Sheffield Centre for Health and Related Research, The University of Sheffield, Sheffield, United Kingdom.
Program of Health Policy, Systems, and Management, Institute of Population Health, University of Chile, Santiago, Chile.
Front Public Health. 2024 Jun 27;12:1404410. doi: 10.3389/fpubh.2024.1404410. eCollection 2024.
Socioeconomic disparities in life expectancy are well-documented in various contexts, including Chile. However, there is a lack of research examining trends in life expectancy inequalities and lifespan variation over time. Addressing these gaps can provide crucial insights into the dynamics of health inequalities.
This study utilizes data from census records, population surveys, and death certificates to compare the life expectancy and the lifespan variation at age 26 of individuals according to their rank in the distribution of years of education within their own birth cohort. The analysis spans three periods (1991, 2002, and 2017) and focuses on two educational groups: individuals in the first (lowest) quintile and tenth (highest) decile of educational attainment. Changes in life expectancy are disaggregated by major causes of death to elucidate their contributions to overall trends.
Consistent with existing literature, our findings confirm that individuals with lower education levels experience lower life expectancy and higher lifespan variation compared to their more educated counterparts. Notably, by 2017, life expectancy for individuals in the lowest quintile of education has caught up with that of the top decile in 1991, albeit with contrasting trends between genders. Among women, the gap has reduced, while it has increased for males. Moreover, lifespan variation decreased (increased) over time for individuals in the tenth decile (first quintile). The leading causes of death that explain the increase in life expectancy in women and men in the tenth decile as well as women in the first quintile are cardiovascular, cancer, respiratory and digestive diseases. In the case of males in the first quintile, few gains have been made in life expectancy resulting from cancer and a negative contribution is associated with digestive conditions.
This study underscores persistent socioeconomic disparities in life expectancy in Chile, emphasizing the importance of ongoing monitoring of health inequalities across different demographic segments. The gender-specific and educational gradient trends highlight areas for targeted interventions aimed at reducing health disparities and improving overall population health outcomes. Further research is warranted to delve into specific causes of death driving life expectancy differentials and to inform evidence-based policy interventions.
在包括智利在内的各种情况下，预期寿命方面的社会经济差异都有充分的记录。然而，目前缺乏研究来检验预期寿命不平等和随时间推移的寿命变化趋势。解决这些差距可以为健康不平等的动态提供重要的见解。
本研究利用人口普查记录、人口调查和死亡证明的数据，根据其在自己出生队列中受教育年限分布中的排名，比较 26 岁个体的预期寿命和寿命变化。该分析跨越三个时期（1991 年、2002 年和 2017 年），并侧重于两个教育群体：受教育程度最低五分位数和最高十分位数的个体。按主要死因对预期寿命的变化进行细分，以阐明其对总体趋势的贡献。
与现有文献一致，我们的研究结果证实，与受教育程度较高的个体相比，受教育程度较低的个体的预期寿命较低，寿命变化较大。值得注意的是，到 2017 年，受教育程度最低五分位数的个体的预期寿命已赶上 1991 年最高十分位数的个体，尽管性别之间存在相反的趋势。在女性中，差距缩小，而在男性中则增加。此外，受教育程度最高十分位数的个体的寿命变化随时间减少（增加），而受教育程度最低五分位数的个体则增加（减少）。解释女性和男性十分位数以及女性五分位数预期寿命增加的主要死因是心血管、癌症、呼吸和消化系统疾病。在男性五分位数的情况下，由于癌症导致预期寿命的增加幅度较小，而由于消化系统疾病导致预期寿命的减少幅度较大。
本研究强调了智利预期寿命方面持续存在的社会经济差异，强调了对不同人口群体的健康不平等进行持续监测的重要性。性别特定和教育梯度趋势突出了针对特定干预措施的领域，旨在减少健康差距，改善整体人口健康结果。需要进一步研究，以深入了解导致预期寿命差异的具体死因，并为循证政策干预提供信息。
