其中男性74.44岁,女性80.68岁。对居民寿命影响最大的死因为循环系统疾病,去除该死因后,期望寿命可提高5.90岁,增长7.68%。结论慢性病尤其是循环系统疾病及肿瘤是今后预防控制的重点,男性的健康问题应引起社会的广泛关注和重视。     

Mortality and life expectancy in Denmark and in other European countries: What is happening to middle-aged Danes?

Background: The trend in life expectancy in Denmark has beenless favourable than in other European countries for severalyears. The aim of this study was to compare mortality in Denmarkwith that in selected European countries, focusing on age groupsand causes of death for which the Danish trends are particularlyunfavourable. Methods: Comparisons were made for the period1952–1993 between Denmark and Norway, the former FederalRepublic of Germany, The Netherlands, the UK, France, Italyand former Czechoslovakia of age-specific mortality rates andchanges in life expectancy specific for each age group and causeof death. Results: At the end of the period only the formerCzechoslovakia had a lower life expectancy than Denmark; thedifference in life expectancy between Denmark and the othersix countries varied between 5 and 48 months. Almost all ofthe difference was due to a higher mortality rate in the 35–74years age group. All heart diseases and ‘symptoms andill-defined conditions’ were responsible for a large proportionof the Danish high mortality, the decrease in mortality fromthis group of diseases being moderate in comparison with theother countries. Lung cancer contributed to a loss of 1–6months more of life expectancy for Danish women than in theother countries. In comparison with Norway, The Netherlandsand the UK, Danish men lost 2 more months' life expectancy dueto liver cirrhosis and Danish women lost 1 month more. Conclusions:A considerable proportion of the extra deaths in Denmark couldbe prevented.     

2013—2018年恩施市常住居民死因监测及减寿分析

目的 分析2013—2018年恩施市常住居民的死亡情况和主要死因的变化趋势,评估不同疾病所导致的疾病负担,为制定疾病防治对策提供依据.方法 收集2013—2018年恩施市常住居民死亡监测数据,分别计算粗死亡率、标化死亡率、期望寿命、潜在减寿年数(PYLL)、标化减寿年数(SPYLL)、潜在减寿率(AYLL)、年度变化百...     

The evolving demography of aging in the United States of American and the former USSR.

In the United States of America and in the republics of the former USSR, the elderly (persons aged 60 and over) will comprise the same proportion of their respective societies by the year 2000, namely 17%. In both countries, this population subgroup is growing at a faster rate than the rest of the population and living longer, although there are now more differences than similarities between the two countries in respect of the elderly, as summarized below. Similarities. In both countries today, the age group 50 years and over represents 26% of the total population, and by the year 2000 it is expected that 17% of the population will be 60 years and over. Diseases of the circulatory system and neoplasms are the major causes of death in both countries. Life expectancy beyond retirement age (i.e. the number of years a person is expected to live after having retired) is about the same in both, but this is due to the statistical fact that in the former USSR women are expected to have an extra year of life expectancy compared to their United States counterparts, while men are expected to live 2.5 years less beyond retirement than their United States counterparts. Differences. Mortality rates in the former USSR are higher than those in the United States. Life expectancy for men in the former USSR is 6.5 years below the figure for United States males. By age 65, the differences are 2.7 years for women and 2.4 years for men. Today, the proportion of the population having reached retirement age is larger in the former USSR than in the United States (17% vs 15%) because of lower retirement age in the former USSR. By the year 2000, these figures are expected to be 19% and 25%, respectively. Men make up 27% of the pension-age population in the former USSR against 41% in the United States. Life expectancy at birth could increase by 4 years for men in the former USSR if they had the same mortality rates from diseases of the circulatory and respiratory systems as their United States counterparts. Similarly, women in the former USSR would gain 4 years of life from these two causes alone. Older women are more likely to be married in the United States than in the former USSR, and this difference increases with age: at age 65, 25% of the former USSR's women are married versus 41% in the United States.     

Analysis of sex,age and disease factors contributing to prolonged life expectancy at birth,in cases of malignant neoplasms in Japan

BACKGROUND: This study aimed to examine the contribution made by the change in mortality from malignant neoplasms to the life expectancy at birth, observed during the years 1965-1995 in Japan. METHODS: We used data on the population and number of deaths by cause, age and sex in 1965, 1975, 1985 and 1995. The contribution of different ages and causes of death to the change in life expectancy were examined with the method developed by Pollard. RESULTS: We found that, among all causes, the decrease of mortality from stomach cancer led to the greatest improvement in life expectancy for both sexes. On the other hand, negative contributions were seen with cancers of many sites, such as cancer of the intestine, liver and lung for males, and cancer of the intestine, gallbladder, lung and breast for females. Recently, the contributing years of all cancers have been negative because of the increase in mortality from malignant neoplasms. In addition, increase of death from malignant neoplasms in middle-aged and elderly people negatively influenced the life expectancy at birth. CONCLUSIONS: Female cancer influenced the improvement in life expectancy at birth. Cancer for males, however, contributed little to improvement of life expectancy at birth except for a little prolongation of life expectancy at birth during the years 1965-1975. To develop a public health policy, the contributing years to life expectancy at birth can be a useful indication in evaluating the impact of death from various diseases. It is necessary to analyze the contribution made by various causes of death to the changes of life expectancy at birth.     

2011年长春市居民死亡原因调查分析

目的了解长春市全死因监测点死因分布特点,计算长春市5城区居民期望寿命以及重要死因对期望寿命的影响,为慢性病的预防、控制提供依据。方法利用死亡率、构成比及期望寿命对2011年五城区居民死亡资料进行统计分析。结果 2011年5城区居民总死亡率5.23‰,男性高于女性。前5位死因依次是心脏病、恶性肿瘤、脑血管病、呼吸系统疾病及其他疾病,占总死因的83.43%。本市5城区居民期望寿命78.56岁,女性期望寿命高于男性。如果去除主要死因,长春市期望寿命将有提高。结论慢性病在总死亡中所占比例最高,是目前危害本市居民健康的主要疾病和死因,预防和控制慢性病是当务之急。     

2005--2010年中国城市居民期望寿命性别差异的分析

目的了解2005--2010年中国城市居民期望寿命的性别差异及其受年龄和死因的影响, 并探讨影响期望寿命年龄差异变化的主要因素。方法利用2005--2010年《中国卫生统计年鉴》中城市居民年龄别死亡率及死因等死亡数据, 采用绘制寿命表法、期望寿命性别差异及其年龄分解和死因分解法, 进行城市居民期望寿命性别差异的分析比较。结果自2005年中国城市人群期望寿命开始呈上升趋势, 女性期望寿命始终高于男性; 2007年期望寿命性别差异显著增加(相差5．3岁)并呈现-个尖峰, 其中以60～79岁年龄组男女性别死亡率的差异最为显著, 是导致性别期望寿命差异的主要因素(42%～47%)。2005-2007年期望寿命性别差异增大, 主要为0～1岁婴幼儿和>75岁老年组; 2007-2008年该差异缩小, 仅表现为1-15岁和50～55岁年龄组; 2009--2010年差异增大, 主要为60-70岁年龄组。影响期望寿命性别差异的主要死因为肿瘤(1．638-2.019岁)、循环系统疾病(1.271～1.606岁)、呼吸系统疾病(0．551～0.800岁)。肿瘤中以肺癌对期望寿命的影响最大, 每年有约0．6岁的差异; 而肝癌导致男女性死亡差异不断缩小。损伤和中毒等原因也影响期望寿命的性别差异(10．60% 15.78%)。结论缩小中国城市居民健康的性别差距, 重点应关注男性>/60岁老年人; 肿瘤、循环系统疾病和呼吸系统疾病是导致中国城市人群期望寿命性别差异的主要疾病, 同时不可忽视外伤、自杀等对期望寿命差异的影响。     

上海市浦东新区大团镇2013年居民期望寿命及死因顺位

[目的]了解2013年上海市浦东新区大团镇居民期望寿命和死因顺位情况,进一步指导疾病的预防控制工作。[方法]分析2013年上海市浦东新区大团镇居民死因监测及人口资料,计算不同性别居民的死因顺位和减寿人年数,并计算期望寿命和某些严重疾病的去死因期望寿命。[结果]2013年上海市大团镇男性和女性居民死因顺位的前3位均为循环系统疾病、肿瘤和呼吸系统疾病。男性居民的出生期望寿命为81.1岁,女性为85.4岁,男性去循环系统疾病死因期望寿命为90.2岁,女性则达99.9岁。[结论]该镇男、女居民的死因顺位前3位均为慢性非传染性疾病,故控制慢性非传染性疾病的发生和减少其导致的损失已成为各级政府、卫生部门及全社会共同面临的问题。     

Change in male and female life expectancy by social class: decomposition by age and cause of death in Finland 1971-95.

STUDY OBJECTIVE: To quantify the contribution of different causes of death and age groups for trends in life expectancy for two major social classes. DESIGN AND SETTING: Prospective study of mortality in Finland among all over 35 year old men and women. Baseline social class (manual/non-manual) was from the 1970, 1975, 1980, 1985 and 1990 census records, and follow up was by computerised record linkage to death certificates for 1971-1995. MAIN RESULTS: From the early 1970s to the early 1990s life expectancy at age 35 increased by about five and four years among Finnish men and women respectively, with largest gains among 55-74 year old men and 65-84 year old women. Life expectancy increase was 5.1 years among non-manual and 3.8 years among manual men; corresponding figures for women were 3.6 and 3.0 years. In the 1980s, when differences in life expectancy increased most rapidly, decline in cardiovascular disease mortality was more rapid in the non-manual than the manual class. Furthermore, increasing mortality for alcohol associated causes, "other diseases", and accidents and violence were most prominent in the manual class. CONCLUSIONS: Explanations of increasing social inequalities in mortality that are based on one underlying factor are difficult to reconcile with the variability in the cause specific trends in social inequalities in mortality. The contribution of older ages to social inequalities in mortality should be more widely recognised.     

辽宁省城乡居民30年间出生期望寿命差异分析

目的 分析30年间辽宁省城乡居民出生期望寿命的变化及主要疾病死亡率对期望寿命年代差异的影响.方法 应用简略寿命表法、期望寿命差异的年龄分解和死因分解法分析辽宁省城乡居民1973-1975年和2004-2005年的死亡数据,以死亡率变化对出生期望寿命年代差异的贡献值及百分比为分析指标.结果 30年间辽宁省城市、农村居民期望寿命分别增加了4.68岁和4.91岁,女性增幅显著大于男性.0～4岁和55～74岁组人群死亡率下降对城乡居民期望寿命增加的贡献比例最大,男性为76.27%和82.81%,女性为58.76%和62.13%.呼吸系统疾病和传染病是对期望寿命年代差异贡献最大的两类疾病;呼吸系统疾病死亡率下降对不同人群期望寿命增加的贡献比例为62.20%(城市女性)～85.39%(农村男性),传染病的贡献比为16.70%(城市女性)～36.26%(农村男性).城乡居民心脏病死亡率、农村居民脑血管病和恶性肿瘤死亡率的增加对期望寿命年代差异的贡献率为负值.结论 呼吸系统疾病和传染病是影响30年间辽宁省城乡居民期望寿命差异的主要疾病,提高慢性非传染性疾病的防治水平是进一步提高居民期望寿命的关键.

Abstract：

Objective To analyze the impact of mortality by age and causes of death on life expectancy at birth among residents of Liaoning province.Methods The study included mortality data of urban and rural residents in two periods (1973-1975 and 2004-2005).Both Abridged Life Table and Arriaga method were used to calculate and to decompose life expectancy changes by age and causes of death.Results From 1975-2005,the life expectancy increased by 4.68 years in urban residents and 4.91 for rural residents with a higher increment among females than males.Most part of the increase (76.27% and 82.81% for urban and rural male,58.76% and 62.13% for urban and rural female) in life expectancy within the last 30 years could be explained by the decrease of mortality in the populations at age 0-4 and 55-74.Diseases related to respiratory system and infectious disease were contributing the most to the gap in life expectancy between the two periods.Mortality of heart disease was a negative contributor to the changes in life expectancy among both rural and urban residents while the mortalities of cerebro-vascular diseases and malignant tumors were the negative contributors for rural residents.Conclusion The increase of life expectancy in the last 30 years was mainly resulted from the decrease of mortality on both respiratory and infectious diseases.Control of chronic diseases is the key point to increase the life expectancy among the residents of Liaoning province.     

Inequalities in life expectancy by educational level and its decomposition in Barcelona, 2004-2018

ObjectiveTo analyse the gap in life expectancy by educational level in the city of Barcelona from 2004 to 2018 and to decompose this gap by age and causes of death.MethodWe computed abridged life tables at the age of 25 years by sex from 2004 to 2018 using standard methods. Educational level was categorised in two groups (lower secondary or less vs. upper secondary or higher education). The life expectancy gap was further decomposed by age and by causes of death based in Arriaga's method in 5-year age blocks up to the age of ≥ 90 years and broad causes of death using ICD-10 codes.ResultsThe life expectancy gap at 25 years by educational level oscillated without trend at around 3.08 years for men and 1.93 years for women. Decomposition by age showed a favourable significant shift in the contribution to this gap from young to older ages for men, with few changes for women. Decomposition by causes of death showed that the diseases concentrating the largest share of the contribution were neoplasms and respiratory and circulatory disease. There was a significant downward trend in external causes for men and in infectious diseases for both men and women but a significant upward trend for respiratory disease for both sexes.ConclusionsThe stability of the life expectancy gap by educational level during the period analysed resulted from a combination of divergent trends by age and causes of death among high and low educational levels.