Max Planck Institute for Demographic Research, Rostock, Germany,
Demography. 2014 Feb;51(1):73-95. doi: 10.1007/s13524-013-0253-x.
Cross-sectional analyses of adult lifespan variation have found an inverse association between socioeconomic position and lifespan variation, but the trends by social class are unknown. We investigated trends in lifespan variation over four decades (1971-2010) by occupational social class (manual, lower nonmanual, upper nonmanual, other) using Finnish register data. We performed age and cause-of-death decompositions of lifespan variation for each sex (a) by occupational class over time and (b) between occupational classes at a shared level of life expectancy. Although life expectancy increased in all classes, lifespan variation was stable among manual workers and decreased only among nonmanual classes. These differences were caused by early-adult mortality: older-age lifespan variation declined for all the classes, but variation in early-adult mortality increased for all classes except the highest. The manual class's high and stagnant lifespan variation was driven by declines in circulatory diseases that were equally spread over early mortality-compressing and older mortality-expanding ages, as well as by high early-adult mortality from external causes. Results were similar for men and women. The results of this study, which is the first to document trends in lifespan variation by social class, suggest that mortality compression is compatible with increasing life expectancy but currently achieved only by higher occupational classes.
横断面分析成年人寿命变化发现,社会经济地位与寿命变化呈负相关,但社会阶层的趋势尚不清楚。我们使用芬兰登记数据,调查了四个十年(1971-2010 年)期间职业社会阶层(体力劳动者、低级非体力劳动者、高级非体力劳动者、其他)对寿命变化的趋势。我们按性别进行了(a)随时间推移的职业阶层和(b)在共享预期寿命水平上的职业阶层之间的寿命变化的年龄和死因分解。尽管所有阶层的预期寿命都在增加,但体力劳动者的寿命变化保持稳定,只有非体力劳动者的寿命变化在减少。这些差异是由成年早期死亡率造成的:所有阶层的老年寿命变化都在下降,但所有阶层的成年早期死亡率变化都在增加,除了最高阶层。体力劳动者阶层的高且稳定的寿命变化是由循环系统疾病的下降驱动的,这些疾病在早期死亡率压缩和老年死亡率扩大的年龄阶段都得到了同等的分布,同时也受到外部原因导致的高早期死亡率的影响。男性和女性的结果相似。本研究首次记录了社会阶层对寿命变化的趋势,结果表明,死亡率的压缩与预期寿命的延长是一致的,但目前只有较高的职业阶层才能实现。