Drefahl Sven, Ahlbom Anders, Modig Karin
Demography Unit, Department of Sociology, Stockholm University, Stockholm, Sweden ; Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Division of Epidemiology, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2014 Feb 6;9(2):e88357. doi: 10.1371/journal.pone.0088357. eCollection 2014.
In the beginning of the 1970s, Sweden was the country where both women and men enjoyed the world's longest life expectancy. While life expectancy continues to be high and increasing, Sweden has been losing ground in relation to other leading countries.
We look at life expectancy over the years 1970-2008 for men and women. To assess the relative contributions of age, causes of death, and smoking we decompose differences in life expectancy between Sweden and two leading countries, Japan and France. This study is the first to use this decomposition method to observe how smoking related deaths contribute to life expectancy differences between countries.
Sweden has maintained very low mortality at young and working ages for both men and women compared to France and Japan. However, mortality at ages above 65 has become considerably higher in Sweden than in the other leading countries because the decrease has been faster in those countries. Different trends for circulatory diseases were the largest contributor to this development in both sexes but for women also cancer played a role. Mortality from neoplasms has been considerably low for Swedish men. Smoking attributable mortality plays a modest role for women, whereas it is substantially lower in Swedish men than in French and Japanese men.
Sweden is losing ground in relation to other leading countries with respect to life expectancy because mortality at high ages improves more slowly than in the leading countries, especially due to trends in cardiovascular disease mortality. Trends in smoking rates may provide a partial explanation for the trends in women; however, it is not possible to isolate one single explanatory factor for why Sweden is losing ground.
20世纪70年代初，瑞典是男女预期寿命均居世界首位的国家。尽管瑞典的预期寿命依然很高且呈上升趋势，但与其他领先国家相比，瑞典已逐渐落后。
我们研究了1970年至2008年期间瑞典男性和女性的预期寿命。为评估年龄、死因和吸烟的相对影响，我们对瑞典与另外两个领先国家日本和法国之间预期寿命的差异进行了分解分析。本研究首次采用这种分解方法来观察与吸烟相关的死亡对各国预期寿命差异的影响。
与法国和日本相比，瑞典在年轻及工作年龄段男性和女性的死亡率一直很低。然而，瑞典65岁以上人群的死亡率比其他领先国家高得多，因为其他国家该年龄段死亡率下降更快。循环系统疾病的不同趋势是导致这种情况的最大因素，对男女皆是如此，但对女性而言，癌症也起到了一定作用。瑞典男性肿瘤死亡率一直很低。吸烟导致的死亡率对女性影响不大，而瑞典男性的这一死亡率远低于法国和日本男性。
瑞典在预期寿命方面正逐渐落后于其他领先国家，因为高龄人群死亡率的改善速度比领先国家慢，尤其是心血管疾病死亡率的趋势所致。吸烟率的趋势可能部分解释了女性的情况；然而，无法找出瑞典逐渐落后的单一解释因素。
