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PubMedDate not supplied

[Income inequality, corruption, and life expectancy at birth in Mexico].

OBJECTIVE: To ascertain if the effect of income inequality on life expectancy at birth in Mexico is mediated by corruption, used as a proxy of social capital. MATERIAL AND METHODS: An ecological study was carried out with the 32 Mexican federative entities. Global and by sex correlations between life expectancy at birth were estimated by federative entity with the Gini coefficient, the Corruption and Good Government Index, the percentage of Catholics, and the percentage of the population speaking indigenous language. Robust linear regressions, with and without instrumental variables, were used to explore if corruption acts as intermediate variable in the studied relationship. RESULTS: Negative correlations with Spearman's rho near to -0.60 (p < 0.05) and greater than -0.66 (p < 0.05) between life expectancy at birth, the Gini coefficient and the population speaking indigenous language, respectively, were observed. Moreover, the Corruption and Good Government Index correlated with men's life expectancy at birth with Spearman's rho -0.3592 (p < 0.05). Regressions with instruments were more consistent than conventional ones and they show a strong negative effect (p < 0.05) of income inequality on life expectancy at birth. This effect was greater among men. CONCLUSION: The findings suggest a negative effect of income inequality on life expectancy at birth in Mexico, mediated by corruption levels and other related cultural factors.

Aged↗
PubMed2006

Measuring the impact of HIV/AIDS, heart disease and malignant neoplasms on life expectancy in the USA from 1987 to 2000.

OBJECTIVES: Quantifying the impact of a disease on society is an important issue for setting priorities for better allocation of healthcare resources and for evaluating the effectiveness of prevention and control of the disease. STUDY DESIGN: The potential gains in life expectancy due to the elimination of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), heart disease and malignant neoplasms were compared for the US population by age and ethnicity from 1987 to 2000. METHODS: The potential gain in life expectancy after hypothetical elimination of cause-specific deaths is an effective indicator of measuring the impact of a disease on a population. Official age-specific mortality rates, by ethnicity, due to HIV/AIDS, heart disease and malignant neoplasms of the US population from the National Center for Health Statistics were used, and multiple decremental life tables were constructed to find the corresponding potential gains in life expectancy. RESULTS: The potential gains in life expectancy for the US population at birth by complete elimination of HIV/AIDS, heart disease and malignant neoplasms were 0.14, 3.71 and 3.06 years in 1987, respectively. In 1995, the potential gain in life expectancy due to the elimination of HIV/AIDS increased from 0.14 years in 1987 and achieved its highest value (0.41 years), whereas the elimination of heart disease and malignant neoplasms led to potential gains in life expectancy of 3.05 and 3.10 years, respectively. Since 1995, the potential gains in life expectancy at birth by eliminating deaths from HIV/AIDS and heart disease have decreased to 0.13 and 2.67 years, respectively, in 2000. However, the potential gain in life expectancy due to elimination of malignant neoplasms remained relatively stable (3.01 years in 2000). It is well known that HIV/AIDS tends to have a greater impact on people of working age, whereas heart disease and malignant neoplasms have a greater impact on people over 65 years of age. To measure the impact of these diseases on life expectancy in people of working age, a partial multiple decremental life table was constructed and the potential gains in life expectancy were computed by partial or complete elimination of various causes of death during the working years. shows the impact on life expectancy of the US working-age population by eliminating deaths from HIV/AIDS, heart disease and malignant neoplasms by race and sex groups. CONCLUSIONS: Since 1995, there has been a rapid reduction in the burden of HIV/AIDS on the life expectancy for the US population, especially for black males of working age. These results could provide useful information when evaluating public health improvements and allocating resources for future disease control programmes.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Cancer screening and life expectancy of Canadian patients with kidney failure.

BACKGROUND: Patients with end-stage renal disease (ESRD) have at least the same prevalence of breast and cervical cancer but a reduced life expectancy compared with the general population. Whereas cancer screening has been found to be effective in the general population, competing risks in ESRD patients may obviate any screening benefit in this population. The purpose of this study was to determine if patients with ESRD benefit, in terms of life expectancy, by screening for breast and cervical cancer. METHODS: The ESRD mortality data from the Canadian Organ Replacement Registry was combined with North American statistics for breast and cervical cancer mortality, incidence, and screening efficacy for 40-, 60-, and 70-year-old women. A validated method of calculating life expectancy, the declining exponential approximation of life expectancy (DEALE), was used to estimate the average life expectancy with and without screening. The benefit of screening is then the estimated difference in the life expectancy with and without mammography or PAP smears. RESULTS: Without screening, the maximum reduction in life expectancy would be 12 days for 60-year-old women with breast cancer. The maximum calculated benefit from screening was an increase in life expectancy of only 3 days with PAP smears for 60-year-old women. CONCLUSIONS: Breast and cervical cancer screening, in women with ESRD, is not associated with as large a gain in life expectancy as for women of the general population. This conclusion does not necessarily apply to the individual woman with multiple risk factors for breast or cervical cancer and few comorbidities.

Adult↗
PubMed1996

Statistical analysis of the standardized mortality ratio and life expectancy.

A new theoretical relation that does not require the constant age-specific mortality ratio assumption is established between the standardized mortality ratio (SMR) and the life expectancy. A set of regression equations is developed from the theoretical relation to derive estimates of the future expectation of life from estimates of the SMR. Curves are presented showing the changes in life expectancy that are associated with a given SMR for individuals aged 25, 45, and 65 years. These results will provide practical applications in estimating remaining life expectancy in epidemiologic studies in which the SMR is the summary statistic. An application is shown for studies in occupational health to develop and illustrate the method.

Adult↗
PubMed2000

Inequalities in life expectancy in Lithuania by level of education.

The purpose of this study was to examine educational inequalities in life expectancy of the Lithuanian population. The life-tables by level of education were calculated on the basis of the individual records of the 1989 census, which were linked to the death records of males and females, aged 25-70 years. In comparison with the group with university education, the life expectancy of males with primary or lower education was 11.7 years shorter, and of females 4.3 years shorter. The greatest impact of educational differentials on life expectancy was the inequality found in the mortality of the population, aged 25-44 years. Sex differences in life expectancy were greatest among those with primary or lower education. External causes of death contributed most to educational differences in life expectancy of males, whereas cardiovascular diseases had a major impact to educational differences in females.

Adult↗
PubMed2004

Life expectancy in people with newly diagnosed epilepsy.

Epilepsy carries a risk of premature mortality, but little is known about life expectancy in people with the condition. The UK National General Practice Study of Epilepsy is a prospective, population-based study of people with newly diagnosed epilepsy. A cohort of 564 patients with definite epilepsy has been followed for nearly 15 years and there have been 177 deaths. These data have been used to estimate life expectancy of people in this cohort by employing a parametric survival model based on the Weibull distribution. Life expectancy in people with epilepsy was estimated as a function of age at, and time from, diagnosis according to two broad aetiological groups. These estimates were then compared with life expectancy in people of the same age and sex in the general population. Reduction in life expectancy can be up to 2 years for people with a diagnosis of idiopathic/cryptogenic epilepsy, and the reduction can be up to 10 years in people with symptomatic epilepsy. Reductions in life expectancy are highest at the time of diagnosis and diminish with time. Our model provides broad estimates, but it appears that the higher mortality rates in people with newly diagnosed epilepsy translate into decreased life expectancy.

Adolescent↗
PubMed1993

Country estimates of social discount rates based on changes in life expectancies.

"When time is the numeraire in a social evaluation of public projects, life expectancies are essentially the unit of account. Since different generations have different life expectancies, pursuing intergenerational equity requires discounting the extra time that future generations are likely to obtain. The result is a Social Discount Rate set by the growth rate in life expectancies. This is called the Life Expectancy Discount Rate (LEDR). After providing estimates of the LEDR for 120 countries, the paper discusses some of the implications of using this rate." (SUMMARY IN FRE AND GER)

Demography↗
PubMedDate not supplied

Major improvements in life expectancy: 1989.

Longevity in 1989 rose to a record for virtually every age. According to MetLife, average remaining lifetime for newborns established a new high of 75.2 years. Expectation of life enhancements were attributed to the absence of major epidemics and the decline in total mortality. Recent longevity differences between males and females continued to narrow but disparities widened among whites and blacks.

Black or African American↗
PubMed2003

Effects of hospital volume on life expectancy after selected cancer operations in older adults: a decision analysis.

BACKGROUND: In addition to lower operative mortality, patients undergoing selected cancer operations at high volume centers have improved longterm survival. We sought to determine the overall effect of hospital volume on life expectancy after cancer surgery. STUDY DESIGN: We used a Markov decision analysis model to estimate life expectancy for patients undergoing resection for pancreatic, lung, or colon cancer. Model inputs included probabilities of operative mortality and longterm survival. For input data, we examined operative mortality (in-hospital or within 30 days) stratified by volume in over 400,000 patients undergoing resection for these three cancers using the national Medicare database (1994-1999). Risks of late mortality were abstracted from published studies (MEDLINE, 1966 to present) to model the effect of hospital volume on longterm survival. In analysis, we first calculated life expectancy for patients undergoing surgery at very low, low, medium, high, and very high volume hospitals. We then explored the effects of various regionalization strategies. RESULTS: Life expectancy increased steadily with hospital volume for all three cancers. Life expectancy after pancreatic cancer resection increased linearly with hospital volume: from 1.9 years at very low volume centers to 3.6 years at very high volume centers. For lung cancer, life expectancy ranged from 5.4 to 6.6 years. Increases in life expectancy for colon cancer were not as dramatic: from 6.8 at very low volume hospitals to 7.4 years at very high volume hospitals. Differences in life expectancy across volume strata were largely attributable to differences in longterm survival, not operative mortality. From a policy perspective, regionalizing surgery for colon cancer would produce the greatest overall life-expectancy gains, but it would require moving most patients. CONCLUSIONS: Patients aged 65 and older with pancreatic, lung, and colon cancer have substantially greater life expectancy after cancer resection at higher volume hospitals. Further work is needed to understand the mechanisms underlying differences in performance across hospitals in cancer care.

Aged↗
PubMed2001

Changes in life expectancy in Russia in the mid-1990s.

BACKGROUND: Between 1987 and 1994, life expectancy in Russia declined substantially. Between 1994 and 1998, this trend reversed, and mortality rates returned to those of the early 1980s. Although the decline in life expectancy has been examined previously, much less is known about the subsequent improvement in mortality rates. We used recently published cause-specific mortality data up to 1998 to clarify this issue. METHODS: Changes in cause-specific death rates at ages 15-74 years were examined. Rates for 1998 were compared with those for 1994 (the year of lowest life expectancy) and for 1991 (the year the Soviet Union broke up). FINDINGS: Death rates among children fell steadily throughout the 1990s, and those in elderly people changed little. The reduction in mortality since 1994 was mainly due to a decrease in the death rate among middle-aged adults, which had increased until 1994. Deaths among those aged 15-30 years, which rose during 1991-94, remained high. Some causes of death, such as stomach cancer and road-traffic accidents, declined throughout the 1990s, whereas others, such as breast and prostate cancers and tuberculosis, increased. The decline in mortality since 1994 was, however, mainly due to a reduction in the rate of deaths from a group of causes associated with alcohol consumption. INTERPRETATION: The changing life expectancy in Russia is a consequence of a complex pattern of trends in different causes of death, some of which have their origins long in the past, and others that result from contemporary circumstances. This study provides further support for the view that alcohol has played an important part in the fluctuations in life expectancy in Russia in the 1990s, although there remains a need for a much better understanding of the factors underlying these continuing changes.

Adolescent↗
PubMed2005

Active life expectancy of older people in Mexico.

BACKGROUND: Social and economic development together with demographic changes and health interventions have resulted in an increase in life expectancy and a rapidly ageing population in Mexico. Whether people will live longer active and independent lives is still, however, unknown. We will address this question, providing the first estimates of active life expectancy by age, sex and local regional area in Mexico. METHODS: Active life expectancy was calculated using the Sullivan method with abridged life tables. Information on the older Mexican population covered by the Mexican Institute of Social Security (IMSS) and the number of deaths for the same group in the year 2000 was obtained from the Office for Health Statistics and Information at IMSS in Mexico. Information on ability to perform basic activities of daily living was obtained from the National Survey on Ageing carried out in IMSS during 1998-99. RESULTS: For males and females combined, active life expectancy decreased from 26.9 years at 60 years to 5.7 years at 85 years. Women's life expectancy exceeded that of men but women lived more years dependent. Similarly, older people in geographical areas with longer life expectancy spent a lower proportion of remaining life active. CONCLUSION: The success in increasing life expectancy above average in some groups of older people covered by IMSS has been accompanied by increments in the proportion of remaining years dependent upon others for help in basic self-care activities.

Activities of Daily Living↗
PubMed1998

[Trends in average life expectancy in the Saxony Free State--results of a cause of death-specific table analysis].

We conducted a specific table analysis on mortality causes that was mainly oriented on the lines of the chapters of ICD-9 to explore the average life expectancy for the population in Saxony particularly since 1988. The drop in average life expectancy of males observed since 1990 can be fully explained only for those around 18 years of age by "accidents" as the cause of death. Between 30 and 55 years of age there were additional losses of average life expectancy via the mortality causes "diseases of the digestive tract", "neoplasms" and "psychiatric diseases". The significance of neoplasms and of psychiatric diseases is receeding in respect of the average life expectancy. In 1991 there was an increase in the incidence of suicide in the age bracket around 51 years in males. Seen on an overall scale across all age brackets the development of the suicide rate has increased average life expectancy. Significant average life expectancy increase developed in the range of death causes due to embryonic or congenital damage as well as cardiovascular diseases, diseases of the respiratory system and infectious diseases. As far as the female population is concerned, only accidents and diseases of the digestive tract had a negative effect on average life expectancy in 1990 and 1991 whereas the negative effect exercised by the mortality cause "neoplasms" is systematically flattening out. There are excessive gains in life expectancy in respect of cardiovascular diseases, clearly in the range of embryonal and congenital diseases and remarkably in respect of suicide. How many of these specific differentiations of causes of death are due to changes in coding, has not yet been assessed. Leaving aside the unnatural causes of death these figures point to a marked influence of improved medical care on average life expectancy.

Adolescent↗
PubMed1994

Why did black life expectancy decline from 1984 through 1989 in the United States?

OBJECTIVES: The objective of this study was to partition the change in US life expectancy into those major causes of death and age groups that contributed most to the decline in life expectancy for Black males and females and to the increase in life expectancy for White males and females in the period from 1984 through 1989. METHODS: By means of a life table partitioning technique, the positive and negative contributions of age and cause of death to changes in life expectancy were estimated. RESULTS: Causes contributing most to the decrease in life expectancy for Black males included human immunodeficiency virus (HIV) infection (< 5 and 20-69 years of age) and homicide (1-4 and 10-34 years of age); for Black females the causes included HIV infection (< 5 and 20-59 years of age) and cancer (65-79 and > or = 85 years of age). CONCLUSIONS: Mortality trends between the two major race groups in the United States diverged sharply, and without precedent, during the late 1980s. A description of these trends in terms of contributions to change in life expectancy may help us better analyze and interpret changes in the health of these groups and may contribute to a better allocation of resources for research, education, and public health programs.

Adolescent↗
PubMed2003

Analysis of sex, age and disease factors contributing to prolonged life expectancy at birth, in cases of malignant neoplasms in Japan.

BACKGROUND: This study aimed to examine the contribution made by the change in mortality from malignant neoplasms to the life expectancy at birth, observed during the years 1965-1995 in Japan. METHODS: We used data on the population and number of deaths by cause, age and sex in 1965, 1975, 1985 and 1995. The contribution of different ages and causes of death to the change in life expectancy were examined with the method developed by Pollard. RESULTS: We found that, among all causes, the decrease of mortality from stomach cancer led to the greatest improvement in life expectancy for both sexes. On the other hand, negative contributions were seen with cancers of many sites, such as cancer of the intestine, liver and lung for males, and cancer of the intestine, gallbladder, lung and breast for females. Recently, the contributing years of all cancers have been negative because of the increase in mortality from malignant neoplasms. In addition, increase of death from malignant neoplasms in middle-aged and elderly people negatively influenced the life expectancy at birth. CONCLUSIONS: Female cancer influenced the improvement in life expectancy at birth. Cancer for males, however, contributed little to improvement of life expectancy at birth except for a little prolongation of life expectancy at birth during the years 1965-1975. To develop a public health policy, the contributing years to life expectancy at birth can be a useful indication in evaluating the impact of death from various diseases. It is necessary to analyze the contribution made by various causes of death to the changes of life expectancy at birth.

Adolescent↗
PubMed2000

Life expectancy calculations for postcode sectors and their use for monitoring inequalities in the nation's health.

OBJECTIVE: To describe how life expectancy calculations can be used to demonstrate differences in mortality between populations of different socioeconomic status at each population census. DESIGN: Population data were obtained in five-year age-sex and deprivation groups at postcode sector level for the Greater Glasgow Health Board area for the censuses of 1981 and 1991. The numbers of deaths for the same groups were obtained for the three-year periods 1980-82 and 1990-92. Life expectancy tables were derived by applying mortality rates calculated from these data to a synthetic cohort of individuals. Regression analyses were applied to the tables thus derived to examine the relationships between census period, level of deprivation and life expectancy. RESULTS: Over the period 1980/82 to 1990/92 life expectancy of the age group 0-4 years increased by 2.1 years in males and 2.9 years in females, increases being greater in the more affluent areas. Differences in life expectancy between the geographically defined most deprived and most affluent areas increased from 7.4 to 9.0 years in males and from 5.9 to 6.0 years in females. CONCLUSION: Life expectancy is increasing in all socioeconomic groups, but particularly in the most affluent. We suggest that life expectancy values should be published routinely for different socioeconomic groupings. Over time these would illustrate more clearly the relationships between health policy and health outcomes, and would demonstrate whether policies are reducing inequalities and generally improving health.

Aged↗
PubMedDate not supplied

Modern antiretroviral therapy improves life expectancy of gay and bisexual males in Vancouver's West End.

This study was undertaken to evaluate the life expectancy of gay and bisexual men in the West End of Vancouver, British Columbia during two time periods. Mortality data for males were obtained for the periods 1990 to 1992 and 1995 to 1997 and population estimates were obtained from the 1991 and 1996 Census. The proportion of the male population over 20 years of age estimated to be gay and bisexual was derived from a random telephone survey. Mortality patterns were assessed by comparing changes in life expectancy at age 20 years between the periods, and by examining the life expectancy lost attributed to HIV/AIDS. Between the periods there was 3.8 +/- 3.4 years increase in life expectancy among gay and bisexual men. At exact age 20 years, life expectancy increased from 37.0 +/- 3.5 years during the period 1990 to 1992 to 40.8 +/- 2.4 years during the period 1995 to 1997. The loss of life expectancy attributed to HIV/AIDS at this age was 13.8 +/- 3.9 during the first period and 9.8 +/- 3.6 years during the second period. This gain is most likely the result of the improved efficacy of antiretroviral therapies.

Adult↗