Mortality: life and health expectancy of Canadian women.

Marie DesMeules,Douglas Manuel,Robert Cho

doi:10.1186/1472-6874-4-s1-s9

Abstract

Health IssueThe sex differences in mortality, life expectancy, and, to a lesser extent, health expectancy, are well recognized in Canada and internationally. However, the factors explaining these differences between women and men are not well understood. This chapter explores the contribution of various causes of death (such as preventable, and sex-specific deaths) on these differences between women and men.Key Findings"External" preventable causes of death (e.g. smoking-related, injuries, etc.) were responsible for a large portion of the sex gap in mortality and life expectancy. When excluding these causes from the calculations, the sex gap in life expectancies were largely reduced, decreasing from approximately 5.5 years (life expectancy being 81.4, years in women, and 75.9 years in men) to approximately 2.2 years (84.9 in women and 82.7 in men). Sex gaps in corresponding health expectancies entirely disappeared when these preventable causes of death were excluded. Moreover, a larger death burden was observed among women than men for sex-specific causes of death (eg. excess breast cancer, gynaecological cancers, maternal mortality). Significant disparities were also observed in the mortality rates of various subgroups of women by geographic regions of Canada.Data Gaps and RecommendationsThese results indicate that women do not appear to have a large biological survival advantage but, rather, are at lower risk of preventable deaths. They also provide additional information needed for the development of policies aimed at reducing disparities in life and health expectancies in Canada and other developed countries.

Highlights

IntroductionMortality and life expectancy are well-established and commonly used indicators of population health, and important patterns by sex and over time have been observed in Canada [1] and internationally. [2] Canadians' life expectancy, estimated at approximately 76 years for men and 81 years for women, [1] has consistently ranked among the top 10 of all OECD (Organization for Economic Co-operation and Development) countries for several decades. [1] The relative difference in mortality and life expectancy between men and women is well documented in the existing literature. [1,2,3,4]The overall decrease in mortality and the corresponding increase in life expectancy over the last century among men and women are well known
Approximately half of the increase in life expectancy before the 1980s can be attributed to a decline in infant mortality, whereas more recent increases are due to a decline in the mortality rate of older people
These artificial hypotheses are useful in isolating the relative contribution of preventable and non-preventable causes to sex and gender gaps in health and in determining the maximum potential impact of possible interventions on reducing these sex and gender gaps in health.] These three categories are not mutually exclusive, as some diagnostic categories are included in two categories

Summary

Introduction

Mortality and life expectancy are well-established and commonly used indicators of population health, and important patterns by sex and over time have been observed in Canada [1] and internationally. [2] Canadians' life expectancy, estimated at approximately 76 years for men and 81 years for women, [1] has consistently ranked among the top 10 of all OECD (Organization for Economic Co-operation and Development) countries for several decades. [1] The relative difference in mortality and life expectancy between men and women is well documented in the existing literature. [1,2,3,4]The overall decrease in mortality and the corresponding increase in life expectancy over the last century among men and women are well known. BMC Women's Health 2004, 4:S9 http://www.biomedcentral.com/1472-6874/4/S1/S9 born at the beginning of the twentieth century could expect to live to about 50 years of age, three years longer than men. This gap in life expectancy reached a peak in the early 1980s (over seven years' difference), has been narrowing since and is currently approximately five years. [3] Over the latter half of the twentieth century, a 52% reduction in the female age-adjusted mortality rate from all causes combined has been observed, as compared with a 39% decrease for males. From 1990 to 1997, the death rate declined by twice as much among males as it did among females. [1] Patterns by cause of death vary between women and men, especially in adulthood (age 20 to 64). [6]

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