Decomposition of age- and cause-specific adult mortality contributions to the gender gap in life expectancy from census and survey data in Zambia

摘要

In the context of high adult mortality and an immense impact on the health burden of Zambia, a decomposition analysis of age- and cause-specific mortality in age group 15–59 was performed to determine the contributions to the gap in life expectancy at birth between males and females. Previous studies on decomposition have examined income groups, ethnicity, and regional differences’ contributions to gaps in life expectancy, but not the adult mortality age group 15–59. These studies focus on developed countries and few on developing countries. Arriaga’s decomposition method was applied to 2010 census and 2010–2012 sample vital registration with verbal autopsy survey (SAVVY) data to decompose contributions of age- and cause-specific adult mortality to the gap in life expectancy at birth between males and females. The decomposition analysis revealed that mortality was higher among males than females and concentrated in age groups 20–49. Age- and cause-specific adult mortality contributed positively, 50% of the years to the gap in life expectancy at birth between males and females. Major cause-specific mortality contributors to the gap in life expectancy were infectious and parasitic diseases (1.17 years, 26.3%), accidents and injuries (0.54 years, 12.2%), suicide and violence (0.30 years, 6.8%). Female HIV mortality offset male mortality. Neoplasms deaths among females contributed negatively to the gap in life expectancy (-0.22 years, -5.4%). Accidents, injuries, suicide, and violence are emerging major causes of death in age group 20–49 in Zambia which health policy and programmes should target. Highlights ? Adult mortality contributed half of the years to the gender gap in life expectancy at birth. ? Male mortality in age group 20–49 years contributed most to the gender difference in life expectancy at birth. ? Accidents and injuries, and suicide and violence among males were major positive contributors to the gender gap in life expectancy at birth. ? Female HIV mortality offset male mortality and contributed negatively to the gender life expectancy gap.