The triple burden of communicable and non-communicable diseases and injuries on sex differences in life expectancy in Ethiopia

Myunggu Jung; Gizachew Balew Jembere; Young Su Park; William Muhwava; Yeohee Choi; Youngtae Cho; Woorim Ko

doi:10.1186/s12939-021-01516-0

The triple burden of communicable and non-communicable diseases and injuries on sex differences in life expectancy in Ethiopia

Int J Equity Health. 2021 Aug 3;20(1):180. doi: 10.1186/s12939-021-01516-0.

Authors

Myunggu Jung¹, Gizachew Balew Jembere², Young Su Park³, William Muhwava⁴, Yeohee Choi⁵, Youngtae Cho⁶, Woorim Ko⁷

Affiliations

¹ Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK.
² EngenderHealth-Ethiopia, Addis Ababa, Ethiopia.
³ Center for Arts and Humanities, Haverford College, Haverford, PA, USA.
⁴ African Centre for Statistics, United Nations Economic Commission for Africa, Addis Ababa, Ethiopia.
⁵ Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, South Korea.
⁶ Institute of Environment and Health, Population Policy Research Center, Seoul National University, Seoul, South Korea.
⁷ Institute of Environment and Health, Population Policy Research Center, Seoul National University, Seoul, South Korea. reako@snu.ac.kr.

Abstract

Background: Ethiopia has experienced great improvements in life expectancy (LE) at birth over the last three decades. Despite consistent increases in LE for both males and females in Ethiopia, the country has simultaneously witnessed an increasing discrepancy in LE between males and females.

Methods: This study used Pollard's actuarial method of decomposing LE to compare age- and cause- specific contributions to changes in sex differences in LE between 1995 and 2015 in Ethiopia.

Results: Life expectancy at birth in Ethiopia increased for both males and females from 48.28 years and 50.12 years in 1995 to 65.59 years and 69.11 years in 2015, respectively. However, the sex differences in LE at birth also increased from 1.85 years in 1995 to 3.51 years in 2015. Decomposition analysis shows that the higher male mortality was consistently due to injuries and respiratory infections, which contributed to 1.57 out of 1.85 years in 1995 and 1.62 out of 3.51 years in 2015 of the sex differences in LE. Increased male mortality from non-communicable diseases (NCDs) also contributed to the increased difference in LE between males and females over the period, accounting for 0.21 out of 1.85 years and 1.05 out of 3.51 years in 1995 and 2015, respectively.

Conclusions: While injuries and respiratory infections causing male mortality were the most consistent causes of the sex differences in LE in Ethiopia, morality from NCDs is the main cause of the recent increasing differences in LE between males and females. However, unlike the higher exposure of males to death from injuries due to road traffic injuries or interpersonal violence, to what extent sex differences are caused by the higher male mortality compared to female mortality from respiratory infection diseases is unclear. Similarly, despite Ethiopia's weak social security system, an explanation for the increased sex differences after the age of 40 years due to either longer female LE or reduced male LE should be further investigated.

Keywords: Decomposition; Ethiopia; Life expectancy; Life table; Sex differences in life expectancy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Child
Child, Preschool
Communicable Diseases* / epidemiology
Ethiopia / epidemiology
Female
Health Status Disparities*
Humans
Infant
Infant, Newborn
Life Expectancy* / trends
Male
Middle Aged
Noncommunicable Diseases* / epidemiology
Sex Distribution
Wounds and Injuries* / epidemiology
Young Adult