Marc Luy

Do Women Live Longer or Do Men Die Earlier? Reflections on the Causes of Sex Differences in Life Expectancy

Background: Although many different factors have been identified to contribute to excess male mortality, it is still unclear which path of the complex cause-effect chain is the decisive driver of the life expectancy gap between women and men. Objective: The question behind this study is whether these sex differences are caused primarily by factors leading to low female mortality or rather by factors causing high male mortality. We hypothesise that they are to a large extent caused by specific subpopulations of men with particularly high mortality levels that decrease the average life expectancy of men. Methods: To test this hypothesis, we investigate in a meta-analysis the variability in mortality (VM) in women and men - defined as the range of death rates prevailing among subpopulations - in empirical studies analysing specific phenomena of mortality differentials. We used the data of 72 empirical studies, including 146 total effects (TE) and 1,718 single effects (SE) for 21 different risk factors. Results: In 85% of TE and three quarters of SE the VM was higher in men than in women, taking into account mens higher overall mortality. The corresponding figures for the direct differences in the VM between women and men are 92 and 82%, respectively. Cases with higher female VM are rare exceptions and appear in particular in the highest age groups. Conclusions: We find support for our hypothesis that the disproportionate high mortality levels of specific male subpopulations are the central cause of the current extent of sex differences in life expectancy. Thus, public health programmes should be targeted toward these disadvantaged subpopulations among men which seem to be related primarily to socioeconomic characteristics.

Ageing in an aged society: experiences and attitudes of Catholic order members towards population ageing and older people

ABSTRACT Population ageing occurs in all industrialised societies and is the demographic phenomenon that currently gets the highest attention from scientists, policy makers and the general public. The main aim of this paper is to broaden our understanding of its societal consequences, such as ageism and intergenerational solidarity. Our study is based on the 2008 investigation of attitudes towards population ageing and older people in seven European countries of Schoenmaeckers et al. We replicate their analysis in a specific human subpopulation in which the process of population ageing started earlier and is much more advanced than in the general societies: the members of Catholic orders. The study compares the attitudes of 148 nuns and monks from three Bavarian monasteries to those of the western German general population using descriptive and multivariate analyses in the context of the debate around population ageing in Germany. We discuss the specific characteristics of order members that might influence their attitudes and also take a brief look at their views on possible political strategies to solve the problems connected with the demographic changes. Our results confirm the findings of Schoenmaeckers et al. and reveal that worldly and monastic populations show an identical basic pattern of a positive attitude towards older people while at the same time considering population ageing a worrisome development. However, order members evaluate older peoples abilities and their role in society more positively. This result gives rise to the optimistic perspective that in an aged population the younger and older generations can build a well-functioning society.

Adult Mortality in Europe

Levels and trends of adult mortality in Europe over the last half-century were clustered geographically: Western Europe with the most favorable health conditions, Eastern Europe with the least favorable, and Central Europe falling in between. Each of these regions shows internal variation in mortality levels, with the least variability among the Western European and the highest differences among the Eastern European countries. The trisection characterizes not only overall adult mortality but also, with a few exceptions, age- and cause-of-death-specific mortality as well as tempo-adjusted life expectancy.

The impact of smoking on gender differences in life expectancy: more heterogeneous than often stated.

Background: Throughout industrialized countries, tobacco consumption is seen as the predominant driver of both the trend and the extent of gender differences in life expectancy. However, several factors raise doubts to this generalization. We hypothesize that the impact of smoking on the gender gap is context-specific and differs between populations. Methods: We decompose the gender differences in life expectancy into fractions caused by smoking and other non-biological factors for 53 industrialized countries and the period 1955–2009 to assess the significance of smoking among the causes that can be influenced by direct or indirect interference. Results: The trend of the gender gap can indeed be attributed to smoking in most populations of the western world. However, with regard to the overall extent of male excess mortality, smoking is the main driver only in the minority of the studied populations. While the impact of smoking to gender differences in life expectancy declines in all populations, the contribution of other non-biological factors is in most cases higher at the end than at the beginning of the observation period. Conclusions: Over-generalized statements suggesting that smoking is the main driver of the gender gap in all populations can be misleading. The results of this study demonstrate that—regardless of the prevailing effect of smoking—many populations have still remarkable potentials to further narrow their gender gaps in life expectancy. Although measures to further reduce the prevalence of tobacco consumption must be continued, more attention should be directed to the growing importance of other non-biological factors.

Estimating Mortality Differences in Developed Countries From Survey Information on Maternal and Paternal Orphanhood

In general, the use of indirect methods is limited to developing countries. Developed countries are usually assumed to have no need to apply such methods because detailed demographic data exist. However, the potentialities of demographic analysis with direct methods are limited to the characteristics of available macro data on births, deaths, and migration. For instance, in many Western countries, official population statistics do not permit the estimation of mortality by socioeconomic status (SES) or migration background, or for estimating the relationship between parity and mortality. In order to overcome these shortcomings, I modify and extend the so-called orphanhood method for indirect estimation of adult mortality from survey information on maternal and paternal survival to allow its application to populations of developed countries. The method is demonstrated and tested with data from two independent Italian cross-sectional surveys by estimating overall and SES-specific life expectancy. The empirical applications reveal that the proposed method can be used successfully for estimating levels and trends of mortality differences in developed countries and thus offers new prospects for the analysis of mortality.

Mortality tempo-adjustment: Theoretical considerations and an empirical application

The number of scholars following the tempo approach in fertility continues to grow, whereas tempo-adjustment in mortality generally still is rejected. This rejection is irrational in principle, as the basic idea behind the tempo approach is independent of the kind of demographic event. Providing the first empirical application to a substantial problem, this chapter shows that mortality tempo-adjustment can paint a different picture of current mortality conditions compared to conventional life expectancy. An application of the Bongaarts and Feeney method to the analysis of mortality differences between western and eastern Germany shows that the eastern German disadvantages still are considerably higher and that the mortality gap between the two entities began to narrow some years later than trends in conventional life expectancy suggest. Thus, the picture drawn by tempo-adjusted life expectancy fits the expected trends of changing mortality and also the self-reported health conditions of eastern and western Germans better than that painted by conventional life expectancy.

THE HALLEY BAND FOR PALEODEMOGRAPHIC MORTALITY ANALYSIS

This paper suggests a computer aided procedure for the direct transformation of an age at death distribution into a stationary Halley type life table, which can be used for the mortality analysis of skeletal populations. It is based on demographic methods and takes into consideration the uncertainty given by the wide age ranges estimated for each of the individual skeletons. The main difficulty connected with the mortality analysis of a prehistoric graveyard is the wide age range of the age estimations based on morphological age traits in the skeleton, whose width for each of the skeletons within a population depends on the state of preservation and the applied methods for age estimation. The method developed here is based on the idea of the Monte Carlo simulation in extracting a random age at death out of the given age range for each skeleton in order to construct a stationary life table population. If this procedure is repeated for a sufficient number of extractions, this will lead to a relatively narrow bundle of Halley type life tables, characterizing the specific mortality pattern of the observed skeletal population and including the uncertainty resulting from the individual age estimations. The limits of the final Halley band can be defined by including only the inmost 95% of age-specific l(x) values for the single Halley type life tables. A number of test simulations show that this method provides robust and informative results for paleodemographic mortality analysis

Demographische Kennziffern und Methoden

Der Beitrag beschreibt die Grundlagen demographischer Methoden, auf denen die wichtigsten Kennziffern zur Charakterisierung der eine Bevolkerung strukturierenden Prozesse (Fertilitat, Nuptialitat, Morbiditat, Mortalitat und Migration) basieren und deren Kenntnis fur ihre richtige Interpretation erforderlich ist. Dies beinhaltet die zentralen demographischen Konzepte der Ereignisrate, der Sterbetafel und ihrer Erweiterung zur Mehrzustandstafel, des stabilen Bevolkerungsmodells, der Perioden- und Kohorten-Analyse sowie der indirekten Schatzverfahren, die zur Gewinnung demographischer Kennziffern in Entwicklungslandern verwendet werden.

Adult Mortality in Industrialized Societies

Adult morality in todays industrialized societies is characterized by steady increases of life expectancy with a tendency toward convergence of mortality levels. Exceptions are countries from Central and Eastern Europe and the Arabian Peninsula. The populations differ more in the causes of death than in the age pattern of mortality changes during the past decades. Women outlive men in all populations. However, differences exist in the time pattern of the sex gap. In general, levels and trends of mortality and sex differences as well as the prevailing driving factors reflect to a large extent the development stages of the populations.

Introduction: Recent Themes in Mortality Research

There has been a recent resurgence in mortality studies, and the annual, or biannual meetings of the EAPS Health, Morbidity and Mortality Working Group have become an important venue for European and other researchers to meet, share and discuss their findings. This introductory chapter presents a brief overview of some of the main themes in current mortality research, and discusses such questions as the meaning of published mortality measures and the relationship between period and cohort life tables. In the second part, we present a summary discussion of the 12 papers in the current volume.