Life expectancy and disparity: an international comparison of life table data

Abstract

ObjectivesTo determine the contribution of progress in averting premature deaths to the increase in life expectancy and the decline in lifespan variation.DesignInternational comparison of national life table data from the Human Mortality Database.Setting40 developed countries and regions, 1840–2009.PopulationMen and women of all ages.Main outcome measureWe use two summary measures of mortality: life expectancy and life disparity. Life disparity is a measure of how much lifespans differ among individuals. We define a death as premature if postponing it to a later age would decrease life disparity.ResultsIn 89 of the 170 years from 1840 to 2009, the country with the highest male life expectancy also had the lowest male life disparity. This was true in 86 years for female life expectancy and disparity. In all years, the top several life expectancy leaders were also the top life disparity leaders. Although only 38% of deaths were premature, fully 84% of the increase in life expectancy resulted from averting premature deaths. The reduction in life disparity resulted from reductions in early-life disparity, that is, disparity caused by premature deaths; late-life disparity levels remained roughly constant.ConclusionsThe countries that have been the most successful in averting premature deaths have consistently been the life expectancy leaders. Greater longevity and greater equality of individuals' lifespans are not incompatible goals. Countries can achieve both by reducing premature deaths.

Perturbation Analysis of Indices of Lifespan Variability

“…However, although individual stochasticity leads to variation in ages at death, it is unlikely that the current distribution is owing entirely to individual stochasticity. If this were the case then we would not expect to find larger variation among lower socioeconomic groups ) or large differences in variation between national populations with similar average mortality levels (Edwards and Tuljapurkar 2005;Smits and Monden 2009;Vaupel et al 2011). Danish twin studies have estimated that genetic processes account for about a quar-ter of the the total variation in lifespan (Herskind et al 1996;McGue et al 1993).…”

“…Some of these correlations have been reported by Vaupel et al (2011) and Wilmoth and Horiuchi (1999). We present the correlations among all seven indices, from birth and from age 10 (Table 1), calculated over all female and male life tables 1 currently in the Human Mortality Database HMD (2012).…”

“…They have also been employed above the modal age at death to examine whether old-age mortality is being compressed, or whether these deaths are shifting to higher ages (Brown et al 2012;Cheung et al 2005;Cheung and Robine 2007;Kannisto 2000;Ouellette and Bourbeau 2011;Thatcher et al 2010). The various indices of lifespan variation have been compared by Anand et al (2001); Cheung et al (2005); Kannisto (2000); Shkolnikov, Andreev and Begun (2003); Vaupel et al (2011) and Wilmoth and Horiuchi (1999). These authors have found such high correlations among indices as to make them apparently interchangeable.…”

“…The longevity experience of a cohort has long been summarized by its expectation, but recently attention has expanded to focus on variation in longevity as a natural complement to describing the average length of life. Indices of variability have been compared across populations to measure the rectangularity of the survival curve or degree of mortality compression for both human and and non-human populations (see for instance Eakin and Witten 1995;Edwards and Tuljapurkar 2005;Smits and Monden 2009;van Raalte et al 2011;Vaupel, Zhang and van Raalte 2011). They have also been employed above the modal age at death to examine whether old-age mortality is being compressed, or whether these deaths are shifting to higher ages (Brown et al 2012;Cheung et al 2005;Cheung and Robine 2007;Kannisto 2000;Ouellette and Bourbeau 2011;Thatcher et al 2010).…”

Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA)

“…Due to worldwide population aging and increasing life expectancy (Mathers, Stevens, Boerma, White, & Tobias, 2014), research on older persons' health has become an important issue (Vaupel, Zhang, & van Raalte, 2011). Many older persons require large amounts of healthcare resources.…”