Meslé F
Unité de recherche "Mortalité, santé, épidémiologie", INED, 133, boulevard Davout, 75980 Paris 20.
Rev Epidemiol Sante Publique. 2004 Sep;52(4):333-52. doi: 10.1016/s0398-7620(04)99063-3.
After a large increase during the 19th and the 20th century, for two decades the gap in life expectancy between sexes has been reducing in most industrialised countries. In France, where it was specially large, it stopped increasing in the early 1980s and decreased in the most recent years. The paper investigates reasons for these recent trends in France and in the industrialised countries.
Two types of data are used for analysis. Death probabilities from life tables are used for calculating male excess mortality by age and estimating the role of various age groups in life expectancy differences by sex. Sex- and cause-specific mortality rates from INED database for France and from WHO database for other countries are used to assess the part played by various causes of death in the gender gap and its evolution.
In France, the stabilisation of the gap is mainly related to the decrease in cardiovascular mortality for men who benefit from the same progress but later than women. In the most recent years, the reduction of the gap is due to the trend reversal of male cancer mortality which is now decreasing, specially because of the reduction of lung cancer mortality. In European countries, taken as examples (England & Wales, Sweden, Switzerland, Italy) cardiovascular mortality is also the main responsible for the decreasing differences. Conversely, in Japan, the gap is still increasing specially for mortality from cancer and respiratory diseases.
The recent gap narrowing between male and female life expectancy in France is not a specific case. It does not mean that female health situation is worsening but it is related to an acceleration of progress for males. This reduction will most probably go on in the next years, except if females would enjoy dramatic progression in old age mortality.
在19世纪和20世纪大幅增长之后，在大多数工业化国家，两性预期寿命差距在过去二十年中一直在缩小。在法国，这一差距特别大，在20世纪80年代初停止扩大，并在最近几年有所下降。本文研究了法国和工业化国家近期出现这些趋势的原因。
使用两种类型的数据进行分析。生命表中的死亡概率用于按年龄计算男性超额死亡率，并估计各年龄组在两性预期寿命差异中的作用。法国国家人口研究所数据库以及其他国家世界卫生组织数据库中的性别和死因别死亡率，用于评估各种死因在性别差距及其演变中所起的作用。
在法国，差距的稳定主要与男性心血管死亡率的下降有关，男性受益于同样的进步，但比女性晚。近年来，差距的缩小归因于男性癌症死亡率的趋势逆转，目前该死亡率正在下降，特别是由于肺癌死亡率的降低。以欧洲国家（英格兰和威尔士、瑞典、瑞士、意大利）为例，心血管死亡率也是差异缩小的主要原因。相反，在日本，差距仍在扩大，特别是在癌症和呼吸系统疾病死亡率方面。
法国近期男女预期寿命差距缩小并非个别情况。这并不意味着女性健康状况正在恶化，而是与男性进步加速有关。这种缩小很可能在未来几年继续，除非女性在老年死亡率方面取得显著进展。
