Convergence and divergence of life expectancy in Europe: a centennial view
Convergence and divergence of life expectancy in Europe: a centennial view
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DOI：
10.1007/s10654-012-9747-x
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发表时间：
2013-03-01
影响因子：
13.6
通讯作者：
Mackenbach, Johan P.
中科院分区：
文献类型：
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作者：
Mackenbach, Johan P.
人们注意到，近几十年来，欧洲的国民预期寿命出现了分歧，但不知道这些最近的趋势与长期发展相比如何。关于预期寿命、特定原因死亡率和死亡率决定因素的数据是从统一的国际数据库中提取的。变化用四分位数范围进行量化，并通过比较观察到的预期寿命变化与基于国民收入水平变化和国民收入与预期寿命之间关系变化的预期寿命变化来分析经济条件变化的贡献。在20世纪的前几十年，欧洲预期寿命的变化在1920年左右达到峰值，然后在1960年（男性）和1970年（女性）下降到最低点，最后再次强劲增长。第一个扩大是由于南欧、中欧和东欧的死亡率下降速度较慢，特别是传染病造成的死亡率下降速度较慢，而且与此同时，国民收入与预期寿命之间的关系日益密切。第二次扩大是由于中欧和东欧的死亡率停滞不前或增加，特别是心血管疾病造成的死亡率增加，同时国家间国民收入差距也大幅扩大。尽管有一些相似之处，但两次预期寿命差异扩大的情况之间的差异，使人们对当前预期寿命扩大的情况仅仅代表流行病学转变的延迟这一观点产生了怀疑。相反，这是一个令人担忧的现象，应该成为欧洲政策制定的主要焦点。
It has been noted that national life expectancies have diverged in Europe in recent decades, but it is unknown how these recent trends compare to longer term developments. Data on life expectancy, cause-specific mortality and determinants of mortality were extracted from harmonized international data-bases. Variation was quantified with the inter-quartile range, and the contribution of changing economic conditions was analyzed by comparing observed life expectancy variations with those expected on the basis of changes in levels of national income and/or changes in the relation between national income and life expectancy. During the first decades of the 20(th) century, variation in life expectancy in Europe increased to reach peak values around 1920, then decreased to reach its lowest values in 1960 (among men) and 1970 (among women), and finally increased strongly again. The first widening was due to less rapid decline in mortality in Southern and Central and Eastern Europe, particularly from infectious diseases, and coincided with an increasing strength of the national income-life expectancy relation. The second widening was due to stagnating or increasing mortality in Central and Eastern Europe, particularly from cardiovascular diseases, and coincided with a very strong rise of between-country differences in national income. Despite some similarities, differences between both episodes of widening differences in life expectancy cast doubt on the idea that the current episode of widening represents a simple delay of epidemiological transitions. Instead, it is an alarming phenomenon that should be a main focus of European policy making.