Life expectancy and national income in Europe, 1900-2008: an update of Preston's analysis
Life expectancy and national income in Europe, 1900-2008: an update of Preston's analysis
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DOI：
10.1093/ije/dyt122
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发表时间：
2013-08-01
影响因子：
7.7
通讯作者：
Looman, Caspar W. N.
中科院分区：
文献类型：
--
作者：
Mackenbach, Johan P.;Looman, Caspar W. N.
过去，将预期寿命与国民收入联系起来的所谓普雷斯顿曲线的向上移动对世界范围内预期寿命的增加做出了重要贡献。这些转变是由于传染病控制的知识和技术从高收入国家迅速传播到低收入国家。我们评估了在世纪后期，当心血管疾病控制的进展是预期寿命增长的主要驱动力时，欧洲预期寿命增长在多大程度上伴随着国民收入和预期寿命之间关系的上升。从国际数据库中提取了1900-2008年期间的人均国内生产总值（以1990年国际元计算）、预期寿命和按死因分列的死亡率。预期寿命（变化）和年龄标准化死亡率回归国民收入（变化），结果国民收入与预期寿命之间的关系在2000年之前才出现大幅上升，而在2001年之前，国民收入与预期寿命之间的关系在2002年之前才出现大幅上升，2003年之前，国民收入与预期寿命之间的关系在2003年之前才出现大幅上升，2004年之前，1960年，由于传染病的死亡率迅速下降，这与国民收入的增加无关。这些变化占这一时期整个欧洲预期寿命增长的三分之二至五分之四。1960年以后，国民收入和预期寿命之间的关系的上升幅度要小得多，对整个欧洲预期寿命的增长贡献只有四分之一到二分之一。在后一时期，心血管疾病死亡率的下降主要是由于增加了国民income.Conclusions在早期相比，最近在欧洲国家的预期寿命的增长似乎一直依赖于他们的经济增长。为了缩小东西方预期寿命的差距，可能需要欧洲高收入国家向低收入国家更迅速地传播心血管疾病控制的知识和技术，但如果没有更平等的经济条件，这是不可能实现的。
Background In the past, upward shifts of the so-called Preston curve, which relates life expectancy to national income, have contributed importantly to worldwide increases in life expectancy. These shifts were due to rapid diffusion of knowledge and technology for infectious disease control from high-income to low-income countries. We assessed to what extent life expectancy growth in Europe has been accompanied by upward shifts in the relation between national income and life expectancy in later parts of the 20th century, when progress in cardiovascular disease control was the main driver of life expectancy growth.Methods Data on national income (gross domestic product per capita, in 1990 international dollars), life expectancy and cause-specific mortality covering the period 1900-2008 were extracted from international data banks. (Change in) life expectancy and age-standardized mortality was regressed on (change in) national income, and the regression parameters were used to estimate the contribution to rising life expectancy and declining mortality in Europe as a whole of changes in national income vs shifts in the relation between national income and health outcomes.Results Large upward shifts in the relation between national income and life expectancy only occurred before 1960, and were due to rapid declines in mortality from infectious diseases which were independent of rises in national income. These shifts account for between two-thirds and four-fifths of the increase in life expectancy in Europe as a whole during this period. After 1960, upward shifts in the relation between national income and life expectancy were much smaller, and contributed only between one-quarter and one-half to the increase in life expectancy in Europe as a whole. During the latter period, declines in mortality from cardiovascular disease were mainly attributable to increases in national income.Conclusions In contrast to earlier periods, recent life expectancy growth in European countries appears to have been dependent on their economic growth. More rapid diffusion of knowledge and technology for cardiovascular disease control from higher- to lower-income countries in Europe may be needed to close the East-West life expectancy gap, but it is unlikely that this can be achieved in the absence of more equal economic conditions.