Twentieth century surge of excess adult male mortality.

Using historical data from 1,763 birth cohorts from 1800 to 1935 in 13 developed countries, we show that what is now seen as normal-a large excess of female life expectancy in adulthood-is a demographic phenomenon that emerged among people born in the late 1800s. We show that excess adult male mortality is clearly rooted in specific age groups, 50-70, and that the sex asymmetry emerged in cohorts born after 1880 when male:female mortality ratios increased by as much as 50% from a baseline of about 1.1. Heart disease is the main condition associated with increased excess male mortality for those born after 1900. We further show that smoking-attributable deaths account for about 30% of excess male mortality at ages 50-70 for cohorts born in 1900-1935. However, after accounting for smoking, substantial excess male mortality at ages 50-70 remained, particularly from cardiovascular disease. The greater male vulnerability to cardiovascular conditions emerged with the reduction in infectious mortality and changes in health-related behaviors.

Years of life lost due to alcohol-related mortality: A nationwide population study in Poland, 1999-2017.

BACKGROUND: The aim of this study was to assess alcohol-related mortality and years of life lost (YLL) in Poland between 1999 and 2017. METHODS: A database of 7,168,765 death certificates of Polish residents who died in 1999-2017 was reviewed. This number included 112,512 people who had died due to alcohol consumption. YLL was calculated with the use of the Standard Expected Years of Life Lost (SEYLL) measure; its value was related to the size of the study population and calculated per 100,000 people (SEYLLp). Time trends were determined by joinpoint regression analysis. RESULTS: In 1999, the SEYLLp value was 653.99 years among males and 71.20 years among females; in 2017, these numbers rose to 1,263.76 and 293.10 years, respectively. Time trend analysis revealed that SEYLLp increased more quickly in females (by 8.69 % per year) than in males (by 3.68 %). The ratio of male to female SEYLLp values decreased from 9.18 to 4.31 over the study period. CONCLUSIONS: In Poland, both males and females are experiencing adverse changes in the number of alcohol-induced YLLs. However, the disparity in YLLs between males and females is gradually decreasing, primarily due to the value increasing more quickly in females.

Looking for an explanation for the excessive male mortality in England and Wales since the end of the 19th century.

Several papers have primarily considered a female disadvantage in mortality as something to explain, considering a male disadvantage to be a "natural condition". Even if, due to biological reasons, shorter life expectancy among males has been demonstrated, other factors need to be involved to explain firstly the increasing, and then the decreasing, of the male relative disadvantage over the past century. The principal aim of this paper is to provide a clearer picture of the major age-class and cause-of-death contributions to male excess mortality in England and Wales from 1881 to 2011. Results indicate a clear shift in contributions to the male disadvantage from differences occurring during the first year of life to those occurring in ageing people, and from tuberculosis, respiratory diseases, external causes and perinatal and congenital conditions to neoplasms and circulatory diseases. In contrast, the narrowing of the gap since 1981 seems to be most closely related to the decrease in the male disadvantage in respiratory diseases and to the simultaneous increasing in the female disadvantage in old-age diseases. The most important novelty of this research relates to the method: instead of using ratios to investigate gender differences in health, we use decomposition methods.

[Trends in excess male mortality in the working age population in a region with the highest mortality rates in Poland]. / Trendy nadumieralnosci mezczyzn w wieku produkcyjnym w województwie o najwyzszych wspólczynnikach zgonów w Polsce.

BACKGROUND: The intensity of premature deaths in the Lódz region in 2014 amounted to 40 per 10 000, and was the highest in the country (the average rate for Poland was 32). Excess mortality of men aged <65 continues to be a major medical and social problem. The aim of the study is to analyze time trends of excess male mortality in the working age population in the Lódz region, both in general and due to the most important causes of deaths. MATERIAL AND METHODS: The research material consists of information on 144 589 deaths of the Lódz region inhabitants aged 20-64 in 1999-2014. Crude and standardized mortality rates were calculated, as well as excess male mortality rates both in general and by cause of death. Standardization was carried out using the direct method according to the standard European population. A study of time trends was performed with the use of the joinpoint regression analysis. Average annual percentage rates of changes were estimated. RESULTS: The excess mortality rate of men at the productive age decreased from 2.9 to 2.8 in the Lódz region in 1999-2014. The most important causes of death among men aged 20-64 in 2014 were (rates per 10 000): cardiovascular diseases (19.1), malignant neoplasms (16.6) and external causes of death (12.3). Among women, the most significant were malignant neoplasms (11.1), cardiovascular diseases (5.1) and diseases of the digestive system (2.1). The excess mortality rate of men aged 20-64 in the analyzed period reached the highest values due to external causes of death (5.1-7.3) and cardiovascular diseases (3.0-3.7). The highest rate of the decline in excess male mortality in 1999-2014 was recorded due to malignant neoplasms, on average 1.4% per year (p < 0.05). Meanwhile, the fastest growth concerned external causes of death, on average 1.0% per year (p < 0.05). CONCLUSIONS: Despite the decline in the mortality rates among both sexes, excess male mortality due to external causes of death and cardiovascular diseases increased. Med Pr. 2020;71(3):325-35.

Population ageing in Central and Eastern Europe and its demographic and social context.

The article focuses on several demographic and socio-economic idiosyncrasies in Central and Eastern Europe, which impact the process of population ageing and intergenerational relations. These include the adverse mortality trends and especially the excess male mortality in certain countries, which exacerbated sex differences in life expectancy beyond anything ever recorded in peace-time population history, the combination of natural population decrease and net emigration, the disordered cohort flows and the shorter generational length. The rapid demographic change in these countries coincided with political, economic and social transformations. The shock of the fall of communism affected differently younger people, who could relatively easily reorganize their life cycles so as to adapt to the changed circumstances, and older persons for whom such reorganization was more difficult, or even impossible. This created the possibility for the opening of an intergenerational rift, as older generations felt being the losers of the transition. The article explores the implications of these idiosyncrasies and social context for living arrangements, kin networks, individual wellbeing and inter-generational relations, and identifies areas where particular challenges are likely to be faced when it comes to policies and programs aimed at older persons.