The determinants of health inequalities are well known. The quality of these estimates relies on the quality of the data in the life Table (UN 2016b). Life expectancy is closely related to people’s socio-economic circumstances. KJI prepared the initial draft of the manuscript. In addition, our findings may not apply to individuals in a particular population, which is a limitation of a socio-ecological study. PubMed Economists and health experts have known for years that people who live in poorer societies live shorter lives. Health Educ Behav. Google Scholar. To fully understand mortality at the population level, life expectancy can be complemented by lifespan inequality, which measures variation in ages at death, capturing differences in lifespans. Les politiques démographiques sont-elles efficaces ? Article Spoerri A, Zwahlen M, Egger M, Gutzwiller F, Minder C, Bopp M. Educational inequalities in life expectancy in German speaking part of Switzerland 1990-1997: Swiss National Cohort. 2017;389(10076):1323–35. 2017b;13(1):58. In the 108 countries examined, MSE, FSE, OPW, and OPR values were the lowest in less developed regions and higher in more developed regions. Granados JA. These strategies should include addressing country-level socio-ecological indicators. This study would not be able to the selection of education variables that other education like primary, higher and literacy status. This exceptional progress in reducing mortality has raised life expectancy at birth from 46.4 years to almost 85 years over the last century. And as the body of evidence accumulates, a clearer picture is emerging of inequality and its relation to health, self-worth, the ability to participate in society and to take control of one’s life. In contrast, 99.7% of female babies born in 2017 survived to their first birthday and almost 70% of them are expected to be alive in 2100 (Figure 1). Population and Societies (English and French ) Zhao Y, Dempsey K. Causes of inequality in life expectancy between indigenous and non-indigenous people in the northern territory, 1981-2000: a decomposition analysis. ILE can be influenced by socio-ecological indicators including the Gini coefficient, secondary education, output per worker, and old age pension. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The national income inequality index, secondary education attainment, labor productivity, and social security are controlled measures that are crucial determinants of ILE. According to the Centers for Disease Control and Prevention (CD… statement and MSE from 2005 to 2014 which is expressed the same as for FSE. Model 1 considers the (personal level + social environment). 2009;372(9656):2124–31. Lifespan inequality is also likely to create uncertainty about the timing of inheritances and financial bequests among family members. PubMed Google Scholar. Policies that address ILE should consider targeted socio-ecological factors, such as the Gini coefficient of income inequality, that give a personal perspective of economic deprivation, attainment of at least a secondary education by both females and males that gives a social environment perspective, output per worker that indicates labor productivity, and the number of old age pension recipients that indicates social security from a public policy perspective. OPW from 2005 to 2012, labor productivity, output per unit of labor input, expressed as GDP per worker, (in 2005 international dollars using purchasing power parity rates, 2011 PPP $), for which data refer to the most recent year available . This study examined the effects on ILE based on social ecology factors. Human development report: Inequality-adjusted Human Development Index. Everybody is free to reproduce our articles, for free, provided the original source is cited. The following map provides raw data on educational opportunity and life expectancy to illustrate communities with overlapping education and health advantages and disadvantages. JIK supervised the data analysis and writing of the manuscript. Dynamics of life expectancy and life span equality. United Nations (UN). The models generate a framework of the components of the socio-ecological perspective [3, 24, 33]. 2017;49(2):239–50. García, J., & Aburto, J. M. (2019). Am J Public Health. Ostrom EA. 2015;16(12):1020–6. Int J Equity Health. JIK and GK declare that they have no competing interests. This study focused on socio-ecological factors based on a macroscopic theory [3, 18, 26,27,28]. Google Scholar. Data for ILE analysis were obtained from the ILE study conducted by the UN . Inequality in life expectancy (ILE) is defined as inequality in the distribution of expected span of life-based on data from survival tables estimated using the Atkinson inequality index. Grzywacz JG, Marks NF. 2013;57(6):963–6. Technical paper (no. The contribution of educational inequalities to lifespan variation. In 1992 Richard Wilkinson published a widely cited paper in the British Medical Journal, arguing that higher levels of income inequality in rich countries lowered average life expectancy (61). Inequalities in national income, education, labor productivity, and social security have negative ramifications for health promotion development [3, 18, 24, 33]. Google Scholar. The effect of subjective survival probabilities on retirement and wealth in the United States. 2001;38(2):227–51. Impact of morbidity and life events on successful aging. Significant positive correlations were found between ILE and GC (r = 0.335, p = 0.001), FSE (r = − 0.757, p = 0.001), MSE (r = − 0.741, p = 0.001), OPW (r = − 0.714, p = 0.001), and OPR (r = − 0.614, p = 0.001). Kim JI, Socio-ecological KG. New York: Population Division, United Nations; 2013. ILE is the inequality in the distribution of expected length of life. 2014a;13(1):106. However, as José Manuel Aburto, Ginevra Floridi and Ella Fegitz argue, another complementary dimension of great relevance in health research and policy intervention is inequality in the length of life or lifespan inequality. The indicators of socio-ecological perspective were obtained from datasets provided by the UN [2, 40, 43]. JIK and GK conducted the statistical analysis. It has been used to compare health disparity between countries. 2013/7). MSE: Male population with at least some secondary education, (% ages 25 and older), 2005–2014. Bloom et al., 2006). The inequality-adjusted human development index in the UN database  captures inequality using the index of human development. Thus, countries with low levels of MSE, FSE, OPW, and OPR and high levels of GC had high ILEs, as seen in Model 3. http://hdr.undp.org/en/faq-page/inequality-adjusted-human-development-index-ihdi#t293n97 Accessed 16 August 2016b. Thus, the outputs are averaged across the populations and then compared using standard statistical methods (Kim and Kim 2016a, 2017). Life expectancy can be predicted by country-level socio-ecological factors including income inequality and education [9, 11,12,13,14,15,16,17,18, 28], labor productivity, and the population of old age pension recipients [19,20,21,22]. The correlation also tends to be stronger for healthy life expectancy rather than total lifespan. 2011;23(4):458–69. Such comparisons inform policy decisions that are contingent on changes in ILE . Article 2013; jech-2012. Regidor E, Calle ME, Navarro P, Domı́nguez V. Trends in the association between average income, poverty and income inequality and life expectancy in Spain. For example, in Finland, between 1971 and 2014, lifespan inequality increased among subgroups with low educational attainment and low income but decreased among more advantaged groups (van Raalte et al., 2018). http://hdr.undp.org/sites/default/files/hdr_2015_statistical_annex.pdf, http://hdr.undp.org/en/faq-page/inequality-adjusted-human-development-index-ihdi#t293n97, http://hdr.undp.org/sites/default/files/2015_human_development_report_1.pdf, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12889-018-5134-1. lifespan inequality has decreased (Figure 2). These variables reflect the components of the socio-ecological indicators [3, 24]. However, it is not association-sensitive, meaning that it does not account for overlapping inequalities (whether the same people are at the lower end of each distribution). volume 18, Article number: 243 (2018) ILE from 2010 to 2015, inequality in the distribution of expected length of life based on data from life tables estimated using the Atkinson inequality index, was calculated from the 2010–2015 life tables provided by UNDESA [38, 39]. For women, the gap is 2.2 years. By simulating the improvement in life expectancy that could have resulted if, ceteris paribus, income inequality had stayed constant at the lowest level after the founding of the People's Republic of China in 1949, we find that the sharply increasing income inequality in China has contributed to life loss in China's population, about 0.6 years for men and 0.4 years for women. In 1920, 13.3% of females born in Italy died before their first birthday and less than 10% of them were expected to reach the age of 82. The relationship between income disparity and life expectancy has been reported [9, 11,12,13], as has the effect of educational inequalities on life expectancy [14,15,16,17,18]. The hypothesis of this study is that the associations between output (ILE, including differences in ILE between countries) and progress (country-level GC, MSE, FSE, OPW, and OPR) predict health inequalities (Figure 1). (2006). The regression analysis on the socio-ecological indicators revealed the strongest predictors among the three regression models (see Tables 3, 4). CAS FSE ranged from 0.9% in Burkina Faso to 100% in Canada, Austria, Finland, and Estonia, with a mean of 58.46% and a spread of 99.1%. Demography. This study identified five country-level socio-ecological indicators as important contributors to inequality in life expectancy. Proceedings of the National Academy of Sciences. Bloom DE, Canning D, Sevilla J. Social factors associated with centenarian rate (CR) in 32 OECD countries. Wilkinson RG. BMC International Health and Human Rights. An additional 10% of employment is associated with around 5 years of healthy life expectancy in this simple relationship. In contrast, Germany has a GDP per capita of 34,401, a life expectancy at birth of 79.80, and a combined enrollment ratio of 88. On the measurement of inequality. The impact of violence on Venezuelan life expectancy and lifespan inequality. The associations between ILE and indicators of socio-ecological perspective in these models are assessed using Pearson correlation coefficients and multiple regression models [3, 24, 28, 33] and assessed the influence in the magnitude of covariates on the ILE. By contrast, in today’s Italy, reducing infant death rates by 5% leads to the same gain in life expectancy as reducing … Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. There is reason to believe that more equal or socially cohesive societies may be more effective at reducing lifespan inequality, for example by reducing violent crime or providing better access to preventive healthcare across all socio-economic groups. An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). The relationship between neighborhood educational opportunity and life expectancy relies on the assumption that teens attend school in their own neighborhoods. Does population aging erode democratic support? Glob Health. Data on socio-ecological indicators were obtained from the United Nations database. Castelló-Climent A, Doménech R. Human capital inequality, life expectancy and economic growth. Thus, policies that address country-level inequality in life expectancy should consider target socio-ecological factors, such as the GC of income inequality, as an intrapersonal measure of economic deprivation, female and male attainment of at least a secondary education from a social environment perspective, output per worker as labor productivity, and the number of old age pension recipients from a public policy perspective. Some studies have investigated the effects of income inequality and schooling on life expectancy. Change in inequality 1970-1995 is significantly related to change in life expectancy and infant mortality, suggesting a causal relationship, but these correlations are not robust with respect to sample or controls. GC was used; a value of 0 represents utter equality and a value of 100 utter inequality, which presented a measure of the difference in the distribution of income among individuals or households within a country from an entirely equal distribution . A variant of the ecological fallacy? Donkin A, Goldblatt P, Lynch K. Inequalities in life expectancy by social class, 1972–1999. , Meisner BA, Logan AJ, Kungl AM, Weir P. Physical activity successful! And ILE were assessed using correlation coefficients are the correct tool to summarise the relationships [ 42 ] NHS 1948. The last century a useful indicator that can help develop ways to reduce inequalities. Lives are saved at older ages ( Figure 3 ) wider and have not been.... M., & Monden, C. ( 2009 ) lower ILE a real labor productivity effect 51... Policy decisions that are contingent on changes in these indicators, multiple regression analysis on the of... In Denmark environment + public policy ) a smaller body of work has investigated socioeconomic disparities in expectancy..., Asaduzzaman M. Literate life expectancy for 187 countries, 1990–2010: a societys level of inequality had... The countries the core inequalities, the biggest gains in life expectancy which! 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