Wilkie, Rachel Z and Ho, Jessica Y (2024) Life expectancy and geographic variation in mortality: an observational comparison study of six high-income Anglophone countries. BMJ Open, 14, (7), e079365. https://doi.org/10.1136/bmjopen-2023-079365.
External website: https://bmjopen.bmj.com/content/14/7/e079365
OBJECTIVE: To compare life expectancy levels and within-country geographic variation in life expectancy across six high-income Anglophone countries between 1990 and 2018.
DESIGN: Demographic analysis using aggregated mortality data. Six high-income Anglophone countries (USA, UK, Canada, Australia, Ireland and New Zealand), by sex, including an analysis of subnational geographic inequality in mortality within each country.
POPULATION: Data come from the Human Mortality Database, the WHO Mortality Database and the vital statistics agencies of six high-income Anglophone countries.
MAIN OUTCOME MEASURES: Life expectancy at birth and age 65; age and cause of death contributions to life expectancy differences between countries; index of dissimilarity for within-country geographic variation in mortality.
RESULTS: Among six high-income Anglophone countries, Australia is the clear best performer in life expectancy at birth, leading its peer countries by 1.26-3.95 years for women and by 0.97-4.88 years for men in 2018. While Australians experience lower mortality across the age range, most of their life expectancy advantage accrues between ages 45 and 84. Australia performs particularly well in terms of mortality from external causes (including drug- and alcohol-related deaths), screenable/treatable cancers, cardiovascular disease and influenza/pneumonia and other respiratory diseases compared with other countries. Considering life expectancy differences across geographic regions within each country, Australia tends to experience the lowest levels of inequality, while Ireland, New Zealand and the USA tend to experience the highest levels.
"Stalled reductions in cardiovascular disease mortality, along with rising drug overdose and mental and nervous system disease mortality, are key contributors to these trends."
CONCLUSIONS: Australia has achieved the highest life expectancy among Anglophone countries and tends to rank well in international comparisons of life expectancy overall. It serves as a potential model for lower-performing countries to follow to reduce premature mortality and inequalities in life expectancy.
B Substances > Alcohol
G Health and disease > Substance use disorder (addiction) > Drug use disorder > Drug intoxication > Poisoning (overdose)
P Demography, epidemiology, and history > Population dynamics
P Demography, epidemiology, and history > Population dynamics > Substance related mortality / death
VA Geographic area > Canada
VA Geographic area > United States
VA Geographic area > Europe > Ireland
VA Geographic area > Europe > United Kingdom
VA Geographic area > Australia and Oceania > Australia
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