Life Expectancy

Sex and Gender-based Analysis of this topic

Definition

Life expectancy is the average number of years of life remaining, at birth or at some other age, based on age-specific mortality rates averaged over a number (3, 5 or 10) of previous years [1, 2]. Life expectancy is used in Canada and internationally as a basic measure of health of a population. There are typically two measures used. Life expectancy at birth takes into account the likelihood that in many countries infant mortality rates can be high and many children die before the age of 5. Life expectancy at 65 is an indicator of the health of elderly people in a population and in many ways is a measure of how well societies take care of their older citizens. A further measure used in Canada is Health Adjusted Life Expectancy (HALE), a measure of the quality of life for residents after the age of 65 [3].

 
 
Sex Issues

World-wide, women live longer than men [4]. In 2005, life expectancy at birth for Canadians was 82.7 years for females and 78.0 years for males. Average life expectancy for the entire population is 80.4 years. Two provinces, British Columbia and Ontario, had slightly higher average life expectancies for females at birth: 83.5 years and 82.7 years, respectively. The male-female life expectancy gap was widest in the three territories, with a difference of 6.4 years. The male-female gap in life expectancy at birth was smallest in 2005 in Ontario: 4.2 years [5]. In Canada, life expectancy at 65 in 2005 was 19.6 years; 21.1 years for women and 17.9 years for males. Life expectancy at 65 in that year was highest in British Columbia, followed by Alberta and Ontario [5].

 
 
Gender Issues

Women live longer than men and they live longer now than they ever have before [1]. Women’s longevity, however, is closely related to their socio-economic status. Women’s life expectancy is compromised by low income, reducing their longevity by as much as 5 years [1, 2]. As women overall have a greater burden of chronic disease and disability in their later years, life expectancy and health-adjusted life expectancy are affected by women’s experience of chronic pain [6], chronic diseases [7, 8] , smoking habits [9] and non-clinical factors such as migration [10].

HALE measures demonstrate that living longer is not the same as a healthy end of life. Sex differences in life expectancy close significantly when HALE is measured: 1.7 years for Canada in 2001, (and 2.1 years difference in Manitoba, for example), highlighting the gendered nature of women’s longevity [11].

 
 
Diversity

Canadian women who live in the north have considerably shorter life expectancies in Canada [12], and this is true within provinces as well (Manitoba for example) [2]. Living in rural southern communities is also linked to reduced life expectancy in the Canadian population as a whole [12]. Aboriginal women have life expectancies that are as much as 8 years shorter than their non-Aboriginal counterparts. One study found that on-reserve First Nations women had a life expectancy that was on average 8 years shorter than non-First Nations women in Manitoba [13]. Remote dwelling and access to health care facilities alone did not appear to account for the differences in life expectancy for First Nations women, pointing to the interaction of income, oppression, and other determinants on women’s health and longevity [13].

 
 
Critique

Canadian women live in better health and live longer than women from many other parts of the world, however life expectancy and HALE remain important measures of how well our social and health systems care for the women who live here. Whether longer life expectancy is accompanied by good health and independent functioning among seniors has important implications for health care and social services systems, and for women, who overwhelmingly bear the burden of informal care to seniors. It is therefore important to monitor both life expectancy and Health Adjusted Life Expectancy (HALE) to include consideration of men’s and women’s quality of life, not just the durations of their lives [11].

 
 
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