Losing Ground - Swedish Life Expectancy in a Comparative Perspective

Abstract

BackgroundIn the beginning of the 1970s, Sweden was the country where both women and men enjoyed the world's longest life expectancy. While life expectancy continues to be high and increasing, Sweden has been losing ground in relation to other leading countries.MethodsWe look at life expectancy over the years 1970–2008 for men and women. To assess the relative contributions of age, causes of death, and smoking we decompose differences in life expectancy between Sweden and two leading countries, Japan and France. This study is the first to use this decomposition method to observe how smoking related deaths contribute to life expectancy differences between countries.ResultsSweden has maintained very low mortality at young and working ages for both men and women compared to France and Japan. However, mortality at ages above 65 has become considerably higher in Sweden than in the other leading countries because the decrease has been faster in those countries. Different trends for circulatory diseases were the largest contributor to this development in both sexes but for women also cancer played a role. Mortality from neoplasms has been considerably low for Swedish men. Smoking attributable mortality plays a modest role for women, whereas it is substantially lower in Swedish men than in French and Japanese men.ConclusionsSweden is losing ground in relation to other leading countries with respect to life expectancy because mortality at high ages improves more slowly than in the leading countries, especially due to trends in cardiovascular disease mortality. Trends in smoking rates may provide a partial explanation for the trends in women; however, it is not possible to isolate one single explanatory factor for why Sweden is losing ground.

How long do centenarians survive? Life expectancy and maximum lifespan

“…It is also worth noting that although Sweden was the country with the highest life expectancy for a short period, this position was not because of the lowest mortality at very advanced ages, but the lowest rate in childhood, adolescence and middle age . At present, Sweden is losing rank relative to other countries with respect to life expectancy or mortality at older ages, starting at around the age of 60 .…”

Visualizing Mortality Dynamics in the Lexis Diagram

“…8.12, contributions of older ages to the increase in life expectancy have been smaller than in some other "vanguard" countries such as France or Japan. Drefahl et al (2014) demonstrate that different trends for mortality from circulatory diseases were the main reason that Sweden is "losing ground".…”

Sex differences in mortality in migrants and the Swedish-born population: Is there a double survival advantage for immigrant women?

“…According to the European Health for All Database, the age-standardized prevalence of tobacco smoking in 2013 among people aged 15+ was very similar among Swedish men and women (21.7% and 22.1%, respectively), but was substantially higher among men than among women in Eastern EU countries, e.g., 34% among men versus 25% among women in Poland (WHO 2017 ). In 2003, across a sample that included most of the high-income countries, Sweden was found to have the lowest smoking-attributable fraction among deaths at ages 50+ among men, and a very small sex difference in the smoking-attributable fraction among deaths at ages 50+ (men vs. women, respectively, 0.09 vs. 0.06 in Sweden, and 0.30 vs. 0.13 in Hungary) (Preston et al 2010 ; Drefahl et al 2014 ).…”