Abstract
Background During the last century, Kerala witnessed drastic mortality reduction and high improvement in longevity. This achievement is often compared with that of developed countries. However, how far the early advantages in mortality reduction have further enhanced in Kerala remains unknown. In most developed countries, advanced stage of mortality reduction and further increase in longevity was achieved mainly due to the mortality shift from adult and older ages to oldest ages (Olshansky and Ault 1986). Objectives Considering the lack of comprehensive study on the change in longevity in Kerala, this study focuses on discovering (i) the historical time-periods that provided the biggest gain to life expectancy and also the beneficiaries (by age group and sex) and (ii) the contributions of major groups of causes of death in mortality reduction and consequent improvement in longevity. Methodology and data The study uses the methodology proposed by Olshansky and Ault in 1986. It used methods such as Temporary Life Expectancy (TLE), Annual Relative Change in TLE, Decomposition of changes in longevity among different age groups (gender and spatial) and causes of deaths, for the analysis. It used data from various sources such as Census, Civil Registration System (CRS) and Directorate of Health Services (DHS), as well as survey data from Sample Registration System (SRS) and Medically Certified Causes of Deaths (MCCD) for this study. Finding and conclusion The study found that overall mortality dramatically declined in the state in the recent decades. Younger ages have contributed the most for this reduction. Therefore, further mortality reduction is possible in adult and early old ages. However, the contribution of these ages to life expectancy was lower than that of youngsters until 1991–2000 especially among males. This may indicate a slow progress towards the advanced stage of epidemiological transition characterized by high prevalence of non-communicable diseases. The paper concludes that although the health issues of infants, children, and mothers in the reproductive age group, are effectively addressed through various policies in Kerala, the state needs to focus more on the health problems of adults, especially males.
Highlights
During the last century, Kerala witnessed drastic mortality reduction and high improvement in longevity
A major focus of the paper is to identify the period during which mortality transition and improvement in human longevity significantly happened in Kerala
Though Kerala has experienced a drastic decline in mortality and a resultant impressive growth in life expectancy throughout the past century, the major reduction occurred between 1951 and 1970
Summary
Kerala witnessed drastic mortality reduction and high improvement in longevity. The paper follows the methodology forwarded by Olshansky and Ault [16] considering the possibility of mortality reduction from adult and early old age groups to the oldest age group It compares the change in absolute value of mortality level by the increase or decrease in life expectancy between different periods. It is often limited to the problems of data reliability in older age groups and the restriction on limits of human life span [24] To avoid these problems, the paper analyses the relative risk of mortality transition for closed age interval (x, x'n) by using Temporary Life Expectancy (TLE) and index of Annual Relative Change (ARC) of TLE in the second section. In recent decades (1971Á80 to 2001Á08), the absolute changes in life expectancy at birth was by
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