Minding the gap: changes in life expectancy in the Baltic States compared with Finland
Minding the gap: changes in life expectancy in the Baltic States compared with Finland
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DOI：
10.1136/jech-2011-200879
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发表时间：
2012-11-01
影响因子：
6.3
通讯作者：
McKee, Martin
中科院分区：
文献类型：
--
作者：
Karanikolos, Marina;Leon, David A.;McKee, Martin
在爱沙尼亚、拉脱维亚和立陶宛这三个波罗的海国家独立以来的20年里，它们在政治、经济和社会方面逐步与西方邻国趋同。相比之下，健康差距扩大。方法在波罗的海三国的预期寿命的趋势进行了比较，芬兰和分解的年龄为1994年，1999年，2004年和2009年的死因为2009年。结果从20世纪80年代中期到90年代中期，波罗的海三国与芬兰之间的预期寿命的差距扩大，尤其是男性。然后，该比例逐渐缩小，但立陶宛除外，该国在1999年后再次扩大。按年龄分解显示，差距缩小主要是由于工作年龄死亡率降低，部分原因是老年人相对未能改善，特别是在立陶宛。按死亡原因分列，循环系统疾病是造成差距的最大因素，老年人的贡献最大。然而，癌症死亡，特别是男性，也很重要，是死亡的外部原因之间的年轻男子。结论虽然在波罗的海国家和芬兰之间的预期寿命的差距有所减少，改善，特别是在拉脱维亚和立陶宛，一直是脆弱的。显然需要采取行动，消除与芬兰之间持续存在差距的主要原因，特别是通过采取行动，消除危险饮酒和其他心血管疾病风险因素。
Background In the 20 years since the three Baltic States, Estonia, Latvia and Lithuania, have been independent, they have converged progressively with a Western neighbours, politically economically and socially. In contrast, the health gap has widened.Methods Trends in life expectancy in the three Baltic States were compared with Finland and were decomposed by age for the years 1994, 1999, 2004 and 2009 and by cause of death for year 2009. 1994 was when life expectancy fell to its lowest level since the three countries regained independence.Results From the mid-1980s to the mid-1990s, the gap in life expectancy between the three Baltic States and Finland widened, especially for men. It then narrowed progressively, except Lithuania where it widened again after 1999. Decomposition by age reveals that the narrowing gap has been driven largely by reduced mortality at working ages, partly counteracted by a relative failure to improve at older ages, especially in Lithuania. Decomposition by cause of death identifies diseases of the circulatory system as the largest contributor to the gap, with the contribution largest at older ages. However, cancer deaths, especially among men, are also important as are deaths from external causes among younger men.Conclusions Although the gaps in life expectancy between the Baltic States and Finland have reduced, improvements, especially in Latvia and Lithuania, have been fragile. There is a clear need to act on the leading causes of the persisting gap with Finland, in particular through action on hazardous drinking and other risk factors for cardiovascular disease.