How has cardiovascular disease contributed to the rural–urban life expectancy gap?

Leah Abrams

In the United States, rural residents do not live as long as their urban counterparts. This disparity has been widening for decades. Around 1970, urban life expectancy was 70.9 years, compared with 70.5 in rural areas, but by 2005–2009, the difference was greater (78.8 versus 76.8 years). In our research recently published in the IJE, we found that the gap in life expectancy would be even wider today if declines in cardiovascular disease (CVD) mortality had not dramatically slowed around 2010.

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Profound impact of smoking, alcohol and obesity on improvements in life expectancy

Fanny Janssen, Sergi Trias-Llimós and Anton Kunst

Smoking, alcohol misuse and behaviours that result in obesity (such as an unhealthy diet and insufficient physical activity) have strong negative effects on individual health. Because these health behaviours are very common among people in Europe, smoking, alcohol and obesity also largely influence mortality rates and life expectancy in Europe.

However, the impact of these three lifestyle factors on life expectancy is likely changing over time. Smoking, obesity and alcohol misuse, like true epidemics, tend to first become more common in a population, followed (eventually) by a decline in their prevalence and associated mortality.

This raises the question of how changes in smoking, obesity and alcohol use have influenced improvements in life expectancy over time. Answering this question is particularly relevant because of the recently observed stagnation in life expectancy improvements in some European countries.

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Trends in European life expectancy: a salutary view

David A. Leon

This article originally appeared on the OUPblog on 14 April 2011: http://blog.oup.com/2011/04/life-expectancy/

Making a difference to the health of populations, however small, is what most people in public health hope they are doing. Epidemiologists are no exception. But often caught up in the minutiae of our day-to-day work, it is easy to lose sight of the bigger picture. Is health improving, mortality declining, are things moving in a positive direction? Getting out and taking in the view (metaphorically as well as literally) can have a salutary effect. It broadens our perspectives and challenges our assumptions. Looking at recent trends in European life expectancy is a case in point.

Since 1950 estimated life expectancy at birth of the world’s population has been increasing. Initially, this was accompanied by a convergence in mortality experience across the globe—with gains in all regions. However, in the final 15 years of the 20th century, convergence was replaced with divergence, in part due to declines in life expectancy in sub-Saharan Africa. However, this global divergence was also the result of declining life expectancy in Europe. Home to 1 in 10 of the world’s population, and mainly comprised of industrialized, high-income countries, Europe has over 50 states. These include Sweden and Iceland that have consistently been ranked among the countries with the highest life expectancies in the world. But while for the past 60 years all Western European countries have shown increases in life expectancy, the countries of Central and Eastern Europe (CEE), Russia and other parts of the former Soviet Union have had a very different, and altogether more negative experience. Continue reading “Trends in European life expectancy: a salutary view”