Malmberg Satu, Tarkiainen Lasse, Junna Liina, Martikainen Pekka
Helsinki Institute for Demography and Population Health, Helsinki, Finland.
Max Planck-University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland.
Scand J Public Health. 2024 Aug 21:14034948241266438. doi: 10.1177/14034948241266438.
The decline in old age mortality and subsequent increase in life expectancy among older women has stalled in some high-income countries. The contribution of causes of death to and sub-group variations in these trends are generally not well understood. We assess trends in mortality and cause-of-death decomposition of life expectancy by income over the past 30 years in Finland.
We obtained total population, annual register-based data on individuals (aged 30-89 years) residing in Finland in 1991-2020. We examined the trends in age-specific mortality rates and decomposed the contribution of various causes of death to changes in partial life expectancy among women aged 65-79 years over time and within each income quintile. In addition, we estimated life expectancy trends for the total population and by income quintile with and without causes related to alcohol consumption and smoking.
Our results indicate stagnation in mortality development among women in Finland aged 65-79 years. The slowdown of improvements in circulatory and heart disease mortality contributed substantially to the observed stagnation, although similar trends were observed in virtually all the causes of death we studied. The lowest income groups experienced the most adverse developments during the study period.
The stagnating life expectancy observed among Finnish women cannot be attributed solely to one cause of death. In contrast to findings on the topic from many other developed countries, smoking-related causes of death were of little significance. The stagnation is linked to growing inequality in mortality development among older women in Finland, which affects the overall trend.
在一些高收入国家，老年女性的老年死亡率下降及随后预期寿命的增加已经停滞。死亡原因对这些趋势的贡献以及亚组差异通常并未得到很好的理解。我们评估了芬兰过去30年按收入划分的死亡率趋势以及预期寿命的死因分解情况。
我们获取了1991年至2020年居住在芬兰的30至89岁个体的基于年度登记的总人口数据。我们研究了特定年龄死亡率的趋势，并分解了不同死亡原因对65至79岁女性部分预期寿命随时间变化以及在每个收入五分位数内变化的贡献。此外，我们估计了总人口以及按收入五分位数划分的有和没有与饮酒和吸烟相关原因的预期寿命趋势。
我们的结果表明芬兰65至79岁女性的死亡率发展停滞。循环系统疾病和心脏病死亡率改善的放缓对观察到的停滞有很大贡献，尽管在我们研究的几乎所有死亡原因中都观察到了类似趋势。在研究期间，最低收入群体经历了最不利的发展。
在芬兰女性中观察到的预期寿命停滞不能仅归因于一种死亡原因。与许多其他发达国家关于该主题的研究结果相反，与吸烟相关的死亡原因意义不大。这种停滞与芬兰老年女性死亡率发展中日益加剧的不平等有关，这影响了总体趋势。
