Разрыв в ожидаемой продолжительности жизни между мужчинами и женщинами в развитых странах: больше общего или различного?
Аннотация
Разрыв в ожидаемой продолжительности жизни (ОПЖ) мужчин и женщин сокращается во всех развитых странах мира после его роста во второй половине XX века. Исследования, проведенные в Западной Европе и англоязычных странах, показали, что смертность населения в возрастах старше 50 лет от причин, связанных с курением, внесла наибольший вклад в увеличение и последующее уменьшение различий в ОПЖ между полами. Восточноевропейские страны, однако, отличаются высокой избыточной смертностью мужского населения в молодых и средних возрастах, которая не может объясняться только негативными последствиями курения. На основе данных Human Mortality Database мы проследили динамику различий в ОПЖ мужчин и женщин в 41 стране и 7 группах стран с конца 1950-х годов – периода, когда появились доступные данные для стран Восточной Европы. Для оценки вклада возрастов в максимальный разрыв ОПЖ и его последующее сокращение использованы методы пошаговой и контурной декомпозиции. Начало сокращения разрыва в ОПЖ сильно варьируется: от 1969 г. в Великобритании до 2009 г. в Греции. Также изменяется и величина максимального разрыва: в России она составила 13,7 года в 2005 г., в то время как Израиль прошел пик в 1999 г. со значением всего 4,4 года. Между странами существует стабильное во времени различие во вкладе возрастов в разрыв ОПЖ мужчин и женщин. Избыточная мужская смертность в молодых и средних возрастах (20–50 лет) в странах Восточной Европы определяет до 35% всей разницы в ОПЖ мужчин и женщин, в то время как в западноевропейских странах эта величина не превышает 20%. Неоднородность стран по уровню различий в смертности между мужчинами и женщинами добавляет новое измерение к уже известному разрыву в смертности между Востоком и Западом. Особенности страны необходимо учитывать при разработке политики общественного здравоохранения, направленной на сокращение неравенства в продолжительности жизни мужчин и женщин.
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