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Document Typology: Research
Methodology addressed by the publication:Parents pedagogy
Title of document: Inequalities in life expectancy
Name of author(s): Ramune Kalediene,Skirmante Starkuviene,Jadvyga Petrauskiene
Name of publisher: Magazine Medicina Kaunas 2011 (57_
Language of the publication: English
Language of the review: English
Information on deaths was obtained from the Lithuanian Department of Statistics. Life table analysis was carried out. Analysis of components was applied in order to assess the contribution of the major causes of death to the differences in life expectancy of males and females. The jointpoint regression analysis was used to identify the critical points, wherever a statistically significant change in life expectancy occurred. RESULTS. Two cut points, dividing the trends in life expectancy into three periods of decreasing, increasing, and again decreasing life expectancy, were characteristic of both males and females in 1990-2006. Changes in life expectancy were more pronounced for males in all three periods. Overall change in life expectancy was not statistically significant for males and was increasing by 0.2% annually for females throughout the period of investigation. The greatest number of years in life expectancy was lost due to cardiovascular diseases in both males and females. External causes contributed most to the difference in life expectancy of able-bodied (aged 15-64 years) males and females. Differences in life expectancy of males and females decreased from 12.3 to 11.8 years throughout the period of 1994-2006; however, it remained among highest in Europe. Since 1991, external causes of death have become the major, though decreasing, contributors to inequalities in life expectancy between males and females. In 2006, compared to 1994, contribution of cardiovascular diseases and cancer increased.
Reviewer's comments on the document:
Attempts to reduce demographic and social inequalities in health should become a priority in social and health policy formulation. The criteria for evaluation of the national and regional health and social programs should reflect aspects of equal opportunities in health for males and females.
Summary measures of population health can be used to assess and compare levels of health; to identify the diseases, injuries and risk factors contributing most to ill health; and to evaluate the health gains from interventions.1 Life expectancy at birth is a useful summary measure for the mortality patterns of populations.We aimed to identify the diseases or conditions contributing to the difference in life expectancy betweenpeople with MS and other disease people in the Lithuania, to estimate the extent of the contribution of these diseases or conditions, and to examine changes in their contributions over time.
With the exception of respiratory diseases, the contribution of most of the chronic disease GBD categories, including digestive diseases and cancer, to the life expectancy gap increased over the ensuing 15 years. By the last period, 1996–2000, digestive diseases and cancer were contributing positively to the gap, albeit in a small way (3% and 4%, respectively), and the contributions of cardiovascular diseases increased from 28% to 33%, genitourinary diseases from 5% to 9%, diabetes from 6% to 9% and perinatal conditions from 2% to 4%. In contrast, the contribution of respiratory diseases (this GBD category comprises asthma and chronic obstructive pulmonary disease) declined considerably over time from 23% to 9%. By the last period, 1996–2000, the contribution of this category was around a third of that in the first period.
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