Life Expectancy Growth Research Articles

Impact of premature deaths from malignant tumors on life expectancy among Chinese residents, 1990-2021

Objective: To analyze premature deaths from malignant tumors among Chinese residents from 1990 to 2021, and to quantify the extent to which changes in premature mortality from malignant tumors affect life expectancy among people aged 30 to 69 years. Methods: Using the Global Burden of Disease 2021 data on selected causes of death in China, the malignant tumor mortality rate was estimated for Chinese residents aged 30-69 years from 1990 to 2021, and life expectancy and de-malignant cause-of-death life expectancy were calculated based on the abridged life table for the Chinese population. Arriaga's decomposition method was used to assess the extent to which changes in malignant tumors mortality contributed to changes in life expectancy for people aged 30-69 years and Potential gains in life expectancy (PGLEs) for people aged 30- 69 years. Results: From 1990 to 2021, the standardized mortality rate of malignant tumors among Chinese people aged 30-69 years decreased from 154.29/100 000 to 98.58/100 000, and the change in the mortality rate of malignant tumors among people aged 30-69 years contributed to the increase of life expectancy of about 0.78 years, and the largest contribution was made by the age group aged 55-59 years, which was about 0.17 years. Among the top 10 malignant tumors, the largest "positive contributions" are stomach cancer, esophageal cancer, and liver cancer, with a cumulative contribution of 0.55 years, while pancreatic cancer hurts the increase of overall life expectancy. The PGLEs of malignant tumors for the population aged 30-69 years will be 1.69 years in 2021, which is higher for men (1.97 years) than for women (1.32 years). The top 5 malignant tumors causing loss of life expectancy in the population were tracheal, bronchus, and lung cancer, stomach cancer, esophageal cancer, colorectal cancer, and liver cancer, in that order. Compared with 1990, in 2021, PGLEs for malignant tumors among people aged 30-69 years increased in seven provinces (autonomous regions and municipalities), including Yunnan and Guizhou, and the rest saw a decline, with the largest decrease in Anhui Province. Conclusions: The standardized mortality rate of malignant tumors among Chinese residents aged 30-69 years declined from 1990 to 2021;the change in mortality rate of malignant tumors showed a positive effect on the growth of life expectancy, the change in PGLEs of malignant tumors varied among provinces (autonomous regions and municipalities), and premature deaths from tracheal, bronchus, and lung cancer and gastrointestinal malignant tumors still need to be paid attention to.

Wealth and mortality among late-middle-aged individuals in Norway: a nationwide register-based retrospective study

BackgroundIn recent decades, we have observed rising wealth inequality while the pace of growth of life expectancy has slowed in many Western welfare democracies. There is scarce evidence, however, on links between wealth and mortality. The main methodological limitation in this area of scholarship is its inability to account for individuals' unobserved heterogeneity, such as personality and genetic factors, which could potentially affect both their wealth level and survival probabilities. This study aims to explore how wealth is linked to mortality risk in late-middle age, providing insights into the broader implications of socioeconomic status on health outcomes. MethodsIn this study, we use high-quality register data on wealth and mortality for the entire population of Norway, one of the world's most advanced welfare states with a low income inequality level but a highly uneven distribution of wealth. We address some of the main methodological constraints of the previous research by exploring if wealth at the age of 37-38 predicts mortality up to age 62. The research design employed mitigates the problem of unobserved heterogeneity by using sibling and twin fixed-effects models. FindingsBoth Kaplan-Meier survival analyses and the Cox proportional hazard regression results suggest that wealth is an important predictor of mortality even after individuals' observed and unobserved characteristics are accounted for with hazard ratios of 2.39 [95% confidence interval, CI 2.02, 2.83] among men and 1.74 [95% CI 1.39, 2.16] among women for the inverted cumulative density rank coefficients. The most disadvantaged groups are non-partnered men and women at the lower end of wealth distribution. Twin analyses align with the findings for the general population, indicating that wealth's effect on mortality is not confounded by genetic or shared family background factors. InterpretationOur findings suggest that wealth is an important predictor of mortality, even in an advanced welfare state with comprehensive healthcare provisions, highlighting the need to address inequalities in wealth distribution to improve population health outcomes. FundingThe Research Council of Norway.

Unpacking occupational and sex divides to understand the moderate progress in life expectancy in recent years (France, 2010’s)

PurposeThe growth in life expectancy (LE) slows down recently in several high-income countries. Among the underlying dynamics, uneven progress in LE across social groups has been pointed out. However, these dynamics has not been extensively studied, partly due to data limitations. In this paper, we explore this area for the 2010 decade using recent French data.MethodsWe utilize the recent change in French census mortality follow-up data (EDP) and apply P-spline models to estimate LEs across five occupational classes (OCs) and indicators of lifespan heterogeneity (edagger) within these OCs, for seven triennial periods (2011-2013 to 2017-2019).ResultsFirst, we found a similar ranking of OCs along the LE gradient over time and across sexes, from manual workers to higher-level OCs. Noteworthy, the lowest LE in women overlaps with the highest one in men drawing a sex-OC gradient. Second, we observe varying progress of LEs. In women, LE increases in higher-level OCs meanwhile it levels off in manual workers, so that the OCs gap widens (up to 3.4 years in 2017-2019). Conversely, in men LE stalls in higher-level OCs and increases in manual workers so that the gap, which is much larger than in women (+5.7 years in 2017-2019), is tending to narrow. Finally, the lifespan homogenizes in OCs only when LE is low.ConclusionOverall, the limited LE progress in France results from LE stalling in the middle of the sex-OC gradient, though LE increases at both ends. At the lower end, LE progress and lifespan homogenization suggest that laggards benefit recently improvements achieved earlier in other OCs. At the upper end, LE progress may come from a vanguard group within higher-lever OC, benefiting new sources of improvements. These findings underscore the need for further research to explore the diverse mortality dynamics coexisting in the current health landscape.

The Role of Government Health Expenditure in Driving Economic Growth: Evidence from OECD Countries

This study examines the influence of government health expenditure and life expectancy on economic growth. The study makes use of panel data analysis and utilizes data from the OECD nations between 2000 and 2021. The study applies panel data analysis using POLS, FEM and REM models and dynamic GMM models. The study also gauges the moderating role of life expectancy on the relationship between government health expenditure and economic growth. The results indicate that government expenditure on health hurts economic growth. A detrimental relationship between life expectancy and economic growth indicates that higher life expectancy could result in elevated healthcare and financial expenses. Nevertheless, the interactive regression model suggests that there is no significant moderation of the association between government expenditure on health and economic growth by life expectancy, implying that the influence of government health expenditure on economic growth is generally unaffected by demographic changes. These findings emphasize the significance of differentiating between the short-term and long-term economic consequences of healthcare expenditure. This study offers insights into the optimization of public spending in OECD nations to promote sustainable economic growth and enhance public health outcomes.

Fostering economic growth in Somalia: the role of life expectancy and environmental degradation

Economic growth is a primary objective for countries worldwide since it has a pivotal impact on enhancing living standards, alleviating poverty, and promoting general societal well-being. Hence, this study examines the connection between life expectancy, environmental pollution, and economic growth in Somalia by using time-series data from 1990 to 2020. The study employs the autoregressive distributed lag (ARDL) bound test and fully modified ordinary least squares (FMOLS) method. The empirical results of the bound test indicate that life expectancy is statistically significant and positively affects economic growth in the long run. However, it does not significantly affect economic growth in the short run. Furthermore, environmental pollution does not significantly impact economic growth in the long run but enhances it in the short run. The study indicates that life expectancy improves economic growth. Based on the empirical evidence, the study provides several policy implications, including public health initiatives, health-related infrastructure, and sustainable environmental practices, which are recommended.

Analyzing the Interaction Among Tourism, Life Expectancy, and Unemployment in Japan: Insights From Cointegration and Conditional Causality Approach

ABSTRACTThis study explores the dynamic interconnectedness among tourism, life expectancy, unemployment, and economic growth in Japan from 1995 to 2023. Despite numerous studies on these variables individually, comprehensive analysis on their interconnections is lacking. Using Bounds testing, ARDL models, and Granger causality techniques, we reveal significant insights into these relationships. The analysis confirms a long‐run co‐integration among all variables, indicating a stable equilibrium over time. In the short run, tourism and life expectancy positively impact economic growth, underscoring their crucial roles in driving Japan's economy. Conversely, the link between unemployment and economic growth is negative and statistically insignificant, suggesting that short‐term unemployment fluctuations do not substantially affect economic performance. Granger causality analysis shows bidirectional causality among economic growth, tourism, and life expectancy, indicating mutual reinforcement and interdependence, while unemployment reveals unidirectional causality. The findings emphasize the need for policies supporting tourism development and as strategic avenues for sustainable economic growth.

ARE COGNITIVELY IMPAIRED PATIENTS SUITABLE CANDIDATES FOR HIP ARTHROPLASTY? A PROPENSITY SCORE-MATCHED COHORT STUDY

The growth of life expectancy during the last decades has led to an increment in age-related conditions such as hip arthritis and fractures. On the other hand, these elderly patients will present a higher incidence of mental diseases which, in some studies, have been associated with inferior results.This study aims to evaluate the differences in early complication rates between patients with cognitive impairment compared with those without this condition following total hip replacement for osteoarthritis or fracture in the context of contemporary perioperative care protocols.We conducted a retrospective cohort study where cognitively-impaired patients who required primary hip arthroplasty were compared to a propensity-score matched cohort of patients without cognitive alterations. Early major complications were measured and analyzed in order to determine significant differences.Screening and matching. 1196 patients were identified during the study period. After screening for inclusion and exclusion criteria and matching, two cohorts comprising 65 patients each were compared. After performing the propensity-score match, no significant differences were found in covariates between the two groups.Outcomes. The occurrence of delirium was more frequent in patients with cognitive deficit (27.5%) than in the control group (9%), p<0.001. No significant differences were found among groups regarding myocardial infarction, venous thromboembolism, blood transfusion requirement, 30-day readmission, in-hospital death, 90-days death, dislocation or surgical site infection. The composite outcome of any adverse event did not exhibit a significant difference either.To our knowledge, this is the first study which demonstrates similar outcomes between patients with cognitive impairment and those without these alterations. Our results might indicate that contemporary protocols and implants are bridging the traditional gap between these two populations. These findings support the use of total hip arthroplasty in patients with mental alterations when indicated, especially in those institutions with strict perioperative protocols.

Relationship between Financial Development and Economic Growth: Evidence from 12 SADC Countries

Purpose: The purpose of this study was to examine the causal relationship between financial development and economic growth in 12 SADC countries for the period 2008-2020. Materials and Methods: The study utilized panel data from 12 SADC member states for the period 2008-2020. This dataset was compiled from the World Bank database, Penn tables, and National Bureau of Statistics websites for the member states. The study employed the Autoregressive Distributed Lag Model (ARDL) to estimate the causal relationship between financial development and economic growth. Findings: The empirical results show that there is bi-directional causality between financial development and economic growth in the SADC region. The findings also suggest that while financial development positively correlates with economic growth in the long run, the short-run effects may vary, with factors such as physical capital accumulation and government expenditure playing significant roles. Trade openness, life expectancy and population growth were also found to have implications for economic growth in the SADC region, highlighting the complex nature of development dynamics. Implications to Theory, Practice and Policy: The presence of bidirectional causality between financial development and economic growth calls for coordinated economic and financial policies as both variables mutually influence each other's dynamics.

The impact of corruption on ESG based on EU countries

Motivation: The impact of corruption on core ESG measures for EU countries has not yet been studied. There are few analyses in the literature on the relationship between corruption and ESG from a ma-cro level, and only such analyses allow an indication of the costs of corruption and the effects from fighting it at the country level. Aim: The study aims to ocean the impact of corruption on ESG measures: CO2 emissions, life expectancy and economic growth in the EU. Calculating the cost of corruption is key to properly assessing the effectiveness of anti-corruption projects. Results: The effect of corruption on ESG measures was shown to be heterogeneous. A non-linear relationship between corruption and CO2 and economic growth was shown, while the relationship between corruption and life expectancy was linear. The impact of corruption on ESG should be considered from the point of view of the ESG component variable in question, rather than on the basis of synthetic ESG measures.

The performance of human capital in relationship with economic growth

In this paper I examine the impact of human capital on the economic growth for the OECD countries during the period 1990-2022 employing fixed effects estimator. My contribution to the literature comes from the chosen variables, as the proxies selected were not yet used by other researchers in the same formula. The indicators selected are tertiary enrollment, spending on health, life expectancy and population growth. The data was constructed into a panel of 38 countries over the period 1990-2022. Results surprisingly show that only tertiary enrollment, life expectancy and population growth have a significant impact on economic growth. Therefore, my recommendations are focusing on improving the quality of life.

Assessment of the Effectiveness of Gemcitabine, Metformin, Citrus Pectin and Their Combinations on the Growth of Transgrant Walker Carcinosarcoma

One of the important problems of modern society is the prevention and treatment of cancer. To increase the effectiveness of existing methods, it is promising to use biological response modifiers, the combination of which with traditional methods makes it possible to increase the effectiveness of therapy. The article presents the results of experiments studying the combined effects of metformin, low molecular weight pectin and the cytostatic drug gemcitabine on a transplantable tumor — Walker carcinosarcoma 256. The experimental results demonstrated a clear effect of reducing the toxicity of gemcitabine when administered in high doses in combination with pectasol and metformin. It has been shown that with combined therapy, the rates of inhibition of tumor growth and increase in life expectancy are higher than with monotherapy.

CO2 emission, life expectancy, and economic growth: a triad analysis of Sub-Saharan African countries

CO2 emission, life expectancy, and economic growth: a triad analysis of Sub-Saharan African countries

Dynamic Linkages among HIV/AIDS, Health Expenditures, Environmental Degradation, Life Expectancy, and Economic Growth: A Case of Eastern Africa Countries.

Eastern African countries are among the countries with a very high HIV/AIDS prevalence rate. High HIV/AIDS prevalence is a problem that has a detrimental effect on the economic development of these countries. Previous studies have generally examined the relationship of HIV/AIDS with life expectancy or economic growth. In this study, three different models have been established and the relationship of HIV/AIDS with economic growth, health expenditures, and life expectancy has been analyzed, and current econometric methods and policy recommendations have been developed according to the results. The aim of this study was to investigate the relationship between health expenditure, environmental degradation, life expectancy, HIV/AIDS, and economic growth. Annual data from 9 Eastern African countries for the period of 2000-2019 were used. Panel ARDL/PMG and Dumitrescu-Hurlin methods were used. HIV/AIDS negatively affects economic growth and life expectancy, and positively affects health expenditures. According to the causality results, HIV/AIDS is the cause of economic growth. In addition, a bidirectional causal relationship has been found between HIV/AIDS and life expectancy. The main conclusion of the study is that HIV/AIDS plays a negative role in economic growth and life expectancy. Further steps must be taken to prevent the further spread of HIV/AIDS, which causes these factors to affect the well-being of the countries.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ ПОДХОДОВ К ОЦЕНКЕ ОЖИДАЕМОЙ ПРОДОЛЖИТЕЛЬНОСТИ ЗДОРОВОЙ ЖИЗНИ

Significance. Healthy life expectancy is a group of indicators that allows to estimate how long a person will live with “good” health given the current level of mortality and health of the population. The relevance of the calculation and assessment of healthy life expectancy is conditioned, among other things, by the Decree of the President of the Russian Federation dated 07.05.2024 N 309 “On the national development goals of the Russian Federation for the period until 2030 and prospects until 2036” - by 2030, it is planned to achieve “outpacing growth of healthy life expectancy indicators”, i.e. to reduce the difference between healthy life expectancy and life expectancy. The purpose of the study is to review the methods of calculating healthy life expectancy, sources of data on healthy life expectancy in Russia and the world, and a brief analysis of the dynamics in healthy life expectancy in Russia. Material and Methods. Literature sources and databases were studied to analyze the calculation methods and existing estimates of healthy life expectancy. Literature sources were searched in PubMed and eLibrary databases, and data - on the websites of the World Health Organization, Global Burden of Disease, Eurostat, “Unified Interdepartmental Information and Statistical System”. Results. One of the two main methods is usually chosen to estimate healthy life expectancy: the widely used Sullivan formula (cross-sectional analysis) and the less frequently used multistatus table method (longitudinal analysis). There are also various methods of defining “good” health: self-rated health or presence or absence of limitations or diseases. From 1990 to 2019, healthy life expectancy increased globally and in Russia; in Russia, there was a decline in healthy life expectancy during the Covid-19 pandemic, followed by a steady recovery afterwards. Conclusion. Healthy life expectancy in research and in public administration has not been as widely used as life expectancy, which is probably a consequence of the peculiarities of the methodology for calculating the indicator and its sensitivity not only to the objective parameter of mortality. However, being an integral indicator, healthy life expectancy can provide information on the “quality” of life expectancy growth.

THE “DOUBLE JEOPARDY” OF MIDLIFE AND OLD AGE MORTALITY TRENDS IN THE UNITED STATES

Abstract Since 2010, U.S. life expectancy growth has stagnated. Much research on U.S. mortality has focused on working age adults given adverse trends in drug overdose deaths, other external causes of death, and cardiometabolic deaths in midlife. We show that the adverse mortality trend at retirement ages (65+ years) has in fact been more consequential to the U.S. life expectancy stagnation since 2010, as well as excess deaths and years of life lost in 2019, than adverse mortality trends at working ages. These results reveal that the U.S. is experiencing a “double jeopardy” that is driven by both mid-life and older-age mortality trends, but more so by older-age mortality. Understanding and addressing the causes behind the worsening mortality trend in older ages will be essential to returning to the pace of life expectancy improvements that the U.S. had experienced for decades.

OCCUPATIONAL THERAPY INTERVENTIONS TO IMPROVE OCCUPATIONAL PARTICIPATION AND REDUCE THE RISK OF FALLS IN ELDERLY PEOPLE WITH OSTEOARTHRITIS

Global trends show an increase in life expectancy. A similar trend in life expectancy growth is typical for Ukraine. However, even a positive trend towards an increase in average life expectancy cannot stop the inevitable process of aging, which leads to a decrease in the functional and physiological capabilities of all body systems.
 Osteoarthritis is the most common disease of elderly. Osteoarthritis of the joints of the lower extremities is a risk factor for falls syndrome. Falls lead to a decrease in physical functioning, independence and occupational participation, increase the fear of the next fall, and bring serious injuries, even depth. The role of an occupational therapist in falls prevention is undeniable. It helps maximize the ability to participate in the occupational activity that is meaningful to the client, and modifies the client's lifestyle and living environment for safe occupational performance.
 The aim of the research. To scientifically justify and develop a comprehensive program of occupational therapy interventions to reduce the risk of falls for elderly women with osteoarthritis of the lower extremities by means of occupational therapy.
 Materials and methods. In order to fully solve the tasks and study the activity of elderly women with osteoarthritis of the joints of the lower extremities, the following research methods were chosen: analysis of special and scientific and methodical literature; content analysis of medical records, interviews, observations; WOMAC Osteoarthritis Index and assessment of fear of falling according to Falls Efficacy Scale International.
 48 women aged 62 to 89 took part in the ascertainment experiment. Women were divided into 2 groups - main (MG) and control (CG), 24 people in each. The main group included women with osteoarthritis of the lower extremities. In the control group people were without damage to the joints. The program lasted for 6 (six) months. The people of CG received recommendations about general physical activity with reference to WHO guideline. The people of MG received therapeutic exercises on strength, balance, coordination, endurance, improvement of walking skills and occupational therapy interventions with: training to perform occupations safely; creation of a new stereotype of behavior to avoid falling; modification of the environment; review of medications which can provoke a fall; learning to use assistive equipment; techniques to get up safely and effectively after a fall.
 Research results. Based on the obtained data, it is evident that both groups experienced an increase of independence level in functioning, less of pain, stiffness and fear of falling.
 Conclusions. Both falling and the fear of falling significantly reduce the ability to lead a full and independent life, bring undesirable consequences, including serious injuries, and interfere with the ability to do what is most important for a person. In the foreign literature, there is a lot of evidence about the contribution of occupational therapy to the prevention of falls. The results of the conducted research give grounds for asserting that the application developed by us a multi-component program of occupational therapy interventions developed for elderly people with osteoarthritis of the joints of the lower extremities is an effective means of reducing the risk of falls in this category of people. The advantages of the developed program are confirmed by the results of own research.

Mortality from circulatory diseases as a reflection of demographic aging

Introduction. Even a decade ago, an increase in mortality from circulatory diseases (CVD) in Russia until 2050 was predicted, in parallel with an increase in number of people older than working age. The forecast did not materialize.
 The purpose is to identify the relationship between the level and structure of mortality from CVD and the proportion of elderly people.
 Materials and methods. Official Rosstat data on mortality in Moscow and the Russian Federation for period 1975–2019 were used. There was made a comparison of age patterns of mortality from CVD at the beginning and end of the analysed period in the country and in the capital separately for men and women. For simplicity of calculations, the trend in the gain in mortality with increasing age was approximated by an exponential function in the Microsoft Excel Software.
 Results. Since 2003 to 2019 in the Russian Federation, mortality from CVD was found to decline among men and women by 2.0 and 2.2 times. In Moscow, with a 2.3- and 2.2-fold decrease in mortality from CVD. During this period losses fell as a result of premature death from CVD by 1.8 and 1.9 times in men and women, as well as in Moscow.
 Limitations. The quality of analysed data is limited by quality of coding of the causes of death in different regions and by accuracy of estimate of age structure of the population in period between population censuses.
 Conclusions. Demographic aging does not lead to an increase in the contribution of CVD to the mortality of the population. The decrease in mortality from CVD significantly contributes to the growth of life expectancy and is accompanied by an increase in the proportion of elderly people. Only during periods of increased mortality, the contribution of CVD to it is directly proportional to proportion of elderly people. Age structure of mortality from CVD indicates the need to strengthen measures to prevent mortality.

VALUATION OF REVERSE MORTGAGES IN THE SPANISH MARKET FOR FOREIGN RESIDENTS

The continuous growth in life expectancy, besides to the difficult economic and financial situation of the public pension system in Spain, makes reverse mortgages an attractive solution for providing additional income to retirees. However, despite being almost 20 years old, the Spanish market remains immature. Consequently, providers face significant risks, due to factors such as interest rates, housing prices, and longevity. Numerous tourists visit Spain, and many retire there, obtaining legal residence. Therefore, lenders could be interested in marketing reverse mortgages to foreign residents. Nevertheless, the longevity risk faced by these lenders may differ depending on the nationality of the borrower, and profits and losses could vary. Consequently, we propose a methodology for comparing the pricing of reverse mortgages in Spain by considering differences in longevity risk. Specifically, we calculate the amount offered by three types of reverse mortgages to customers of different nationalities, genders, and ages with contracts made in Spain. Our conclusions are pertinent to Spanish lenders since the results indicate that, in general, a Spanish lender would assume a slightly larger risk when lending reverse mortgages to borrowers of the selected nationalities, regardless of other considerations, such as legal issues, which are not addressed in this article.

Environmental pollution and life expectancy in Somalia: do renewable energy, urbanization, and economic growth matter?

Ensuring good quality of health and longevity became a topical for policymakers and academicians. Various determinants, including socio-economic factors, have been discussed in the literature. Nevertheless, the empirical studies on this issue are scanty in least-developed countries like Somalia where the health indicators are poor. In this regard, this undertaking examines the impacts of renewable energy, urbanization, environmental pollution, and economic growth on life expectancy in Somalia for the period straddling 1990-2016. The study uses a novelty machine learning method - Kernel regularized least square (KRLS)method. The empirical results indicated that renewable energy, economic growth, and urbanization are statistically significant; whereas, environmental pollution is statistically insignificant. Renewable energy, economic growth, and urbanization exert positive effects on life expectancy in Somalia and have increasing marginal effects. Besides, bidirectional causality between renewable energy and life expectancy, life expectancy and economic growth, and environmental pollution and life expectancy are established. Moreover, unidirectional causality from urbanization to life expectancy is also observed. The study suggests that a budgetary revision be made to sort out health-related concerns resulting from a lack of healthcare services and poor sanitation for improving the longevity of the people. Additionally, investments in clean energy are necessary as will improve health outcomes without compromising economic growth and life expectancy.

THE SUBJECTIVE STRUCTURE OF THE MIDDLE AGE AND AGING

Middle Age and Aging is a collection of behavioral scientists' research on aging, focusing on social and psychological adaptations for individuals in their second half of life. It highlights age-status, age-sex roles, psychological changes, social-psychological theories, attitudes towards health, family roles, work, retirement, leisure, and cultural settings. The suggestion suggests studying middle age as a distinct life stage with distinctive characteristics, drawing social science attention to its adaptability and plasticity, focusing on context, culture, biological growth, and individual development. Middle age, a social concept influenced by life expectancy growth, has significantly altered human life, including sexuality, gender roles, and life phases, necessitating the creation of an analytical category.