Abstract
BackgroundTo address change in the 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 over time.MethodsThe temporal trend in GGLE was evaluated using retrospective demographic analysis with Joinpoint regression. Causes of death were coded in accordance with the International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. The life table technique and decomposition method were used to express changes in GGLE.ResultsThe trend of GGLE in Shanghai experienced two phases, i.e., 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 the recent plateau phase.ConclusionsNon-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. This will also ensure improvements in health and health equity in Shanghai China.
Highlights
To address change in the 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 over time
The GGLE decreased from 8.4 years in 1973 to 4.8 years in 2018
Change of GGLE could be divided into two phases, the descent (1973 to 1999) saw a dramatic drop in GGLE from 8.4 to 4.2 (slope is − 0.11 with 95% CI (− 0.14, − 0.08)); the plateau (1999 to 2018) where GGLE fluctuated between 4.0 and 4.9 years
Summary
To address change in the 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 over time. The gender gap in life expectancy at birth (GGLE), which is the difference in life expectancy at birth (LE) by gender, was 4.4 years in 2016 (74.2 years for females and 69.8 years for males) [1]. While the gender ratio at birth in China is male-biased, the GGLE is female-biased and suggest a need for increased effort to understand the underlying cause of shorter male life expectancy at birth. Understanding long-term trends in GGLE and the cause of death will provide evidence for health professionals and policymakers to prioritize efforts and narrow gender inequity in LE. Shanghai has yet to see the GGLE inflection with male catching up with females’ LE
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