http://esa.un.org/unpd/wpp/ Accessed 15 April 2016b. Journal of Public Economic Theory. Bloom et al., 2006). OPW: Output per worker, (2011 PPP $), 2005–2012. Meeting these goals could decrease the risk factors for ILE and increase the standard of living. Whether income inequality is related to population health is still open to debate. OPR: Old age pension recipients, (% of statutory pension age population), 2004–2012. ILE can be influenced by socio-ecological indicators including the Gini coefficient, secondary education, output per worker, and old age pension. In the proposed models, it is evident that if countries improve values of GC, MSE, FSE, OPW, and OPR, they can obtain lower ILE. Therefore, policies that improve these country-level socio-ecological factors are expected to have latent effects on ILE. With this goal, this study considers how ILE correlates with socio-ecological indicators. One of the core inequalities, the relationship between deprivation and life-expectancy is systemic. 2014b;14:113. However, the associations between ILE and GC, MSE and FSE, OPW, and OPR have not been examined. Model 1 considers the (personal level + social environment). Some studies have investigated the effects of income inequality and schooling on life expectancy. 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). A recent article shows that changes in both life expectancy and lifespan inequality can be expressed as rates of progress in reducing mortality (Aburto et al 2020). 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). The average life expectancy at age 45 has increased by 3−4.5 years in twenty years. Redistribution of in-come from rich to poor, whether within or between countries, will increase the health of the poor more than it hurts the health of the rich, and thus improve average national or world health. A., Sasson, I., & Martikainen, P. (2018). The impact of violence on Venezuelan life expectancy and lifespan inequality. Article  Because it is an average, life expectancy does not show differences in length of life among individuals; these differences can be substantial, however. 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. Some studies have addressed the association between ILE and black and white populations, indigenous and non-indigenous people, and women and men [4, 6, 7, 10]. Significant correlations were evident between ILE and the following indicators from a socio-ecological perspective: Gini coefficient (GC: r = 0.335, p = 0.001) as an indicator of income inequality, female population with at least some secondary education (FSE: r = − 0.757, p = 0.001), male population with at least some secondary education (MSE: r = − 0.741, p = 0.001), output per worker as a measure of labor productivity (OPW: r = − 0.714, p = 0.001), and number of old age pension recipients (OPR: r = − 0.641, p = 0.001). World Population Prospects: The 2012 Revision. Impact of income inequality on life expectancy in a highly unequal developing country: the case of Brazil. 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 [2]. Khan HR, Islam AA, Ababneh F. Substantial gender gap reduction in Bangladesh explained by the proximity measure of literacy and life expectancy. Human development report: Inequality-adjusted Human Development Index. Editing – graphics – web design Public Health. Therefore, as individuals’ health status and standard of living apparent based on socio-ecological indicators values decrease and increase, so too does ILE. Health Educ Behav. However, this problem also applies to other observational studies and randomized controlled trials [24, 27]. Health Stat Q. 2009;17(2):223–35. ILE can be influenced by socio-ecological indicators including the Gini coefficient, secondary education, output per worker, and old age pension. Wilkinson RG, Income PKE. Am J Public Health. Science, 362(6418), 1002-1004. there would be a negative relationship across countries between income inequality and life expectancy. Detailed information on the Human development report (2015) is provided on the United Nations, Statistical Annex via access dataset http://hdr.undp.org/sites/default/files/hdr_2015_statistical_annex.pdf upon request. In the above study, smoking provided an explanation across geographic areas for some of the variation in life expectancy across income quartiles.7 Indeed, there is no question that there is an overall link between smoking and mortality. PRB Data Sheet (English), You are invited to contribute to this new publication: please check our guidelines and submit your 1000 word contribution to contact@niussp.org, If you want to get in touch with us write an email to contact@niussp.org, ISSN 2704-7067 – N-IUSSP – www.niussp.org, Caterina Livi Bacci During the study period, as income inequality determined by the Gini coefficient decreased and education level (at least secondary education) increased, ILE decreased as well. People live longer in nations with lower levels of inequality, as measured here by the Gini coefficient, a standard global benchmark. 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]. 2007;5:131–42. The birth of the NHS in 1948 was greeted with considerable optimism. 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. Kim JI, Kim G. Factors affecting the survival probability of becoming a centenarian for those aged 70, based on the human mortality database: income, health expenditure, telephone, and sanitation. 2005;95(5):1653–72. 2016a;129(1):391–402. The associations between socio-ecological indicators and ILE were assessed using correlation coefficients and multiple regression models. Atkinson AB. Thus, the outputs are averaged across the populations and then compared using standard statistical methods (Kim and Kim 2016a, 2017). In addition, our findings may not apply to individuals in a particular population, which is a limitation of a socio-ecological study. These findings … 2006;120(11):994–1001. Hosseinpoor AR, Harper S, Lee JH, Lynch J, Mathers C, Abou-Zahr C. International shortfall inequality in life expectancy in women and in men, 1950-2010. This study focused on socio-ecological factors based on a macroscopic theory [3, 18, 26,27,28]. The effect of subjective survival        probabilities on retirement and wealth in the United States. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Google Scholar. Castelló-Climent A, Doménech R. Human capital inequality, life expectancy and economic growth. Asia Pac J Public Health. 2016b;83(4):402–17. Whiteford P, Pension WE. GC ranged from 24.8 in Ukraine to 65 in South Africa, with a mean of 38.12 and a spread of 40.2. A limitation of this study is a lack of comparable data between some of the countries. The gap between most and least deprived is over 9 years for males and over 7 years for females. Privacy J Appl Stat. In addition, the outputs of this study are based on populations. 2001;38(2):227–51. PubMed  Baker J, Meisner BA, Logan AJ, Kungl AM, Weir P. Physical activity and successful aging in Canadian older adults. volume 18, Article number: 243 (2018) Thus, countries with low levels of MSE, FSE, OPW, and OPR and high levels of GC had high ILEs, as seen in Model 3. Article  Maturitas. Kim JI, Kim G. Labor force participation and secondary education of gender inequality index (GII) associated with healthy life expectancy (HLE) at birth. J Am Med Dir Assoc. Life expectancy at birth is a measure of the mean level of mortality. 2005;59(2):158–62. The present study examines the possible associations between ILE and socio-ecological inequality using several indicators: (1) national income inequality on the personal level [3, 8, 13, 23, 24]; (2) education of at least a secondary education by males and females, which is an indicator of the social environment [15, 17, 18]; (3) labor productivity [19] (Cervellati and Sunde 2005); and (4) the number of old age pension recipients [21], which indicates public policy. This relationship holds true across the whole population and is known as the social gradient in … JIK and GK participated in the design of the study. Challenges and pension reforms in OECD countries. 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. Data for ILE analysis were obtained from the ILE study conducted by the UN [2]. Bloom DE, Canning D, Sevilla J. Economists and health experts have known for years that people who live in poorer societies live shorter lives. To confirm whether higher ILE is vulnerable to changes in these indicators, this study examined the associations between ILE and socio-ecological indicators. Science. FSE from 2005 to 2014 as a percentage of those 25 years of age or older, a percentage of the population aged 25 years or older who have reached a secondary level of education [2]. An additional 10% of employment is associated with around 5 years of healthy life expectancy in this simple relationship. Hrealth at advanced age: social inequality and other factors potentially impacting longevity in nine high-income countries. Finally, the predictors of ILE were used to build a model in which higher ILE was predicted by higher values of GC and lower MSE, FSE, OPW, and OPR (R2 = 0.648, p < 0.001). 2008;118(528):653–77. Kim, J.I., Kim, G. Effects on inequality in life expectancy from a social ecology perspective. Socioeconomic and ethnic inequalities in health are of great concern, and life expectancy provides a readily understood means of monitoring such inequalities. De Vogli R, Mistry R, Gnesotto R, Cornia GA. Has the relation between income inequality and life expectancy disappeared? The Atkinson inequality index A (1) is calculated as A (1) = 1- (geometric mean length of life / arithmetic mean length of life) [1, 41], but we used data from UN [40], which already applied the Atkinson method, to calculate the ILE (%) from 2010 to 2015. Therefore, one is a conceptual model of ILE and the other is a framework comprising socio-ecological indicators that relate to ILE (see Figure 1). Science. PubMed  Google Scholar. Life expectancy at birth is widely employed to measure longevity. Consequently, socio-ecological indicators are likely major contributing factors to ILE and indirectly reflect country-level socio-ecological conditions required for healthy living. Such comparisons inform policy decisions that are contingent on changes in ILE [37]. Bousquet J, Malva J, Nogues M, Mañas LR, Vellas B, Farrell J, MACVIA Research Group. Three models were developed from the socio-ecological perspective. Ann N Y Acad Sci. We assume that appropriate changes in the country-level ILE will produce changes in the GC as a measure of economic deprivation from a personal perspective, FSE and MSE attainment from a social environment perspective, OPW as a measure of labor productivity, and the number of OPR as a measure of the welfare of the older population from a public policy perspective. The data used for this study comes from the United Nations database. 1996;312(7037):1004–7. http://hdr.undp.org/sites/default/files/hdr_2015_statistical_annex.pdf Accessed 16 August 2016a. Correspondence to The indicators of socio-ecological perspective were obtained from datasets provided by the UN [2, 40, 43]. The healthy life expectancy gap between the most and least deprived parts of the UK is 19 years. Studies have shown that such increased uncertainty within a society is likely to be concentrated among those from disadvantaged socio-economic groups. Country-level socio-ecological indicators seem to have an important effect on inequality in life expectancy. Data on socio-ecological indicators were obtained from the United Nations database. The impact of violence on Venezuelan life expectancy and lifespan inequality. Historically, advances in health have been major contributors to economic growth [52]. Google Scholar. BMC Geriatr. https://doi.org/10.1186/s12889-018-5134-1, DOI: https://doi.org/10.1186/s12889-018-5134-1. Inequality and socioeconomic gradients in mortality. The relationship between neighborhood educational opportunity and life expectancy relies on the assumption that teens attend school in their own neighborhoods. 2012;10:3. Decreases in GC and increases in MSE, FSE, OPW, and OPR lead to decreases in ILE, suggesting that improving these factors can improve ILE. ILE is estimated from the abridged life Tables (5-year age cohorts) and reflects the current inequality in mortality patterns—some people die before the age of one and others die at 75 or later [40]. Rasella D, Aquino R, Barreto ML. We aimed to critically assess the relationship between income inequality and mortality in 43 European countries using comparable data between 1987 and 2008, controlling for time-invariant and time-variant country-level confounding factors. Based on the collective findings, it is reasonable to think that country-level ILE and socio-ecological indicators may differ between countries (see Figure 1). For example, in 1920’s Italy, the biggest gains in life expectancy were achieved if progress was concentrated in infancy. According to the Centers for Disease Control and Prevention (CD… BMJ. The quality of these estimates relies on the quality of the data in the life Table (UN 2016b). Jong In Kim or Gukbin Kim. Healthy ageing is a multifactorial characteristic that is influenced by biological, psychosocial, and environmental factors [3, 18, 25,26,27,28]. 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. 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. 2013/7). The impact of structural inequities follows individuals “from womb to tomb.” It means that the more deprived an area a person is from, the shorter their life expectancy on average. UNDESA (United Nations Department of Economic and Social Affairs). In less developed countries, country-level income and educational inequality have likely contributed to poor progress in attaining health equality [18, 24, 27]. The contribution of educational inequalities to lifespan variation. An important message of recent research is that policies and interventions can affect this relationship by reducing mortality at ages that matter the most (Aburto et al., 2020). 2015;16(12):1020–6. Prev Med. Demography. To investigate the direct relationships between ILE and the socio-ecological indicators, multiple regression analysis was conducted. ILE ranged from 2.8% in Iceland to 51.2% in Sierra Leone. The regression analysis on the socio-ecological indicators revealed the strongest predictors among the three regression models (see Tables 3, 4). A smaller body of work has investigated socioeconomic disparities in life expectancy, which have widened in many countries since 1980. In terms of policy interventions, one key question to ask is how different types of healthcare investments, such as preventive as opposed to end-of-life care, may relate to inequality in lifespans. 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. An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). By contrast, in today’s Italy, reducing infant death rates by 5% leads to the same gain in life expectancy as reducing … 2007;17(6):585–6. Raising the age at which senior citizens qualify for public pension benefits is a detriment to the health of low income seniors [50]. Technical paper (no. ILE is the inequality in the distribution of expected length of life. Demos (Dutch) BMC International Health and Human Rights. Inequalities in national income, education, labor productivity, and social security have negative ramifications for health promotion development [3, 18, 24, 33]. Springer Nature. These results indicate the great impact of socio-ecological factors on ILE. Especially, a retrospective analysis of country-level socio-ecological factors that contribute to ILE could help identify the most important determinants of ILE [3, 8]. 2013;380(9859):2144–62. 2003;93(8):1294–6. Thus, OPW and OPR can be seen as innovative tools for health promotion when viewed from a public policy prospective, and their values have implications that can help to improve the standard of living. Geronimus AT, Bound J, Waidmann TA, Colen CG, Steffick D. Inequality in life expectancy, functional status, and active life expectancy across selected black and white populations in the United States. Immunogenetics, gender, and longevity. In multivariate regression, the ILE predictors were higher GC and lower levels of FSE, MSE, OPW, and OPR (R2 = 0.648, p < 0.001). Ostrom EA. Statistical tabulations suggest that the relationship is nonlinear. 1988;15(4):351–77. Kim JI, Kim G. Country-level socioeconomic indicators associated with survival probability of becoming a centenarian among older European adults: gender inequality, male labor force participation, and proportions of women in parliaments. New York: Population Division, United Nations; 2013. Hertog S. The association between two measures of inequality in human development: income and life expectancy. ILE: Inequality in life expectancy, (%), 2010–2015 . Population and Societies (English and French ) JIK supervised the data analysis and writing of the manuscript. Int J Aging Hum Dev. 2015 Revision. It was believed that a fully comprehensive welfare state where people had their needs taken care of from the cradle to the grave would bridge the gap between the haves and the have nots. By using this website, you agree to our 2002;15:5–15. Lifespan inequality is reduced significantly if lives are saved at infancy but increases if lives are saved at older ages (Figure 3). Cite this article. 2006;22(1):78–94. 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