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.     

Women's empowerment and life expectancy at birth in Mexico]

OBJECTIVES: To assess the effect of women's empowerment (WE) on life expectancy at birth (LEB) in the federative states of Mexico and to compare the results of measuring WE with various compound indicators that reflect, to a greater or lesser degree, an individual or population focus.METHODS: This was an ecological study conducted in Mexico's 32 federative states. We estimated the correlations between overall and sex-specific LEB on the one hand, and a measure of gender empowerment (MGE), the index of women's ability to make decisions within the household (WADH), the index of women's autonomy (IWA), income inequality, certain aspects of the physical environment, the proportion of the population who spoke an indigenous language, and the net migratory rate on the other. By using robust regressions, we studied the effect on LEB of MGE, IWA, and WADH, after mutually adjusting for other independent variables.RESULTS: A very strong inverse correlation (-0.93) was found between overall LEB and factors of the physical environment linked to population vulnerability and biodiversity. Significant direct and inverse correlations were also found between LEB on the one hand and WADH, IWA, net migratory rate, the percentage of the population that spoke an indigenous language, and the Gini coefficient on the other. Multiple robust regressions showed inverse associations between MGE and LEB in women (beta: -1.44; 95% confidence interval [95% CI]: -2.71 to -0.17). WAI was positively associated with LEB in men (beta: 0.88; 95% CI: 0.01 to 1.75) and women (beta: 0.66; 95% CI: 0.03 to 1.30).CONCLUSION: The use of MGE as a surrogate for WE failed to reveal a positive effect of WE on LEB in Mexico. It is necessary to review the components that make up MGE and the relevance of using such a measure in different contexts. WAI showed a greater association with LEB and its effect was greater among men. This indicator made it possible to measure WE in Mexico and its use is recommended, as long as there are no other indicators available for capturing more effectively all the components that affect WE.     

Measuring the impact of HIV/AIDS, heart disease and malignant neoplasms on life expectancy in the USA from 1987 to 2000

OBJECTIVES: Quantifying the impact of a disease on society is an important issue for setting priorities for better allocation of healthcare resources and for evaluating the effectiveness of prevention and control of the disease. STUDY DESIGN: The potential gains in life expectancy due to the elimination of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), heart disease and malignant neoplasms were compared for the US population by age and ethnicity from 1987 to 2000. METHODS: The potential gain in life expectancy after hypothetical elimination of cause-specific deaths is an effective indicator of measuring the impact of a disease on a population. Official age-specific mortality rates, by ethnicity, due to HIV/AIDS, heart disease and malignant neoplasms of the US population from the National Center for Health Statistics were used, and multiple decremental life tables were constructed to find the corresponding potential gains in life expectancy. RESULTS: The potential gains in life expectancy for the US population at birth by complete elimination of HIV/AIDS, heart disease and malignant neoplasms were 0.14, 3.71 and 3.06 years in 1987, respectively. In 1995, the potential gain in life expectancy due to the elimination of HIV/AIDS increased from 0.14 years in 1987 and achieved its highest value (0.41 years), whereas the elimination of heart disease and malignant neoplasms led to potential gains in life expectancy of 3.05 and 3.10 years, respectively. Since 1995, the potential gains in life expectancy at birth by eliminating deaths from HIV/AIDS and heart disease have decreased to 0.13 and 2.67 years, respectively, in 2000. However, the potential gain in life expectancy due to elimination of malignant neoplasms remained relatively stable (3.01 years in 2000). It is well known that HIV/AIDS tends to have a greater impact on people of working age, whereas heart disease and malignant neoplasms have a greater impact on people over 65 years of age. To measure the impact of these diseases on life expectancy in people of working age, a partial multiple decremental life table was constructed and the potential gains in life expectancy were computed by partial or complete elimination of various causes of death during the working years. shows the impact on life expectancy of the US working-age population by eliminating deaths from HIV/AIDS, heart disease and malignant neoplasms by race and sex groups. CONCLUSIONS: Since 1995, there has been a rapid reduction in the burden of HIV/AIDS on the life expectancy for the US population, especially for black males of working age. These results could provide useful information when evaluating public health improvements and allocating resources for future disease control programmes.     

Subjective life expectancy in the US: correspondence to actuarial estimates by age, sex and race.

This study maps the relationship between subjective and actuarial life expectancy in a 1995 national sample of 2037 Americans of ages 18-95. Subjective estimates parallel age-specific actuarial ones based on current age-specific mortality rates. However males expect to live about 3 years longer than the actuarial estimate and blacks expect to live about 6 years longer. The apparent optimism remains after adjusting for socioeconomic status and the signs and symptoms of good health. Contrary to economists' rational-expectations hypothesis, young adults do not adjust their life expectancies upward to account for the favorable trends in mortality rates.     

Adding years to life: effect of avoidable mortality on life expectancy at birth.

STUDY OBJECTIVE--The aim was to determine the number of years that could be gained by preventing avoidable deaths. DESIGN--The study arose from the concept of avoidable causes of death and life expectancy at birth. Four abbreviated life tables were computed. The first included all causes of death; the second excluded all avoidable causes of death; the third and fourth excluded respectively primary and secondary avoidable causes of death. SETTING--Mortality and population data were taken from Mortality Statistics Offices in Valencia Region, Spain. MAIN RESULTS--Life expectancy at birth (LEB) was 75.7 years. After removing all avoidable deaths, LEB increased by 1.74 years. This improvement is attributed to avoidable deaths by primary prevention (1.09 years) and avoidable death by secondary prevention (0.37 year). CONCLUSIONS--According to these results the greatest improvement in LEB would be gained by primary prevention.     

Secular trends of sex ratios at birth in Japan

OBJECTIVE: To describe secular trends of change in sex ratio at birth in Japan during the 100 years from 1899 to 1998. METHODS: Data on sex ratios (number of males to females at birth by prefecture) from 1899 to 1998 were obtained from the vital statistics of Japan. We used moving averages (9-years averages) to minimize the effects of yearly fluctuation on the sex ratio and calculated simple linear regression coefficients to examine trends in change for the period between 1925 and 1969 and between 1970 and 1998. RESULTS: The male: female sex ratio in Japan increased during the period through 1925 to about 1970 and thereafter decreased. The increase was the case for all prefectures with few exception, while these but Fukushima, Ibaraki, Fukui, Yamanashi and Kumamoto demonstrated subsequent decrease. The prefectures with strong decrease in the sex ratio from about 1970 at largely distributed facing the Sea of Japan; e.g. Akita, Toyama, Ishikawa, Kyoto, Shimane and Fukuoka. CONCLUSION: Our study confirmed a decline in the male: female sex ratio at birth in recent decades in Japan as a whole and in most prefectures. Although we do not know whether this is an effect of environmental pollution due to chemical substances, monitoring of secular trends in sex ratios should be continued with due attention to counsel to government.     

Increase in life expectancy at birth in Japan: some implications for variable patterns of decrease in mortality.

The characteristics of the increase in life expectancy at birth (eo) in Japan were analyzed using the life tables of developed countries in which the values of eo were almost the same. When the decrease in age-specific probability of dying (qx) and its contribution to total gain in eo in Japan were compared to those of other developed countries, the decline in qx in prime, middle and old age groups accounts for much of the change; the decrease in this variable for males aged 50 years and over accounted for 35% of the recent increase in eo. Well-organized medical care and public services are discussed in relation to this unique and unusually rapid increase in eo for the Japanese population.     

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.     

Physical environment and life expectancy at birth in Mexico: an eco-epidemiological study

The objective of this ecological study was to ascertain the effects of physical environment on life expectancy at birth, using data from all 32 Mexican states. 50 environmental indicators with information about demography, housing, poverty, water, soils, biodiversity, forestry resources, and residues were included in exploratory factor analysis. Four factors were extracted: population vulnerability/susceptibility, and biodiversity (FC1), urbanization, industrialization, and environmental sustainability (FC2), ecological resilience (FC3), and free-plague environments (FC4). Using OLS regressions, FC2, FC3, and FC4 were found to be positively associated with life expectancy at birth, while FC1 was negatively associated. This study suggests that physical environment is an important macro-determinant of the health of the Mexican population, and highlights the usefulness of ecological concepts in epidemiological studies.     

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.     

1990-2015年中国分省期望寿命和健康期望寿命分析

目的 分析中国及各省期望寿命和健康期望寿命现状及其变化情况。方法 利用2015年全球疾病负担研究结果,对2015年中国居民与全球主要国家期望寿命和健康期望寿命进行比较;分析全国及各省期望寿命和健康期望寿命的差异和1990-2015年全国及各省期望寿命和健康期望寿命的变化幅度。结果 2015年中国居民的期望寿命为76.2岁,健康期望寿命为68.0岁,分别比全球平均水平高出4.4岁和5.2岁。2015年中国人均期望寿命和健康期望寿命,女性均高于男性。我国期望寿命和健康期望寿命较高的省份有上海、北京、香港、澳门、浙江、江苏、天津和广东等东部发达省份,较低的省份有西藏、青海、贵州、新疆和云南等西部省份。1990-2015年,中国居民期望寿命和健康期望寿命均呈上升趋势,期望寿命增加了9.5岁,健康期望寿命增加了8.4岁。全国及各省期望寿命增加的岁数均高于健康期望寿命增加的岁数。结论 1990-2015年中国居民的期望寿命和健康期望寿命有了较大程度的提高,但各省之间差异较大。     

Analysis of disability-free life expectancy over the lifespan: from maturity to old age

Objective

To determine the life stages in which disability-free life expectancy is shortened before the age of 70 years.

Method

A retrospective longitudinal analysis was carried out in a cohort of 1,286 non-institutionalized people aged from 70 to 74 years old living in metropolitan areas. Disability was measured by instrumental and basic activities of daily living. Disability-free life expectancy was calculated. The Kaplan-Meier method was used to calculate survival probabilities.

Results

The incidence of basic disability increased from 50 to 54 years old and progressively accelerated until the age of 65-69 years old when the probability of instrumental disability was slightly higher among men than among women (0.23 in men versus 0.19 in women). Disability-free survival was lower among women than among men both for all types of disability (LogRank = 5.80; p = 0.016) and for basic disability (LogRank = 4.315; p = 0.038).

Conclusions

This study reveals the importance of instrumental disability for domestic tasks among older men. Women had a lower probability of disability-free survival and were more likely to be affected by any type of disability as well as by basic disability. For both genders, there is a slight decrease in disability-free survival from the age of 40 to 60 years. From this age onwards, this decrease markedly accelerates.     

A prospective study of age at menarche, parity, age at first birth, and coronary heart disease in women

Reproductive events in women are associated with alterations in blood lipids and blood pressure and may therefore influence determinants of coronary heart disease. To investigate the risk of coronary heart disease in relation to age at menarche, parity, and age at first birth, the authors evaluated prospectively the experience of 119,963 US women aged 30-55 years who were free from coronary heart disease in 1976 and were followed through 1982. During 700,809 person-years of observation, 308 incident cases of nonfatal myocardial infarction or fatal coronary heart disease occurred. Younger age at menarche was weakly associated with coronary heart disease (age-adjusted rate ratio of 1.3 for menarche before age 11 years compared with menarche at age 13 years; chi, Mantel extension test for trend = -1.1, p = 0.2). Nulliparous women experienced only a slightly higher rate of coronary heart disease than parous women (rate ratio = 1.2, 95 per cent confidence interval 0.8-1.8). Among parous women, there was no alteration in risk with increasing number of births. Likewise, there was no significant association between age at first birth and coronary heart disease (chi, Mantel extension test for trend = -0.4, p = 0.4). Established risk factors for coronary heart disease nevertheless showed expected relations. These findings show no important association between reproductive experiences and risk of coronary heart disease.     

Geographical variation in life expectancy at birth in England and Wales is largely explained by deprivation

STUDY OBJECTIVE: To describe the population mortality profile of England and Wales by deprivation and in each government office region (GOR) during 1998, and to quantify the influence of geography and deprivation in determining life expectancy. DESIGN: Construction of life tables describing age specific mortality rates and life expectancy at birth from death registrations and estimated population counts. Life tables were created for (a) quintiles of income deprivation based on the income domain score of the index of multiple deprivation 2000, (b) each GOR and Wales, and (c) every combination of deprivation and geography. SETTING: England and Wales.PATIENTS/ PARTICIPANTS: Residents of England and Wales, 1998. MAIN RESULTS: Life expectancy at birth varies with deprivation quintile and is highest in the most affluent groups. The differences are mainly attributable to differences in mortality rates under 75 years of age. Regional life expectancies display a clear north-south gradient. Linear regression analysis shows that deprivation explains most of the geographical variation in life expectancy. CONCLUSIONS: Geographical patterns of life expectancy identified within these data for England and Wales in 1998 are mainly attributable to variations in deprivation status as defined by the IMD 2000 income domain score.     

中国人均预期寿命时空变化及影响因素分析

运用变异系数和灰色关联分析法,对中国人均预期寿命时空变化特征及影响因素的强度进行研究。结果表明:(1) 1981—2015年,我国人均预期寿命增长经历了慢—快—慢—快的四个阶段,预期寿命增长指数上升到113,其中男性上升到111,女性上升到115,男女预期寿命差距逐步增大。(2) 1990—2010年,全国31个省份人均预期寿命变异系数从0. 051降低到0. 036,预期寿命水平较低省份的增长速度明显高于较高的省份。(3)我国人均预期寿命的地域分布大体上分为东南部高预期寿命水平区、中北部中预期寿命水平区、西南部低预期寿命水平区。2010年我国人均预期寿命水平绝大多数省份处于第二级(76～80岁)和第三级(71～75岁),相对于1990年提高了两级。到2020年,我国将有北京、天津和上海3市处于第一级寿命水平(81～85岁),其余为第二和第三级预期寿命水平。影响我国省际人均预期寿命时空差异的因素是多方面的,其中最主要的是各地区的经济发展、医疗服务和医疗保障水平。