Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China

Abstract

Background: To address change in 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 overtime.Methods: Retrospective demographic analysis with application of Joinpoint regression to evaluate the temporal trend in GGLE. Causes of death were coded in accordance with International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. Life table technique and decomposition method was used to express changes in GGLE.Results: Trend of GGLE in Shanghai experienced two phases ie., 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 recent plateau phase.Conclusions: Non-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 and ensure improvement in health and health equity in Shanghai China.