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Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis

BACKGROUND: Reducing lifespan inequality is increasingly recognized as a health policy objective. Whereas lifespan inequality declined with rising longevity in most developed countries, Danish life expectancy stagnated between 1975 and 1995 for females and progressed slowly for males. It is unknown...

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Autores principales: Aburto, José Manuel, Wensink, Maarten, van Raalte, Alyson, Lindahl-Jacobsen, Rune
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033219/
https://www.ncbi.nlm.nih.gov/pubmed/29973183
http://dx.doi.org/10.1186/s12889-018-5730-0
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author Aburto, José Manuel
Wensink, Maarten
van Raalte, Alyson
Lindahl-Jacobsen, Rune
author_facet Aburto, José Manuel
Wensink, Maarten
van Raalte, Alyson
Lindahl-Jacobsen, Rune
author_sort Aburto, José Manuel
collection PubMed
description BACKGROUND: Reducing lifespan inequality is increasingly recognized as a health policy objective. Whereas lifespan inequality declined with rising longevity in most developed countries, Danish life expectancy stagnated between 1975 and 1995 for females and progressed slowly for males. It is unknown how Danish lifespan inequality changed, which causes of death drove these developments, and where the opportunities for further improvements lie now. METHODS: We present an analytical strategy based on cause-by-age decompositions to simultaneously analyze changes in Danish life expectancy and lifespan inequality from 1960 to 2014, as well as current Swedish-Danish differences. RESULTS: Stagnation in Danish life expectancy coincided with a shorter period of stagnation in lifespan inequality (1975–1990). The stagnation in life expectancy was mainly driven by increases in cancer and non-infectious respiratory mortality at higher ages (−.63 years) offsetting a reduction in cardiovascular and infant mortality (+ 1.52 years). Lifespan inequality stagnated because most causes of death did not show compression over the time period. Both these observations were consistent with higher smoking-related mortality in Danes born in 1919–1939. After 1995, life expectancy and lifespan equality increased in lockstep, but still lag behind Sweden, mainly due to infant mortality and cancer. CONCLUSIONS: Since 1960, Danish improvements in life expectancy and lifespan equality were halted by smoking-related mortality in those born 1919–1939, while also reductions in old-age cardiovascular mortality held back lifespan equality. The comparison with Sweden suggests that Denmark can reduce inequality in lifespans and increase life expectancy through a consistent policy target: reducing cancer and infant mortality. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-018-5730-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-60332192018-07-12 Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis Aburto, José Manuel Wensink, Maarten van Raalte, Alyson Lindahl-Jacobsen, Rune BMC Public Health Research Article BACKGROUND: Reducing lifespan inequality is increasingly recognized as a health policy objective. Whereas lifespan inequality declined with rising longevity in most developed countries, Danish life expectancy stagnated between 1975 and 1995 for females and progressed slowly for males. It is unknown how Danish lifespan inequality changed, which causes of death drove these developments, and where the opportunities for further improvements lie now. METHODS: We present an analytical strategy based on cause-by-age decompositions to simultaneously analyze changes in Danish life expectancy and lifespan inequality from 1960 to 2014, as well as current Swedish-Danish differences. RESULTS: Stagnation in Danish life expectancy coincided with a shorter period of stagnation in lifespan inequality (1975–1990). The stagnation in life expectancy was mainly driven by increases in cancer and non-infectious respiratory mortality at higher ages (−.63 years) offsetting a reduction in cardiovascular and infant mortality (+ 1.52 years). Lifespan inequality stagnated because most causes of death did not show compression over the time period. Both these observations were consistent with higher smoking-related mortality in Danes born in 1919–1939. After 1995, life expectancy and lifespan equality increased in lockstep, but still lag behind Sweden, mainly due to infant mortality and cancer. CONCLUSIONS: Since 1960, Danish improvements in life expectancy and lifespan equality were halted by smoking-related mortality in those born 1919–1939, while also reductions in old-age cardiovascular mortality held back lifespan equality. The comparison with Sweden suggests that Denmark can reduce inequality in lifespans and increase life expectancy through a consistent policy target: reducing cancer and infant mortality. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-018-5730-0) contains supplementary material, which is available to authorized users. BioMed Central 2018-07-04 /pmc/articles/PMC6033219/ /pubmed/29973183 http://dx.doi.org/10.1186/s12889-018-5730-0 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Aburto, José Manuel
Wensink, Maarten
van Raalte, Alyson
Lindahl-Jacobsen, Rune
Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis
title Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis
title_full Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis
title_fullStr Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis
title_full_unstemmed Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis
title_short Potential gains in life expectancy by reducing inequality of lifespans in Denmark: an international comparison and cause-of-death analysis
title_sort potential gains in life expectancy by reducing inequality of lifespans in denmark: an international comparison and cause-of-death analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033219/
https://www.ncbi.nlm.nih.gov/pubmed/29973183
http://dx.doi.org/10.1186/s12889-018-5730-0
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