Much less is known about the sex gap in lifespan variation, which reflects inequalities in the length of life, than about the sex gap in life expectancy (average length of life). We examined the ...contributions of age groups and causes of death to the sex gap in lifespan variation for 28 European countries, grouped into five European regions. In 2010-15, males in Europe displayed a 6.8-year-lower life expectancy and a 2.3-year-higher standard deviation in lifespan than females, with clear regional differences. Sex differences in lifespan variation are attributable largely to higher external mortality among males aged 30-39, whereas sex differences in life expectancy are due predominantly to higher smoking-related and cardiovascular disease mortality among males aged 60-69. The distinct findings for the sex gap in lifespan variation and the sex gap in life expectancy provide additional insights into the survival differences between the sexes.
En este trabajo se presenta un análisis de las características socioeconómicas y étnico-raciales en México respecto a la probabilidad de mortalidad de un hijo antes de sus cinco años con datos de la ...encuesta ESRU de Movilidad Social de México de 2017 (del Centro de Estudios Espinosa Yglesias). Se documenta que las mujeres con tono de piel más oscura tienen una probabilidad de perder un hijo antes de que cumpla cinco años de 2,82 (1,39-5,74 IC) veces más alta que las de con de piel más claro. Estos resultados están controlados por diferentes cohortes de nacimiento, características sociodemográficas, territoriales y socioeconómicas. En un escenario contrafactual se estimó que la probabilidad de perder un hijo se explica hasta en un 28,7% por las características étnico-raciales y, por las características socioeconómicas, hasta en un 58,5%. En conclusión, la pérdida de un hijo es un evento demográfico distribuido de manera desigual en la población y está determinado no solo por las características socioeconómicas, sino también por las características étnico-raciales. La idea de mestizaje en México que propone una igualdad étnico-racial en la población demuestra ser errónea y evita salvar vidas.
En las edades mayores el último año de vida es cuando la salud más se deteriora y es la etapa más demandante de atención médica y de cuidados. En consecuencia, también es la etapa más costosa. Se ...analizan diferencias por sexo en los determinantes de los gastos en salud por cuenta propia durante el último año de vida de personas de 50 o más, usando la encuesta del Estudio Nacional de Salud y Envejecimiento en México. Con estimaciones de gasto en tres niveles: ninguno, medio-bajo, y alto, controlando por variables sociodemográficas los resultados indican que el número de noches de hospital es la mayor determinante de gastos en salud, por encima de los relacionados con las enfermedades reconocidas como causa de muerte. Este factor tiene implicaciones en los gastos tanto por cuenta propia y como de las instituciones médicas. Son temas relevantes ante los cambios en el sistema de salud pública.
During the last year of life of the elderly health deteriorates the most, thus becoming the period of time when needs of medical services, personal care requirements and related costs are at highest. ...Using the Mexican Health and Aging Study, differences by sex in the determinants for out-of-pocket health expenditures during the last year of life of people 50 and over are discussed. Three levels of out-of-pocket expenses disbursement are contemplated: none, medium-low, and high. Controlling by sociodemographic variables, findings suggest that the number of hospital nights is the main determinant of health expenses, even above those related to diseases that are regarded as main causes of death. This fact impacts both out-of-pocket expences and the costs for medical institution. It is another issue in the over-hauling of the public health system.
BackgroundAcross Europe, socioeconomic inequalities in mortality are large and persistent. To better understand the drivers of past trends in socioeconomic mortality inequalities, we identified ...phases and potential reversals in long-term trends in educational inequalities in remaining life expectancy at age 30 (e30), and assessed the contributions of mortality changes among the low-educated and the high-educated at different ages.MethodsWe used individually linked annual mortality data by educational level (low, middle and high), sex and single age (30+) from 1971/1972 onwards for England and Wales, Finland and Italy (Turin). We applied segmented regression to trends in educational inequalities in e30 (e30 high-educated minus e30 low-educated) and employed a novel demographic decomposition technique.ResultsWe identified several phases and breakpoints in the trends in educational inequalities in e30. The long-term increases (Finnish men, 1982–2008; Finnish women, 1985–2017; and Italian men, 1976–1999) were driven by faster mortality declines among the high-educated aged 65–84, and by mortality increases among the low-educated aged 30–59. The long-term decreases (British men, 1976–2008, and Italian women, 1972–2003) were driven by faster mortality improvements among the low-educated than among the high-educated at age 65+. The recent stagnation of increasing inequality (Italian men, 1999) and reversals from increasing to decreasing inequality (Finnish men, 2008) and from decreasing to increasing inequality (British men, 2008) were driven by mortality trend changes among the low-educated aged 30–54.ConclusionEducational inequalities are plastic. Mortality improvements among the low-educated at young ages are imperative for achieving long-term decreases in educational inequalities in e30.
México está experimentando un acelerado proceso de envejecimiento demográfico que no viene acompañado de mejoras en las condiciones de salud y mortalidad. El objetivo de este trabajo es comparar la ...evolución de la esperanza de vida a la edad 65 (e65) en México con los diez países de América Latina y el Caribe con los niveles de e65 más altos en cada año durante el periodo de 1990 a 2019. Se utilizan las tablas de vida de Naciones Unidas, revisión 2022, y los métodos de descomposición para comparar las diferencias en e65 de México con otros países y su evolución en el tiempo. Se encontró que la mayoría de las diferencias en e65 de México con los otros países comparados se explica por una mayor mortalidad antes de los 79 años, la cual ha detenido el progreso en la e65 en México entre 1990 y 2019. Los resultados reflejan los retos de las políticas en salud.
Abstract
In low-and-middle-income countries like Mexico the impact of disadvantaged early childhood conditions (ECC) on later-life health in not well known and may be changing across birth cohorts. ...Our objective is to examine the impact of ECC on the propensity to have diabetes in three different cohorts of older adults aged 60-69 (born in 1930-1939, 1940-1949, 1950-1959). We examine to what extent differences in ECC, sociodemographic characteristics, and lifetime obesity explain the differences in the prevalence of diabetes across the cohorts. We use five waves of data from the Mexican Health and Aging Study (n=10,313). We estimate a series of logistic regression models and use counterfactual analyses to identify the roles of ECC and lifetime obesity on cohort-specific diabetes prevalence and on differences in diabetes prevalence across cohorts. Our results suggest that improvements in ECC would decrease prevalence of diabetes by 12.5% in the 1930-1939 cohort and 10% in the 1950-1959 cohort. However, the rise of obesity at age 50 counters this effect and leads to higher prevalence of diabetes in both cohorts. Our models show that if everyone had a normal weight at age 50, the prevalence of diabetes would decrease by 31.3% for the 1930-1939 cohort, 27.3% for the 1940-1949, and 26.7% for the 1950-1959 cohort. Despite improvements in socio-economic conditions during childhood in Mexico, the increase in lifetime obesity appear to offset the benefits derived from better ECC resulting in higher rates of diabetes.
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