Sex Differences In Life Expectancy Research Articles

Life expectancy at birth and life disparity: an assessment of sex differentials in mortality in India

This study aims to examine the sex differentials in life expectancy at birth and life disparity, and to estimate the age-specific contribution of the differences for India and its major states. Life dispari-ty measures the variation in the distribution of deaths, and life expectancy at birth measures the average length of life. Complete life tables generated from death rates and abridged life tables of the Sample Reg-istration System in India from 1970–1975 to 2006–2010 were used to fulfill the research goals. Stepwise replacement algorithm was used for the decomposition of sex differences in life expectancy at birth and in life disparity. The results indicate that the increase in life expectancy at birth and decline in life disparity was higher for females. The sex differential was more prominent in urban areas than in rural areas. A ma-jority of the states in India experienced changes in the direction and magnitude of sex differentials in life expectancy at birth and life disparity from 1970–1975 to 2006–2010. The sex differentials in life expec-tancy at birth and life disparity in 1970–1975 were primarily attributed to child mortality, whereas the sex differentials in recent decades were attributed to adult mortality.        

ETHNIC DIFFERENCES IN HEALTHY LIFE EXPECTANCY IN CHILE

Abstract Socioeconomic and sex differences in life expectancy (total and healthy) in Chile have been well established. However, the existence of ethnic differences in population longevity is unknown. Thus, we estimate total, healthy, and unhealthy life expectancy among Mapuche (largest indigenous group) and non-Mapuche older adults (≥60 years) in Chile. We estimated abbreviated mortality tables (using indirect demographic methods) and with the EDES health prevalence we applied Sullivan’s method. Disability was defined as the unhealthy state, evaluated through the methodology suggested by Albala et al. (2004). Results show that at age 60 the Mapuche have a life expectancy 7 years lower (26.4 vs. 18.9 years respectively). Although differences diminish with age, Mapuches always have lower total life expectancy. In addition, we detected that the proportion of disability-free life years is higher for non-Mapuche (1.5, 2.0 and 3.7 times higher at 60, 75 and 90 years respectively). In contrast, Mapuches expect to live a higher fraction of their life with disability compared to non-Mapuche (e.g., 84.1% vs. 62.9% at age 80). This is the first study addressing inequities in healthy life expectancy between the Mapuche ethnic group and non Mapuche population, reflected in lower life expectancy, lower healthy life expectancy and higher disabled life expectancy in Mapuche when compared with no Mapuche population.

Contributions of age groups and causes of death to the sex gap in lifespan variation in Europe

Much less is known about the sex gap in lifespan variation, which reflects inequalities in the length of life, than about the sex gap in life expectancy (average length of life). We examined the contributions of age groups and causes of death to the sex gap in lifespan variation for 28 European countries, grouped into five European regions. In 2010–15, males in Europe displayed a 6.8-year-lower life expectancy and a 2.3-year-higher standard deviation in lifespan than females, with clear regional differences. Sex differences in lifespan variation are attributable largely to higher external mortality among males aged 30–39, whereas sex differences in life expectancy are due predominantly to higher smoking-related and cardiovascular disease mortality among males aged 60–69. The distinct findings for the sex gap in lifespan variation and the sex gap in life expectancy provide additional insights into the survival differences between the sexes.

Complex Sex Differences in Life Expectancy in French Guiana.

In the complex context of French Guiana, different vulnerabilities and different risk factors between genders may lead to complex differences in health outcomes, mortality, and life expectancy. Our aim was, thus, to compare male and female mortality and life expectancy, to compare it between French Guiana and mainland France, and to look at temporal trends and the main specific causes of death in order to identify actionable singularities. National databases were used to obtain life expectancy at birth, at 20, 40, and 60 years, and mortality statistics. Standardized death rates and causes of death for French Guiana and mainland France were obtained through the CEPIDC, which analyzes information from death certificates. When comparing with mainland France, life expectancy at birth was significantly shorter both in males and females (mean = -2.9 years); life expectancy at 20 years, which allows to remove the effect of the greater child mortality in French Guiana, was also shorter in French Guiana for males (mean = -1.8 years) and females (mean = -2 years). The differences between mainland France and French Guiana regarding life expectancy at 40 and 60 years (mean = -1.5 and -1.3 years) was mainly found among females, males in French Guiana life expectancy at 40 and 60 years was closer to that in mainland France (mean = -0.8 and -0.6 years). Although they have a greater life expectancy at birth than men, women in French Guiana are substantially more affected by overweight/obesity and type 2 diabetes. The observed patterns of life expectancy at different ages presumably reflect the burden of external causes and AIDS in males and perhaps metabolic diseases in women.

Sex-differences in life expectancy at birth: A descriptive analysis of the contributions of age and causes of death to the gap in Norway, 1881–2011

Official mortality statistics provide ample evidence that women live longer than men. In many European countries, the sex difference in life expectancy began to increase near the end of the nineteenth century, peaking between the 1960s and the 1980s, before declining again. In Norway, there was another earlier peak before the sex gap started to converge to that in other European countries.This study investigated changes in sex differences in life expectancy at birth in Norway from 1881 to 2011 as well as the contribution of broad age groups and causes of death to those differences. The total sex gap was broken down by age and cause using decomposition methods. Available mortality statistics were used for every tenth year between 1881 and 2011, excluding the war year of 1941. We regrouped the causes of death into 14 categories to reduce comparability problems across different classification systems.At the end of the 19th century, the gap in life expectancy at birth was largely due to the excessive mortality in males aged 15–29, particularly external causes of death, and in infant mortality in boys (under 1 year) due to perinatal and congenital causes. Since the 1970s, excess mortality in males aged 60 years and over has explained more than half of the sex gap, and the most relevant contributors have been circulatory diseases, neoplasms, and external causes. The recent narrowing of this gap has been related to the increase in pathologies affecting women in old age, such as senility and dementia. Differences in smoking behavior have likely played a role as well: women started smoking a few decades later than men, and they also reduced their smoking later.

Probability of males to outlive females: an international comparison from 1751 to 2020

ObjectiveTo measure sex differences in lifespan based on the probability of males to outlive females.DesignInternational comparison of national and regional sex-specific life tables from the Human Mortality Database and the...

Urban–rural lifespan disparities and cause-deleted analysis: evidence from China

ObjectivesTo examine the length and dispersion level of lifespan for the subnational populations in China, identify the urban–rural gap and sex differences, and analyse the contribution made by causes of...

The triple burden of communicable and non-communicable diseases and injuries on sex differences in life expectancy in Ethiopia

BackgroundEthiopia has experienced great improvements in life expectancy (LE) at birth over the last three decades. Despite consistent increases in LE for both males and females in Ethiopia, the country has simultaneously witnessed an increasing discrepancy in LE between males and females.MethodsThis study used Pollard’s actuarial method of decomposing LE to compare age- and cause- specific contributions to changes in sex differences in LE between 1995 and 2015 in Ethiopia.ResultsLife expectancy at birth in Ethiopia increased for both males and females from 48.28 years and 50.12 years in 1995 to 65.59 years and 69.11 years in 2015, respectively. However, the sex differences in LE at birth also increased from 1.85 years in 1995 to 3.51 years in 2015. Decomposition analysis shows that the higher male mortality was consistently due to injuries and respiratory infections, which contributed to 1.57 out of 1.85 years in 1995 and 1.62 out of 3.51 years in 2015 of the sex differences in LE. Increased male mortality from non-communicable diseases (NCDs) also contributed to the increased difference in LE between males and females over the period, accounting for 0.21 out of 1.85 years and 1.05 out of 3.51 years in 1995 and 2015, respectively.ConclusionsWhile injuries and respiratory infections causing male mortality were the most consistent causes of the sex differences in LE in Ethiopia, morality from NCDs is the main cause of the recent increasing differences in LE between males and females. However, unlike the higher exposure of males to death from injuries due to road traffic injuries or interpersonal violence, to what extent sex differences are caused by the higher male mortality compared to female mortality from respiratory infection diseases is unclear. Similarly, despite Ethiopia’s weak social security system, an explanation for the increased sex differences after the age of 40 years due to either longer female LE or reduced male LE should be further investigated.

Testosterone and Life Span or Why Women Live Longer than Men: A Hypothesis

Women around the world live longer than men. The question of why this is happening is very interesting, but still unresolved in gerontology. There are a number of proposals to explain the mechanisms underlying this phenomenon, but there are no clearly confirmed or refuted ones among them. This is probably due to the fact that it is extremely difficult to organize the testing of such hypotheses for Homo sapiens, and the available data on animals are often contradictory and their results cannot be fully transferred to humans. In the article, we tried to identify one of the possible mechanisms leading to sex differences in life expectancy in the human population. The depressing effect of testosterone on the immune system of women is much weaker than on the immune system of men. The concentration of testosterone in the blood of men is 10–18 times higher than that of women, and, after the onset of menopause, the already low concentration of testosterone in women drops by another 25–50%. The immune system of men weakens with age to a greater extent, which leads to an increased incidence of infectious, oncological, and other immune-dependent pathologies, which just reduces the minimal, middle, and maximum life span of men compared with women.

Assessments of provincial mortality in China’s 2010 population census based on the Developing Countries Mortality Database model life table

The provincial mortality data of China’s 2010 population census sustains the study of regional mortality disparities, but the data suffer from the disadvantage of underestimation. Due to the deficiency of relevant information, little research on the quality of province-specific mortality data has been published with respect to the 2010 census. We estimated provincial underestimation of infant and old-age mortality, analysed regional disparities using the Developing Countries Mortality Database model life table and re-calculated sex-specific life expectancy at birth and at age 60 for the 2010 census. Results show that in most provinces the infant mortality rate is underestimated by at least 70% and that the related data for the eastern and southwestern provinces show better quality than that of other areas. Old-age mortality underestimate rates vary among provinces: the eastern, south-central and northern provinces present less severe underestimations than the southwest, northwest and northeast provinces. After adjustments, the province gap in e0 ranged from 0 to 14.8 years for boys and 0 to 15.9 years for girls, that in e60 ranged from 0 to 8.8 years for men and 0 to 9.9 years for women. Sex differences in life expectancy increased compared to the reported values of the 2010 census.

What has contributed to the large sex differentials in lifespan variation and life expectancy in South Korea?

To date, research on sex differentials in lifespan variation and life expectancy has mainly been conducted in Western countries and there is a dearth of data from South Korea. This study aimed to further the understanding of mortality transition and life expectancy in South Korea, and the associated trajectories of age-at-death variation, through an analysis of life disparity by gender. Using complete life tables for South Korea for 1970-2015, sex differentials (female-male differences) in life disparity and life expectancy at birth were estimated, and sex differentials in life expectancy were decomposed by age and cause of death. The results showed that sex differentials in life expectancy at birth have not reduced significantly in the last 45 years (1970: 7.1 years; 2015: 6.2 years). Life disparity has reduced more rapidly for females than males, and the difference increased from -0.1 year in 1981 to -1.6 years in 2015. Sex differentials in life expectancy and life disparity in South Korea were higher during 1970-2015 than in several Western countries with high life expectancy. The elderly age group (60 and above) contributed 50% of the total sex difference in life expectancy at birth in 1970, and this increased to 70% in 2015. The contribution of the age group 15-59 years reduced significantly over the period. Decomposition of life expectancy at birth by cause revealed that diseases of the circulatory system (2.2 years), followed by external causes (1.3 years), were the most important causes of the sex differences in life expectancy at birth in 1983, and in 2015 neoplasms (2.2 years) and external causes (1.1 years) explained half of the total sex differences. There has been a significant shift in the age-specific pattern of the contribution towards each cause of death. Overall, sex differentials in life disparity and life expectancy at birth have remained significant in South Korea in the last 45 years.

The Mechanism Underlying Change in the Sex Gap in Life Expectancy at Birth: An Extended Decomposition.

The relationship between differential mortality rates and differences in life expectancy is well understood, but how changing differential rates translate into changing differences in life expectancy has not been fully explained. To elucidate the mechanism involved, this study extends existing decomposition methods. The extended method decomposes change in the sex gap in life expectancy at birth into three components capturing the effects of the sex difference in mortality improvement (ρ-effect), life table deaths density by age (f-effect), and remaining life expectancy by age (e-effect). These three effects oppose and augment each other, depending on relative change in sex-differential mortality rates. The new method is applied to period data for 35 countries and cohort data for 25 countries. The results demonstrate how the mechanism, involving the three effects, operates to determine change in the sex difference in life expectancy. We observe the pivotal importance of the f-effect, which is predominantly negative because of lower female mortality, in favoring narrowing rather than widening of the sex gap, in shifting the overall effect to younger ages, and in exaggerating fluctuations due to crisis mortality. The new decomposition provides a more detailed basis for substantive analyses examining change in differences in life expectancy.

Projections of Future Life Expectancy in Selected Belt and Road Countries

Background: In 2013, China launched the Belt and Road (B&R) Initiative to promote global collaboration in trade, infrastructure and cultural exchange. An ensemble method was used to forecast future life expectancy (LE) among selected B&R countries, to assist plans for future health and social services. Methods: LE data from 20 selected B&R countries for 1950-2015 were compiled and analyzed. An ensemble method was used to forecast future LE in 2030. Findings: LE was projected to increase in all selected B&R countries with probabilities of 95·2% for women and 94·2% for men. South Korean women would have the highest projected LE in 2030 with a 62·6% probability to reach 90 years, followed by Singapore with a 55·3% probability. A projected probability of 29·1% that LE among men in Singapore, South Korea, New Zealand, and Israel would surpass 85 years in 2030. Of the countries studied, Russia, Croatia, and Thailand would have the lowest projected LE gains for men and women, respectively. The sex difference in LE was likely to shrink by 2030 in all countries except for Israel, which would have a larger LE gain in women than men. More than one-third of the projected gains in LE in women would be resulted from improved longevity above age 65 years. Interpretation: LE in the B&R countries would continue to increase till 2030. This calls for more resources for health care and social services. Funding: China Medical Board (Grant No. 16-262) Declaration of Interest: We declare no competing interests.

Tuberculosis mortality and the male survival deficit in rural South Africa: An observational community cohort study.

BackgroundWomen live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa—a high mortality population with a large sex disparity—is an exception, but the causes of death that contribute to this difference are not well understood.MethodsUsing data from a demographic surveillance system in rural KwaZulu-Natal (2000–2014), we estimate differences between male and female adult life expectancy by HIV status. The contribution of causes of death to these life expectancy differences are computed with demographic decomposition techniques. Cause of death information comes from verbal autopsy interviews that are interpreted with the InSilicoVA tool.ResultsAdult women lived an average of 10.4 years (95% confidence Interval 9.0–11.6) longer than men. Sex differences in adult life expectancy were even larger when disaggregated by HIV status: 13.1 (95% confidence interval 10.7–15.3) and 11.2 (95% confidence interval 7.5–14.8) years among known HIV negatives and positives, respectively. Elevated male mortality from pulmonary tuberculosis (TB) and external injuries were responsible for 43% and 31% of the sex difference in life expectancy among the HIV negative population, and 81% and 16% of the difference among people living with HIV.ConclusionsThe sex differences in adult life expectancy in rural KwaZulu-Natal are exceptionally large, atypical for an African population, and largely driven by high male mortality from pulmonary TB and injuries. This is the case for both HIV positive and HIV negative men and women, signalling a need to improve the engagement of men with health services, irrespective of their HIV status.

Cambios en las diferencias por sexo en la esperanza de vida en España (1980-2012): descomposición por edad y causa

ObjectiveTo calculate and analyse the contributions of changes in mortality by age groups and selected causes of death to sex differences in life expectancy at birth in Spain from 1980 to 2012. MethodsCross-sectional study with three time points (1980, 1995, and 2012). We used data from Human Cause-of-Death Database and Human Mortality Database. We use a decomposition method of the differences in life expectancy and gender differences in life expectancy from changes in mortality by 5-year age groups and causes of death between women and men. ResultsFrom 1980 to 1995, the lower mortality of women from 25 years old, and the differences in mortality by HIV/AIDS, lung cancer, and chronic obstructive pulmonary diseases contributed to the gap increase. From 1995 to 2012, greatest improvement in mortality of males under 74 years of age, and in improving male mortality from HIV/AIDS, acute myocardial infarction and traffic accidents contributed to the narrowing. ConclusionsThe difference in life expectancy at birth between men and women has decreased since 1995 due to a greater improvement in mortality from causes of death associated with risky behaviours and habits of the working age male population.

Socioeconomic, remoteness and sex differences in life expectancy in New South Wales, Australia, 2001–2012: a population-based study

ObjectivesDespite being one of the healthiest countries in the world, Australia displays substantial mortality differentials by socioeconomic disadvantage, remoteness and sex. In this study, we examined how these mortality differentials...

Sex Differences in Age-Related Decline of Urinary Insulin-Like Growth Factor-Binding Protein-3 Levels in Adult Bonobos and Chimpanzees.

There is increasing interest in the characterization of normative senescence in humans. To assess to what extent aging patterns in humans are unique, comparative data from closely related species, such as non-human primates, can be very useful. Here, we use data from bonobos and chimpanzees, two closely related species that share a common ancestor with humans, to explore physiological markers that are indicative of aging processes. Many studies on aging in humans focus on the somatotropic axis, consisting of growth hormone (GH), insulin-like growth factors (IGFs), and IGF binding proteins (IGFBPs). In humans, IGFBP-3 levels decline steadily with increasing age. We used urinary IGFBP-3 levels as an alternative endocrine marker for IGF-I to identify the temporal pattern known to be related with age-related changes in cell proliferation, growth, and apoptosis. We measured urinary IGFBP-3 levels in samples from 71 bonobos and 102 chimpanzees. Focusing on samples from individuals aged 10 years or older, we found that urinary IGFBP-3 levels decline in both ape species with increasing age. However, in both species, females start with higher urinary IGFBP-3 levels than males, experience a steeper decline with increasing age, and converge with male levels around the age of 30–35 years. Our measurements of urinary IGFBP-3 levels indicate that bonobos and chimpanzees mirror human patterns of age-related decline in IGFBP-3 in older individuals (<10 years) of both sexes. Moreover, such as humans, both ape species show sex-specific differences in IGFBP-3 levels with females having higher levels than males, a result that correlates with sex differences in life expectancy. Using changes in urinary IGFBP-3 levels as a proxy for changes in GH and IGF-I levels that mark age-related changes in cell proliferation, this approach provides an opportunity to investigate trade-offs in life-history strategies in cross-sectional and in longitudinal studies, both in captivity and in the wild.

The contribution of a history of heavy smoking to Scotland's mortality disadvantage

Scotland has a lower life expectancy than any country in Western Europe or North America, and this disadvantage is concentrated above age 50. According to the Human Mortality Database, life expectancy at age 50 has been lower in Scotland than in any other developed country since 1980. Relative to 15 developed countries that we have chosen for comparison, Scotland's life expectancy in 2009 at age 50 was lower by an average of 2.5 years for women and 1.6 years for men. We estimate that Scottish women lost 3.6 years of life expectancy at age 50 as a result of smoking, compared to 1.4 years for the comparison countries. The equivalent figures among men are 3.1 and 2.1 years. These differences are large enough for the history of heavy smoking in Scotland to account both for most of the shortfall in life expectancy for both sexes and for the country's unusually narrow sex differences in life expectancy.

The Adoption of Smoking and Its Effect on the Mortality Gender Gap in Netherlands: A Historical Perspective.

We examine in depth the effect of differences in the smoking adoption patterns of men and women on the mortality gender gap in Netherlands, employing a historical perspective. Using an indirect estimation technique based on observed lung cancer mortality from 1931 to 2012, we estimated lifetime smoking prevalence and smoking-attributable mortality. We decomposed the sex difference in life expectancy at birth into smoking-related and nonsmoking-related overall and cause-specific mortality. The smoking epidemic in Netherlands, which started among men born around 1850 and among women from birth cohort 1900 onwards, contributed substantially to the increasing sex difference in life expectancy at birth from 1931 (1.3 years) to 1982 (6.7 years), the subsequent decline to 3.7 years in 2012, and the high excess mortality among Dutch men born between 1895 and 1910. Smoking-related cancer mortality contributed most to the increase in the sex difference, whereas smoking-related cardiovascular disease mortality was mainly responsible for the decline from 1983 onwards. Examining nonsmoking-related (cause-specific) mortality shed new light on the mortality gender gap and revealed the important role of smoking-related cancers, the continuation of excess mortality among women aged 40–50, and a smaller role of biological factors in the sex difference than was previously estimated.

Sex differences in health and mortality in Moscow and Denmark

In high income countries females outlive men, although they generally report worse health, the so-called male-female health-survival paradox. Russia has one of the world's largest sex difference in life expectancy with a male disadvantage of more than 10 years. We compare components of the paradox between Denmark and Moscow by examining sex differences in mortality and several health measures. The Human Mortality Database and the Russian Fertility and Mortality Database were used to examine sex differences in all-cause death rates in Denmark, Russia, and Moscow in 2007-2008. Self-reported health data were obtained from the Study of Middle-Aged Danish Twins (n = 4,314), the Longitudinal Study of Aging Danish Twins (n = 4,731), and the study of Stress, Aging, and Health in Russia (n = 1,800). In both Moscow and Denmark there was a consistent female advantage at ages 55-89 years in survival and a male advantage in self-rated health, physical functioning, and depression symptomatology. Only on cognitive tests males performed similarly to or worse than women. Nevertheless, Muscovite males had more than twice higher mortality at ages 55-69 years compared to Muscovite women, almost double the ratio in Denmark. The present study showed that despite similar directions of sex differences in health and mortality in Moscow and Denmark, the male-female health-survival paradox is very pronounced in Moscow suggesting a stronger sex-specific disconnect between health indicators and mortality among middle-aged and young-old Muscovites.