Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
Soc Sci Med. 2012 Oct;75(7):1280-7. doi: 10.1016/j.socscimed.2012.04.026. Epub 2012 May 23.
Women live much longer than men in Korea, with remarkable gains in life expectancy at birth for the past decades. The gender differential has steadily increased over time, reaching a peak of more than 8 years in 1980s, and decreased thereafter to 6.7 years in 2005. Studies to investigate the pattern and contributing factors to changes in the life expectancy gender gap have been mostly from Western countries, and there has been no such study in Asian countries, except in Japan. We therefore aimed to examine age- and cause-specific contributions to the changing gender differentials in life expectancy in Korea, in particular the decline of the gap, using a decomposition method. Between 1970 and 1979 when the gender gap in life expectancy widened, faster mortality decline among women in ages 20-44 explained 66% of the total increase in the gender gap, which would be due to substantial improvements in reproductive health among women and excess male mortality in occupational injuries and transport accidents. Although greater survival advantage among elderly women over 70 contributed to further increase in the gender gap, the contributions from younger ages with the ages 15-64 contributing the most (-2 years) resulted in the overall reduction of the gender gap which began in 1992 and continued to 2005. Among causes of death, liver diseases (-0.5 years, 38% of the total decline), transport accidents (-0.4 years, 31%), hypertensive diseases (-0.3 years, 19%), stroke (-0.1 years, 11%), and tuberculosis (-0.1 years) contributed the most to the overall 1.4 years reduction in the gender gap. However, changes in mortality from lung cancer (+0.3 years), suicide (+0.3 years), chronic lower respiratory diseases (+0.2 years), and ischemic heart diseases (+0.1 years) contributed to widening the gap during the same period. In sum, while smoking-related causes of death have contributed most to the narrowing gap in most other industrialized countries, these causes contributed toward increasing the gender gap in Korea. Instead, liver disease, hypertension-related diseases, and transport accidents were major contributing causes of death to the narrowing of gender differentials in life expectancy in Korea.
韩国女性的寿命比男性长很多,过去几十年,女性的预期寿命显著提高。性别差异随着时间的推移稳步增加,在 20 世纪 80 年代达到了 8 年以上的峰值,此后在 2005 年下降到 6.7 年。研究性别差异对预期寿命影响的模式和因素的研究主要来自西方国家,除了日本,亚洲国家没有这样的研究。因此,我们使用分解方法,旨在研究韩国预期寿命性别差异变化的年龄和原因特异性,特别是差距的缩小。在 1970 年至 1979 年期间,性别差距扩大,女性在 20 至 44 岁年龄段的死亡率下降更快,这解释了性别差距总增长的 66%,这归因于女性生殖健康的实质性改善和职业伤害和交通事故中男性的超额死亡率。尽管 70 岁以上老年女性的生存优势进一步增加了性别差距,但年龄在 15 至 64 岁之间的年龄贡献最大(减少 2 年),导致性别差距从 1992 年开始缩小,并持续到 2005 年。在死亡原因中,肝脏疾病(-0.5 年,占总下降的 38%)、交通事故(-0.4 年,占 31%)、高血压疾病(-0.3 年,占 19%)、中风(-0.1 年,占 11%)和结核病(-0.1 年)对性别差距整体减少 1.4 年贡献最大。然而,同期肺癌(+0.3 年)、自杀(+0.3 年)、慢性下呼吸道疾病(+0.2 年)和缺血性心脏病(+0.1 年)的死亡率变化导致性别差距扩大。总之,虽然与吸烟有关的死亡原因在大多数其他工业化国家对缩小差距贡献最大,但这些原因导致韩国的性别差距扩大。相反,肝脏疾病、高血压相关疾病和交通事故是导致韩国预期寿命性别差异缩小的主要死亡原因。