Nathalie Auger1, Pascaline Feuillet2, Sylvie Martel3, Ernest Lo4, Amadou D Barry3, Sam Harper5. 1. Analyse de la santé et des inégalités sociales et territoriales, Institut national de santé publique du Québec, Montréal, Canada; Axe Risques à la santé, Research Centre of the University of Montreal Hospital Centre, Montreal, Canada. Electronic address: nathalie.auger@inspq.qc.ca. 2. Institut de Démographie de l'Université Paris 1, Université Panthéon-Sorbonne, Paris, France. 3. Analyse de la santé et des inégalités sociales et territoriales, Institut national de santé publique du Québec, Montréal, Canada. 4. Analyse de la santé et des inégalités sociales et territoriales, Institut national de santé publique du Québec, Montréal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada. 5. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
Abstract
PURPOSE: Life expectancy is used to measure population health, but large differences in mortality can be masked even when there is no life expectancy gap. We demonstrate how Arriaga's decomposition method can be used to assess inequality in mortality between populations with near equal life expectancy. METHODS: We calculated life expectancy at birth for Quebec and the rest of Canada from 2005 to 2009 using life tables and partitioned the gap between both populations into age and cause-specific components using Arriaga's method. RESULTS: The life expectancy gap between Quebec and Canada was negligible (<0.1 years). Decomposition of the gap showed that higher lung cancer mortality in Quebec was offset by cardiovascular mortality in the rest of Canada, resulting in identical life expectancy in both groups. Lung cancer in Quebec had a greater impact at early ages, whereas cardiovascular mortality in Canada had a greater impact at older ages. CONCLUSIONS: Despite the absence of a gap, we demonstrate using decomposition analyses how lung cancer at early ages lowered life expectancy in Quebec, whereas cardiovascular causes at older ages lowered life expectancy in Canada. We provide SAS/Stata code and an Excel spreadsheeet to facilitate application of Arriaga's method to other settings.
PURPOSE: Life expectancy is used to measure population health, but large differences in mortality can be masked even when there is no life expectancy gap. We demonstrate how Arriaga's decomposition method can be used to assess inequality in mortality between populations with near equal life expectancy. METHODS: We calculated life expectancy at birth for Quebec and the rest of Canada from 2005 to 2009 using life tables and partitioned the gap between both populations into age and cause-specific components using Arriaga's method. RESULTS: The life expectancy gap between Quebec and Canada was negligible (<0.1 years). Decomposition of the gap showed that higher lung cancer mortality in Quebec was offset by cardiovascular mortality in the rest of Canada, resulting in identical life expectancy in both groups. Lung cancer in Quebec had a greater impact at early ages, whereas cardiovascular mortality in Canada had a greater impact at older ages. CONCLUSIONS: Despite the absence of a gap, we demonstrate using decomposition analyses how lung cancer at early ages lowered life expectancy in Quebec, whereas cardiovascular causes at older ages lowered life expectancy in Canada. We provide SAS/Stata code and an Excel spreadsheeet to facilitate application of Arriaga's method to other settings.
Authors: Catherine Dearie; Christine Linhart; Eric Rafai; Devina Nand; Stephen Morrell; Richard Taylor Journal: BMC Public Health Date: 2021-06-22 Impact factor: 3.295