Mortality in Catalonia in the context of the third, fourth and future phases of the epidemiological transition theory

Abstract

In the period 1960-2000, male and female life expectancy increased by 8,2 and 10,5 years, respectively, in Catalonia, one of Spain's Autonomous Regions, to one of the highest in the world. Initially, most gains were due to lower infant mortality, but as cardiovascular diseases declined this later shifted to advanced ages. Between the mid-1980s and early 1990s life expectancy improvements stagnated as the mortality risk from traffic accidents and HIV/AIDS in young adults increased. Both the age-delay in old-age mortality and the simultaneous influence of behaviour and life style reflect distinct aspects of the fourth stage of the epidemiological transition. This analysis quantifies the age and cause of death contributions to changes and sex-differences in life expectancy in Catalonia. It subsequently compares the most recent life table for women with the Duchene-Wunsch limited life table to estimate the potential gain in life expectancy when all deaths would be ageing-related and on which ages these improvements would fall.