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International Journal for Equity in Health

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Open Access 01-12-2024 | Research

Unpacking occupational and sex divides to understand the moderate progress in life expectancy in recent years (France, 2010’s)

Authors: Ophélie Merville, Florian Bonnet, Guy Launoy, Carlo Giovanni Camarda, Emmanuelle Cambois

Published in: International Journal for Equity in Health | Issue 1/2024

Abstract

Purpose

The growth in life expectancy (LE) slows down recently in several high-income countries. Among the underlying dynamics, uneven progress in LE across social groups has been pointed out. However, these dynamics has not been extensively studied, partly due to data limitations. In this paper, we explore this area for the 2010 decade using recent French data.

Methods

We utilize the recent change in French census mortality follow-up data (EDP) and apply P-spline models to estimate LEs across five occupational classes (OCs) and indicators of lifespan heterogeneity (edagger) within these OCs, for seven triennial periods (2011-2013 to 2017-2019).

Results

First, we found a similar ranking of OCs along the LE gradient over time and across sexes, from manual workers to higher-level OCs. Noteworthy, the lowest LE in women overlaps with the highest one in men drawing a sex-OC gradient. Second, we observe varying progress of LEs. In women, LE increases in higher-level OCs meanwhile it levels off in manual workers, so that the OCs gap widens (up to 3.4 years in 2017-2019). Conversely, in men LE stalls in higher-level OCs and increases in manual workers so that the gap, which is much larger than in women (+5.7 years in 2017-2019), is tending to narrow. Finally, the lifespan homogenizes in OCs only when LE is low.

Conclusion

Overall, the limited LE progress in France results from LE stalling in the middle of the sex-OC gradient, though LE increases at both ends. At the lower end, LE progress and lifespan homogenization suggest that laggards benefit recently improvements achieved earlier in other OCs. At the upper end, LE progress may come from a vanguard group within higher-lever OC, benefiting new sources of improvements. These findings underscore the need for further research to explore the diverse mortality dynamics coexisting in the current health landscape.

Available only for authorised users

The sample size increased in 2008 from 1% to 4% of the population. Our first year of estimates should ideally start from 2012 to fully benefit from the sample increase (with a setback in 2008-2012 ACSs). We included data from 2011 without significantly affecting the number of individuals.

For further details on data organization, please refer to Supplementary Materials A.1.

ESCO is the classification of European Skills, Competences, and Occupations. Classification versions can be downloaded from https://esco.ec.europa.eu/en.

Table B.1 in Supplementary Materials B presents population and death counts by sex for each 3-year period.

Table B.2 in Supplementary Materials B presents population (individuals and person-years) and death counts by sex and OC for the period 2017–2019, both with and without sample weights.

Table B.3 in Supplementary materials B. \(LE_{35}\) for manual workers is 0.7 year lower when reintegrating the currently inactive: this value is smaller than the change over time which was estimated for this OCs)

Data accessible via https://www.insee.fr/fr/statistiques/6327207

Figures B1 and B2 (found in Supplementary Materials B) replicate this figure, presenting data for men and women across different 3-year periods.

Detailed values can be found in Table B.4 (Supplementary Materials B) for \(LE_{35}\) and in Supplementary Materials C for LE at all ages between 35 and 100.

Figure B3 (Supplementary Materials B) presents the trends of \(ed_{35}\) by OC over the decade (point estimates and 95% CI) for each sex. We provide detailed values for \(ed_{35}\) in Supplementary Materials C

Figure B3 (Supplementary Materials B) presents the trends of ed35 by OC over the decade (point estimates and 95% CI).

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Title: Unpacking occupational and sex divides to understand the moderate progress in life expectancy in recent years (France, 2010’s)
Authors: Ophélie Merville
Florian Bonnet
Guy Launoy
Carlo Giovanni Camarda
Emmanuelle Cambois
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: International Journal for Equity in Health / Issue 1/2024
Electronic ISSN: 1475-9276
DOI: https://doi.org/10.1186/s12939-024-02310-4

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Abstract

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