How Cause-Specific Mortality Contributes to Sex Differences in Life Expectancy over Time. Trends in Utah and Denmark

Female life expectancy exceeds male life expectancy. To better understand the basis for this discrepancy, we use Arriaga decomposition methods to examine differences in life expectancy by exploring age-specific and cause-specific mortality differences between the sexes and how these differences arise over time and between two distinct populations, Denmark and Utah (U.S.). Our focus is on how specific causes point to shifts in secular circumstances and behavioral factors that help to explain female-male differences in mortality across these two populations. Our findings point to the prominence of cardiovascular mortality as a key contributor to the female advantage in life expectancy for both Denmark and Utah but its influence is waning. External causes of mortality, including suicide and homicides along with motor vehicle accidents, also have large effects for both locales despite differences in lifestyles and policies. Cancer mortality in younger reproductive ages slightly subtract from the female life expectancy advantage. Overall, if the objective is to reduce sex differences in life expectancy, achieving this goal can be aided by promoting policies that reduce overall mortality but also mortality from key causes of death that are the basis for these discrepancies.