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Convergences and divergences in mortality. A new approach to health transition
George Myers Memorial Lecture by Jacques Vallin
INED, Paris
First stage :Omran’s epidemiologic transition
Long-term trends in female life expectancy for selected industrialized countries until the mid-60s
25
30
35
40
45
50
55
60
65
70
75
80
1740 1765 1790 1815 1840 1865 1890 1915 1940 1965
Life expectancy at birthLife expectancy at birth
Long-term trends in female life expectancy for selected industrialized countries until the mid-60s
25
30
35
40
45
50
55
60
65
70
75
80
1740 1765 1790 1815 1840 1865 1890 1915 1940 1965
Life expectancy at birth
New Zealand
Denmark
England & W.
France
Japan
Life expectancy at birth
Italy
Hungary
NetherlandsRussia
Long-term trends in female life expectancy for developing countries except Sub-Saharan Africa and countries affected by war
20
30
40
50
60
70
80
1950 1960 1970 1980 1990 2000
Life expectancy
Yemen
Puerto Rico
Mexico
Indonesia
Hong Kong
A
Long-term trends in female life expectancy for developing countries except Sub-Saharan Africa and countries affected by war
20
30
40
50
60
70
80
1950 1960 1970 1980 1990 2000
Norway
Puerto Rico
Mexico
Indonesia
Yemen
Life expectancy
B
Long-term trends in female life expectancy for Sub-Saharan Africa
25
35
45
55
65
75
85
1950 1960 1970 1980 1990 2000
IndonesiaYemen
Life expectancy
Countries with slow progress
Niger
Ghana
25
35
45
55
65
75
85
1950 1960 1970 1980 1990 2000
Indonesia
Yemen
Life expectancy
African countries with AIDS
Zimbabwe
Uganda
Second stage:the cardiovascular revolution
Trends in life expectancy (both sexes) since 1965 in industrialized countries
64
66
68
70
72
74
76
78
80
82
1965 1970 1975 1980 1985 1990 1995 2000
Life expectancy
Japan
Russia
England/Wales
Czech Republic
Trends in life expectancy (both sexes) since 1965 in industrialized countries
64
66
68
70
72
74
76
78
80
82
1965 1970 1975 1980 1985 1990 1995 2000
Life expectancy
Japan
Russia
Sweden
Ukraine
Czech Republic
France
England/WalesDenmark
United States
Poland
Hungary
Romania
Contribution of trends in age-
specific mortality for seven main
groupes of causes to changes in
male life expectancy since
1965-1,0
-0,5
0,0
0,5
1,0
1,5
2,0
2,5
RUSSIA1965-2000
Contribution (years)
-1,0
-0,5
0,0
0,5
1,0
1,5
2,0
2,5
UNITED KINGDOM1965-1997
Contribution (years)
Infection Cancer
Cardiovascular diseases Respiratory diseases
Digestive diseases Other diseases
Injury and poisoning
Trends in male
standardized mortality rate
from cardiovascular diseases since
1965 in 6 industrialized
countries
Third stage:the fight against ageing
Trends in life expectancy since 1980 in some Western industrialized countries
70
72
74
76
78
80
82
84
1980 1985 1990 1995 2000
Life expectancy
Japan
Sweden
France
EnglandDenmark
USA
Netherland
Italy
Males
70
72
74
76
78
80
82
84
1980 1985 1990 1995 2000
Life expectancy
Japan
SwedenItaly
Netherland
England
France
Denmark
USA
Females
Contribution of trends in age-specific mortality by groups of causes in changes in female life expectancy from 1980 to 1999
-1,0
-0,5
0,0
0,5
1,0
1,5
2,0
2,5
JAPAN
Contribution (years)
-1,0
-0,5
0,0
0,5
1,0
1,5
2,0
2,5
NETHERLANDS
Contribution (years)
-1,0
-0,5
0,0
0,5
1,0
1,5
2,0
2,5
DENMARK
Contribution (years)
-1,0
-0,5
0,0
0,5
1,0
1,5
2,0
2,5
FRANCE
Contribution (years)
Infection Cancer Cardiovascular diseases Respiratory diseases
Digestive diseases Other diseases Injury and poisoning
What about sub-national differences ?
Trends in female life
expectancy by French
Départements as compared to the upper and lower limits of national trends
in industrialized
countries 20
30
40
50
60
70
80
90
1805 1825 1845 1865 1885 1905 1925 1945 1965 1985
Life expectancy at birth
Morbihan
Hautes-Pyrénées
Upper limit
Lower limit
Historical trends in
maximum, minimum, mean and standard
déviation of female life
expectancy by French
Départements
20
30
40
50
60
70
80
90
1800 1850 1900 1950 2000
Maximum
MinimumMean
Life expectancy
0
2
4
6
8
1800 1850 1900 1950 2000
Standard deviation
Geographical variations in life expectancy in France and Japan since le 1920s
35
40
45
50
55
60
65
70
75
80
85
1920 1930 1940 1950 1960 1970 1980 1990 2000
Males
Females
* Bouches-du-Rhône
* IndreIlle-et-Vilaine
Landes
Life expectancy
*
*
FRANCE
35
40
45
50
55
60
65
70
75
80
85
1920 1930 1940 1950 1960 1970 1980 1990 2000
Females
Males
Life expectancy
* Ishikawa
Toyama
Okinawa
* Miyazaki
*
*
JAPAN
Trends in sex differences in life expectancy
0
1
2
3
4
5
6
7
8
1750 1800 1850 1900 1950 2000
DenmarkNetherlands
Norway
Sweden
Difference
Nordic countries
0
1
2
3
4
5
6
7
8
1750 1800 1850 1900 1950 2000
US
E&W
New ZealandCanada
Australia
Difference
Anglo-Saxon countries
Trends in life expectancy at birth in England and Wales by social classes
66
68
70
72
74
76
78
1970 1975 1980 1985 1990 1995
Professionnal
Mangerial & tech.
Skilled, non manual
Skilled, manualPartly skilled, manual
Unskilled, manual
The end
