Increasing longevity and decreasing gender mortality
differentials: newperspectives from a study on
Italian cohortsGraziella CaselliDipartimento di Scienze Sociali, Economiche, Attuariali e [email protected]
Marco MarsiliDirezione Centrale Statistiche e Indagini sulle Istituzioni [email protected]
Joint Eurostat-UNECE Work Session on Demographic ProjectionsLisbon (Portugal), 28-30 April 2010
Outline
4. Adults and elderly: what causes of death have been, or could be, responsible for their low mortality and their increasing longevity?
1. More long-lived, less different
6. Some conclusions
5. Are women losing some of their advantage or men recouping their disadvantage?
3. Cohort mortality models: why elderly today are different from elderly in the past and in the future?
2. Data and method
Life expectancy at birth by sex and gender differences from 1886 to 2007
2007
ΔG = 5.3
1979
ΔG = 6.9
More long-lived…
0
10
20
30
40
50
60
70
80
90
1886 1896 1906 1916 1926 1936 1946 1956 1966 1976 1986 1996 2006-2
-1
0
1
2
3
4
5
6
7
Men
Women
e0F-e0M
e0 e0F-e0M
Years
Life expectancy at birthYear Men Wome
nΔG
1979 70.4 77.3 6.92007 78.7 84.0 5.3
ΔP 8.3 6.7 -1.6
1886e0=35.5M and W
Trends of gender differences in life expectancy at birth, at age 65 and 80, from
1886 to 2007
-1
0
1
2
3
4
5
6
7
8
1886 1896 1906 1916 1926 1936 1946 1956 1966 1976 1986 1996 2006
e80
e65
e0
Differences
Differences in Life expectancy : W-M
Year LE at birth
LE at age 65
LE at age 80
1979 6.9 3.7 1.32007 5.3 3.7 1.9ΔP -1.6 0.0 0.6
Years More long-lived AND less different
Age specific Sex ratios – over male mortality – in the years 1886, 1979 and 2007
40-69 years
0
50
100
150
200
250
300
350
400
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100
2007
1979
1886
Age
(qxM/qxF)*100
1-14 yearsThe leading ages of a new mortality model
How should we interpret the reduction of the female advantage in adulthood? A particularly fortunate period for men?
A problem in survival trends of women?
Which causes of death are responsible for?
As we know, different life histories influence the final outcome, anticipating or postponing the age at death. Studies of mortality that start from macro-data claim that the different mortality histories of the cohorts are the result of different life experiences.
Analysing mortality models by age and by cause for succeeding cohorts may be helpful in better understanding the characteristics of the last thirty years in the history of mortality in Italy.
Completing some cohort mortality histories may
help us see in which direction the recent mortality trends might be going.
The aim of this presentation
Predictions will be necessary to complete the mortality histories of these cohorts, considering the cause of death too. A cohort perspective will be adopted to study longevity, BUT PARTICULARLY to analyze the changes of gender survival differences
The intention is to compare their mortality histories – total and by cause – with those of adults of today, who will be the elderly of tomorrow.
is to analyze the developing characteristics of the mortality of the cohorts that entered adult age (45-64 years) at the end of the 1970s and that have become elderly more recently.
DataMortality rates and/or probabilities by Sex, Leading causes of death, Age (0-100), Period and Cohort
SOURCES:From 1861 to 1973 - Department of Demography - Rome (Human mortality database)From 1974 to 2007 - ISTAT
Cohorts up to 1907 EXTINCT Cohorts from 1908 to 1965 PARTIALLY OBSERVED
Leading causes of death and corresponding codes
in IX ICD Rev.Infectious diseases 1-139; 279.1 Cancers 140-239Circulatory system diseases 390-459Respiratory system diseases 460-519Digestive system diseases 520-579Violent causes 800-999Other causes Remainder
Harmonized database in time according to IX ICD REVISION
REFERENCES:Caselli G., Long Term Trends in European Mortality, Studies on Medical and Population Subjects, N. 56, OPCS, London.Caselli G., Health transition and cause specific mortality, in. The decline of mortality in Europe (Edited by R. Schofield, D. Reher and A. Bideau), Clarendon Press, Oxford;Caselli G., National differences in the Health transition in Europe, Historical Methods, Vol. 29, n. 3;
THE PROJECTION MODEL
To project the risk of death, a model taking account of age, period and cohort components of mortality (APC model) was used.
)()()()log( *,, xtctpxaay xtxt
That is:k
k kj
j ji
i ixtxt xtdtcxbay )()()()log( *,,
321 h1,..,k;h1,..,j;h1,..,i
3hd,..,d;
2hc,..,c;
1hb,..,ba 111; Parameters to be
estimated
Projections carried out for each cause of death and sex.
The sum of the projected rates represents the overall mortality (“by cause” approach).
Approach = deterministic - single variantSingle Age = 0,1,2,….,100Jump-off year = 2008Last projected year = 2065Last fully projected cohort = 1965
We mainly focus our study on cohorts from 1865 to 1965
PROJECTION STRATEGY
Schema for identifying some interesting cohorts, from those of adult age (45-64) in 1967, now
extinct, to those who were adult in 2007, who will be extinct in 2037-2047. The cohorts to be
followed at the various ages are those aged 45-64 on the blue diagonal
CohortsYears
1947 1957 1967 1977 1987 1997 2007 2017 2027 2037 2047 20571903-1922
25-44 35-54 45-64
55-74
65-84
75-94
1913-1932
15-34 25-44 35-54 45-64
55-74
65-84
75-94
1923-1942
05-24 15-34 25-44 35-54 45-64
55-74
65-84
75-94
1933-1952
00-14 05-24 15-34 25-44 35-54 45-64
55-74
65-84
75-94
1943-1962
00-14 05-24 15-34 25-44 35-54 45-64
55-74
65-84
75-94
1953-1972
00-14 05-24 15-34 25-44 35-54 45-64
55-74
65-84
75-94
1963-1982
00-14 05-24 15-34 25-44 35-54 45-64
55-74
65-84
75-94
For a synthesis of the main results we will refer to the intermediate cohorts of the various groups, and in particular, the cohorts born in the years 1912, 1922, 1932, 1942 and 1952, also considering the cohorts of 1865 and 1890, now extinct, and the one born in 1965, whose history of mortality in adult and old age is projected from the age 42 years and beyond.
Life expectancy at birth by sex and cohort, 1865-1965, Men and Women
Cohort1965M=81.3W=87.6
Cohort1902M= 42.1W= 49.8
Cohort1917M= 44.3W= 49.4
Cohort1912M= 51.4W= 56.2
0
10
20
30
40
50
60
70
80
90
1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965
e0
Men
Women
Cohorts
Life expectancy at birth
Cohort Men Women ΔG
1932 61,8 69,2 7.41952 74.9 81.7 6.81965 81.3 87.6 6.3
Contributions by age (30+) of the leading causes of death to differences in life expectancy at birth between two
selected cohorts, MEN
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1890 vs 1912 - MenContributions
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1912 vs 1932 - MenContributions
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Infectious diseases Respiratory system CancersCirculatory diseases Digestive system Violent causesOther diseases
Cohort 1932 vs 1952 - MenContributions
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1932 vs 1952 - MenContributions
Cohort CANCERS (ALL AGES)
CIRC. SYSTEM
(ALL AGES)
ALL CAUSES
(ALL AGES)
1890-1912
-0.3 1.0 13.0
1912-1932
-0.2 1.7 10.3
1932-1952
1.3 2.2 13.2
Contributions by age (30+) of the leading causes of death to differences in life expectancy at birth between two
selected cohorts, WOMEN
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Infectious diseases Respiratory system CancersCirculatory diseases Digestive system Violent causesOther diseases
Cohort 1932 vs 1952 - MenContributions
Cohort CANCERS (ALL AGES)
CIRC. SYSTEM (ALL AGES)
ALL CAUSES (ALL AGES)
1890-1912
0.0 2.1 14.0
1912-1932
0.1 2.4 13.0
1932-1952
0.8 2.2 12.5-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1890 vs 1912 - WomenContributions
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1912 vs 1932 - WomenContributions
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1932 vs 1952 - WomenContributions
Contributions by age (30+) of the leading causes of death to differences in life expectancy at birth between cohorts
1932-1952, MEN and WOMEN
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Infectious diseases Respiratory system CancersCirculatory diseases Digestive system Violent causesOther diseases
Cohort 1932 vs 1952 - MenContributions
Cohort CANCERS (ALL AGES)
CIRC. SYSTEM (ALL AGES)
ALL CAUSES (ALL AGES)
MEN 1.3 2.2 13.2
WOMEN 0.8 2.2 12.5
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1932 vs 1952 - WomenContributions
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1932 vs 1952 - MenContributions MEN
WOMEN
Elderly Today vs
Elderly Tomorrow
Adult in the Past vs
Adult Today
Life expectancy at birth
Cohort
Men Women ΔG
1932 61.8 69.2 7.41952 74.9 81.7 6.81965 81.3 87.6 6.3
0
10
20
30
40
50
60
70
80
90
1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965
e0
0
1
2
3
4
5
6
7
8
9
Men
W-M
W-M
Women
Cohorts
Life expectancy at birth by sex and gender differences - Cohorts 1865-1965
W-M Cohort1965=6.3
W-M Cohort1902=7.7
W-M Cohort1917=5.1
Deep change in gender differences trend as a result of cohort dynamics in life expectancy at birth
Life expectancy at birth by sex and gender differences – Cohort and Period
PERIOD 1925-2025
COHORTS 1865-1965
0
10
20
30
40
50
60
70
80
90
1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965
e0
0
1
2
3
4
5
6
7
8
9
Men
W-M
W-M
Women
Cohorts
0
10
20
30
40
50
60
70
80
90
1925 1935 1945 1955 1965 1975 1985 1995 2005 2015 2025
e0
0
1
2
3
4
5
6
7
8
9
Men
W-M
W-M
Women
Years
Cohorts aged 45-64 in 1979, showing an increase of gender differences, are those born in 1915-1934
Sex ratios, observed and projected by age and for some cohorts
50
100
150
200
250
300
350
400
0 10 20 30 40 50 60 70 80 90 100
Age
(qxM/qxF)*100
1865
1952
19321912
1890
1922
Differences in life expectancy at birth
1865=1.4
1890=3.7
1912=4.8
1922=6.9
1932=7.4
1952=6.8
1965=6.345-64 years
The leading adult ages of cohort mortality model
SMR’s for ages 45-64 years by Circulatory diseases and Cancers, MEN and WOMEN (per
1000)
0
1
2
3
4
5
1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965
Men - Cardiov. diseases
Women - Cardiov. diseases
Men - Cancers
Women - Cancers
SR x 1000
Cohorts
Ages 45-64 years
Cohort circulatory mortality at ages 80+ showing the same trend by gender. Observed cancer mortality trend at ages 80+ still increasing for men 0
20
40
60
80
100
120
1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965
SR x 1000
Cohorts
Men - Cancers
Women - Cancers
Men - Cardiov. diseases
Women - Cardiov. diseases
Ages 80 and over
0
5
10
15
20
25
30
35
1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965
Ages 65-79 years Ages 65-79 years
SR x 1000
Women - Cardiov. diseases
Women - Cancers
Men - Cancers
Men - Cardiov. diseases
Cohorts
0
1
2
3
4
5
1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965
Men - Cardiov. diseases
Women - Cardiov. diseases
Men - Cancers
Women - Cancers
SR x 1000
Cohorts
Ages 45-64 years
SMR’s for ages 45-64, 65-79 and 80+ years by Circulatory diseases and Cancers, MEN and WOMEN (per
1000) 65-79 years45-64 years
80+ years
Contributions by age (45+) of the leading causes of death to increase or decrease gender differences between two selected cohorts in life expectancy at birth
-0,2
-0,1
0
0,1
0,2
0,3
0,4
0,5
0,6
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Infectious diseases Respiratory system CancersCirculatory diseases Digestive system Violent causesOther diseases
Cohort 1932 vs 1952 - MenContributions
Cohorts CANCERS (ALL AGES)
CIRC. SYSTEM
(ALL AGES)
ALL CAUSES
(ALL AGES)
1912-1932
0.3 0.8 2.7
1932-1952
0.1 -0.6 -0.7
1952-1965
-0.1 -0.5 -0.5
-0.3
-0.2
-0.1
0
0.1
0.2
0.3
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1912 vs 1932
-0.3
-0.2
-0.1
0
0.1
0.2
0.3
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1932 vs 1952
-0.3
-0.2
-0.1
0
0.1
0.2
0.3
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70-7
4
75-7
9
80-8
4
85-8
9
90-9
4
95+
Cohort 1952 vs 1965
POSITIVE BAR: contribution to increasing the distance from male life expectancy at birthNEGATIVE BAR: contribution to bridging the distance from female life expectancy at birth
Conclusions
Gender gaps in survival are often the result of a life history that penalized men (World War I and II) with adoption of dangerous life styles such as cigarette smoking. At the same time, for years Italian women, who had been marginalized from the world of work and protected by a traditional culture, were protected from more harmful life styles and so were able to gain more years of life, gradually increasing the gap from men.
Making projections by cohort has the advantage of starting from a mortality history, partially already observed, and so limiting predictions to just one part of the whole story.
Cohort analysis allow us to see the final result of a whole history of survival and so to interpret some of the differences that can be seen between cohorts as the effects of having experienced different life histories.
Important modifications of the longevity between cohorts and between genders, and, above all, a rapid bridging of the gap between men and women.
Conclusions / 2
In conclusion, we would like to interpret the GRADUAL CLOSENING of male and female survival as the result of a FEMINIZING OF MALE BEHAVIOUR. We might conclude that Italian males in the younger generations seem to have understood that they need to study women if they want to live longer, hoping that Italian women do not imitate the men of the previous generations!
Men in the most recent cohorts, by contrast, reduce some risks of illness and death that are typically male. Greater care for their bodies, for example, leads them directly or indirectly to follow the path of prevention and to detect in advance some illnesses.
In other countries the reduction in the gender gap for the most recent cohorts was caused by a worsening in female survival due to the new life styles of women, which became more and more similar, negatively, to those of men. This was not true in Italy.
