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Gender gap in life expectancy in India and role of age groups: A comparison between before and after male - female life expectancy at birth crossover.

ABSTRACT: To assess the gender gap in life expectancy at birth in India and its major states as well as the timing of male-female life expectancy at birth crossover. To analyze the age-specific contributions to the changing gender differences before and after the crossover at the national and sub-national levels. We have used sample-survey-based age-specific mortality data available for the periods 1970-2018 to construct abridged life tables. The contribution of different age groups to the gender gap is estimated by using Arriaga's method of decomposition. During 1981-85 female life expectancy at birth caught up with male life expectancy at birth for India and by 2005 all major states completed the crossover. The male-female crossover in life expectancy at the national level in the early 80s is remarkable in the face of continued female disadvantage from birth till adolescence, even for some richer states. We provide evidence that gender difference in longevity in favour of females is largely a function of adult age groups and younger age groups contribute negatively to the gender gap in life expectancy at birth in most states. Juxtaposing the results from contribution in an absolute number of years and their relative contribution change before and after the crossover, it is established that although the adult and old age groups contribute the highest in the absolute number of years before and after the crossover, the contribution of the reproductive age groups and childhood years in the recent time is most relevant in relative terms.

SUBMITTER: Borah G

PROVIDER: S-EPMC8638908 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Although the black-white gap in life expectancy has narrowed in the U.S., there is considerable variability across states. In Wisconsin, the black-white gap exceeds 6 years, well above the national average. Reducing this disparity is an urgent public health priority, but there is limited understanding of what contributes to Wisconsin's racial gap in longevity. Our investigation identifies causes of death that contribute most to Wisconsin's black-white gap in life expectancy among males and females, and highlights specific ages where each cause of death contributes most to the gap. METHODS:Our study employs 1999-2016 restricted-use mortality data provided by the National Center for Health Statistics. After generating race- and sex-specific life tables for each 3-year period of observation (e.g., 1999-2001), we trace recent trends in the black-white life expectancy gap in Wisconsin. We subsequently conduct a series of analyses to decompose the black-white gap in three time periods into 13 separate causes and 19 different age groups. RESULTS:In 2014-16, Wisconsin's black-white gap in life expectancy was 7.34 years for males (67% larger than the national gap), and 5.61 years for females (115% larger than the national gap). Among males, homicide was the single largest contributor, accounting for 1.56 years of the total gap. Heart disease and cancer followed, contributing 1.43 and 1.42 years, respectively. Among females, heart disease and cancer were the two leading contributors to the gap, accounting for 1.12 and 1.00 years, respectively. Whereas homicide contributed most to the racial gap in male longevity during late adolescence and early adulthood, heart disease and cancer exerted most of their influence between ages 50-70 for both males and females. Other notable contributors were unintentional injuries (males), diabetes and cerebrovascular disease (females), and perinatal conditions (males and females). CONCLUSIONS:Our study identifies targets for future policy interventions that could substantially reduce Wisconsin's racial gap in life expectancy. Concerted efforts to eliminate racial disparities in perinatal mortality and homicide early in the life course, and chronic conditions such as cancer and heart disease in later life, promise to help Wisconsin achieve the public health objective of racial parity in longevity.

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Gender gap in life expectancy in India and role of age groups: A comparison between before and after male - female life expectancy at birth crossover.

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