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INTRODUCTION Like many developed countries, life expectancy at birth in Australia has improved remarkably over the last 125 years. Significant decreases in death rates, most notably for infants, and changes in the prevalence of disease patterns have contributed to the Australian population living longer than previously recorded. While life expectancy at birth in Australia is at a record high, years gained vary considerably by age, sex, time period and state and territory. This article investigates improvements in life expectancy estimates over time by age, sex and geography using ABS data. Changes in death rates and disease patterns over the century are then used to support the analysis. TOTAL GAINS IN LIFE EXPECTANCY AT BIRTH Life expectancy estimates presented in this article have been taken from life tables produced by the ABS between 1890 and 2015. A person born in 2015 is expected to live between 33.2 years and 33.7 years longer than someone born in 1890. Life expectancy increased from 47.2 years to 80.4 years for males and from 50.8 years to 84.5 years for females. While overall life expectancy has improved, gains have not occurred equally across selected time periods (Table 1). Table 1: Total and average life expectancy gain, 1890–2015, Australia(a)
The highest gains in life expectancy at birth were recorded during 1890-1910 and 1910-1934, when both males and females gained a total of 8.0 years of life. Considering the past 125 years, the highest average yearly gain of 0.4 years occurred in 1890-1910. Following this period, males and females maintained their total gains in life expectancy until 1934-1955, whereby gains subsequently decreased from 8.3 years to 3.7 years for males, and from 8.3 years to 5.6 years for females. Gains in life expectancy continued to decline during 1955-1977, with total gains decreasing from 3.7 years to 2.4 years for males and from 5.6 years to 3.8 for females. Over this period, causes of deaths from cardiovascular disease (including ischaemic heart disease and stroke) and lung cancer peaked, which largely contributed to the slowing of gains in life expectancy (Endnote 1). Major contributing factors to the rise of cardiovascular disease and lung cancer include: high blood pressure, elevated cholesterol in the blood, dietary factors (especially dietary saturated fat and salt) and smoking (Endnote 2).
Improvements in life expectancy for males rebounded after the post-war period, with total gains rising from 2.4 years in 1955-1977 to 6.0 years in 1977-1997. Gains for females only slightly increased from 3.8 to 4.7 years over the same period. Larger gains in life expectancy estimates for males and females in the latter half of the 20th century have been attributed to the decline in deaths from heart disease and lung cancer in males, partly as a result of social and lifestyle factors such as improved diet and anti-smoking initiatives, as well as prevention strategies and advanced medical treatment of cardiovascular conditions (Endnote 2). LIFE EXPECTANCY GAINS BY AGE One of the most notable features of 20th century death rates is the changing age at which deaths were occurring. These changes were largest for children and the elderly. In the first half of the century, the largest gains were made in reducing the death rates of infants, children aged less than 5 years, and young women of child bearing age. Conversely, in the second half of the century, death rates among older persons declined the most (Endnote 3). Infants During 1890 to 2015, life expectancy improved at all ages. However, lower death rates for infants contributed the most to the improvements. Male infants contributed 40.2% to life expectancy gain over this period and female infants, 28.2% (Tables 1 and 2 in the Appendix). From 1997 to 2015, these contributions had decreased to 4.2% for males and 4.4% for females. This shift reflects the decline in infant mortality rates in Australia over the past 125 years. Infant deaths decreased from 105 deaths per 1,000 live births in 1901 to 3.2 deaths per 1,000 live births in 2015. These declines in infant mortality rates have been linked to the development of vaccines and ensuing programs of mass vaccination, effective use of antibiotics, and improvements in public sanitation and health education (Endnote 4). These led to lower mortality from gastroenteritis and other infections in the first half of the century. Improvements in neonatal care in the 1970s also played a major role in the continued decline in infant mortality (Endnote 5). People aged 65 years and over As a consequence of an ageing population and improvements in social, economic and living standards, there has been a major shift in causes of death from infectious diseases to chronic diseases within older age groups over the century (Endnote 2). This has resulted in larger gains in life expectancy over time for people aged 65 years and over. From 1890 to 2015, males aged 65 years and over shared 5.3% of total male life expectancy gain, which accelerated to 59.4% during 1997 to 2015. Similarly, the gain in life expectancy for females aged 65 years and over increased from 13.0% during 1890 to 2015 to 68.2% by 1997 to 2015. Footnote(s): (a) See Tables 1 and 2 in Appendix for data tables with more age groups. Source(s): Life Tables, States, Territories and Australia 3302.0.55.001 LIFE EXPECTANCY GAINS BY STATE AND TERRITORY Improvements in life expectancy occurred in all states and territories. The largest improvement in life expectancy occurred in the Northern Territory, where males gained 7.2 years and females 4.5 years between 1995 and 2015. However, this improvement was off a low base, and the Northern Territory continues to have the lowest life expectancy of all states and territories. Conversely, both males and females in Tasmania experienced the lowest gains of 4.9 years and 2.9 years respectively. Males and females aged 65 years and over contributed the most gain in life expectancy across all states and territories – reflecting the national trends in the shifting contribution of life expectancy gain from infants to persons aged 65 years and over. In the Northern Territory, improvement in life expectancy for female infants was greater than for male infants (11.1% compared with 6.4% - Tables 3 and 4 in the Appendix). Footnote(s): (a) See Tables 3 and 4 in Appendix for data tables with more states. Source(s): Life Tables. States, Territories and Australia 3302.55.001 INTERNATIONAL COMPARISONS Australia has the third highest male and female combined life expectancy in the world, according to the United Nations - only Japan and Switzerland having higher life expectancies than Australia. Australia’s male life expectancy is ranked third and female sixth in the world. Table 2: Life expectancy estimates at birth by sex, top 7 countries in the world(a), 2010-2015
Source: For all countries excluding Australia, see United Nations World Population Prospects: The 2017 Revision (estimates), last viewed 20 September 2017. ENDNOTES 1. Magnus, P., Sadkowsky, K (2006). 'Mortality over the twentieth century in Australia: Trends and patterns in major causes of death'. Mortality surveillance series no. 4. Cat. no. PHE 73. Canberra. Australian Institute of Health and Welfare. <http://www.aihw.gov.au>
2. AIHW (2000). 'Changes in Australia’s disease profile: a view of the twentieth century'. Australian’s Health 2000. Australia’s Health no. 7. Cat. no. AUS 19. Canberra. Australian Institute of Health and Welfare. <www.aihw.gov.au>
3. ABS (2001). 'Mortality and Morbidity: Mortality in the 20th century'. Australian Social Trends (cat. no. 4102.0). Canberra. Australian Bureau of Statistics. <www.abs.gov.au> 4. Stanley, F.J. (2001). 'Child health since federation'. ABS Year Book Australia 2001 (cat. no. 1301.0). Canberra. Australian Bureau of Statistics. <www.abs.gov.au> 5. ABS (2002). 'Mortality and Morbidity: Infant mortality'. Australian Social Trends (cat. no. 4102.0). Canberra. Australian Bureau of Statistics. <www.abs.gov.au>
Table 2: Percentage of life expectancy gain by age, females – Australia
Table 3: Percentage of life expectancy gain by state and territory, males –1995-2015(a)
Table 4: Percentage of life expectancy gain by state and territory, females –1995-2015(a)
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