The impact of violence on Venezuelan life expectancy and lifespan inequality

Abstract

Background Venezuela is one of the most violent countries in the world. According to the United Nations, homicide rates in the country increased from 32.9 to 61.9 per 100 000 people between 2000 and 2014. This upsurge coincided with a slowdown in life expectancy improvements. We estimate mortality trends and quantify the impact of violence-related deaths and other causes of death on life expectancy and lifespan inequality in Venezuela. Methods Life tables were computed with corrected age-specific mortality rates from 1996 to 2013. From these, changes in life expectancy and lifespan inequality were decomposed by age and cause of death using a continuous-change model. Lifespan inequality, or variation in age at death, is measured by the standard deviation of the age-at-death distribution. Results From 1996 to 2013 in Venezuela, female life expectancy rose 3.57 [95% confidence interval (CI): 3.08–4.09] years [from 75.79 (75.98–76.10) to 79.36 (78.97–79.68)], and lifespan inequality fell 1.03 (–2.96 to 1.26) years [from 18.44 (18.01–19.00) to 17.41 (17.30–18.27)]. Male life expectancy increased 1.64 (1.09–2.25) years [from 69.36 (68.89–59.70) to 71.00 (70.53–71.39)], but lifespan inequality increased 0.95 (–0.80 to 2.89) years [from 20.70 (20.24–21.08) to 21.65 (21.34–22.12)]. If violence-related death rates had not risen over this period, male life expectancy would have increased an additional 1.55 years, and lifespan inequality would have declined slightly (–0.31 years). Conclusions As increases in violence-related deaths among young men (ages 15–39) have slowed gains in male life expectancy and increased lifespan inequality, Venezuelan males face more uncertainty about their age at death. There is an urgent need for more accurate mortality estimates in Venezuela.

Uneven state distribution of homicides in Brazil and their effect on life expectancy, 2000–2015: a cross-sectional mortality study

“… 42 Another study in Venezuela found that an increase in firearm-related deaths led to life expectancy stagnation in 1996–2013. 43 In Colombia, although homicides have decreased over the last decade, they still represent a large share of total mortality (around 5%), which is estimated to cause a loss of life expectancy of 2.2 and 0.2 years for men and women, respectively. 44 Similar evidence from Brazil at the national level showed that life expectancy could improve 1.5 years for men if homicides were eliminated.…”

Dynamics of life expectancy and life span equality

“…The tight link between life expectancy and life span equality has been shaped by improvements in mortality at the most important ages for life expectancy and for life span equality: early ages in the 18th century and adult ages today. In recent years, more instances of a temporary reversal of the relationship between life expectancy and life span equality have been observed in several countries and subgroups of populations (12,(20)(21)(22). Often these cases were due to midlife mortality deterioration or to major improvements in old-age mortality above the threshold age.…”

“…In Denmark, life span equality decreased among the lowest income subgroup over the period of 1986 to 2014 despite the increase in life expectancy (19). In some countries in Eastern Europe and Latin America, life expectancy and life span equality moved independently over periods of slow improvements in life expectancy (20)(21)(22). Indeed, in many countries and subgroups within a country in recent decades, life span equality declined, although the average life span rose or vice versa (as indicated by the points in the second and fourth quadrants of Fig.…”

Black-white disparities during an epidemic: Life expectancy and lifespan disparity in the US, 1980–2000

“…As an indicator of average mortality, life expectancy conceals substantial variation in length of life which can be measured by an index of variation or inequality (Tuljapurkar 2010), such as the standard deviation, years of life lost (lifespan disparity) or the interquartile range. Although life expectancy has historically been negatively correlated with lifespan disparity (Smits andMonden 2009 andVaupel et al 2011), recent studies have found a positive association between these two indicators in some countries and subpopulations, often reflecting mortality crises at younger ages (Brønnum-Hansen 2017, García andPermanyer et al 2019). Therefore, determining the health status of a population based only on life expectancy might lead one to ignore substantial divergences in the equality of health more generally.…”