Why is Life Expectancy in Busan Shorter than in Seoul? Age and Cause-Specific Contributions to the Difference in Life Expectancy between Two Cities

Disability type–specific mortality patterns and life expectancy among disabled people in South Korea using 10-year combined data between 2008 and 2017

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People with any disabilities accounted for a quarter of total deaths.

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People with disabilities had higher average ages and poor economic conditions.

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All disability types presented higher mortality rates and lower life expectancy.

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The major causes of death differed according to the type of disability.

People with disabilities have a higher mortality risk than non-disabled people. However, mortality patterns and life expectancy according to disability types are under-researched. This study investigated the sociodemographic characteristics and compared mortality and life expectancy among people with disabilities according to disability type in Korea using 10-year combined data between 2008 and 2017. The National Health Information Database from the National Health Insurance Service covering the total Korean population between 2008 and 2017 was obtained. This study described the age and income distributions of people with disabilities and calculated the mortality rate, proportional mortality ratio, and life expectancy according to disability type. Most disability subgroups had higher average ages than were found for non-disabled people. The proportion of the bottom 20% household income group was also higher in all types of disabilities than in non-disabled people. The crude mortality rate, age-standardized mortality rate, and life expectancy were all worse in people with all types of disabilities than in their non-disabled counterparts, but variations according to disability type were found. The composition of causes of death also varied across disability types. Although all types of disabilities were associated with higher mortality rates and lower life expectancy, the sociodemographic characteristics and mortality and life expectancy patterns differed across types of disability. People with disabilities experienced various health-related problems and financial burdens. Public assistance needs to be strengthened to guarantee adequate income and health care services for people with disabilities, considering their sociodemographic characteristics and mortality patterns.

Stagnation of life expectancy in Korea in 2018: A cause-specific decomposition analysis

According to the most recent annual report released by Korea Statistics, the life expectancy at birth (for both sexes) in 2018 was 82.7 years, an increase of 0.0 years over 2017, reflecting the first stagnation in life expectancy since 1960. In this study, a time-series analysis was conducted of trends in life expectancy from 2003 to 2018, and causes of death were analyzed using the Kannisto-Thatcher method and the Arriaga decomposition method. The time trend analysis of yearly life expectancy changes indicated that, in Korea, there was a tendency for the yearly increase in life expectancy between 2003 and 2018 to decrease by 0.0211 years per calendar year. The contribution of cardiovascular diseases, the most important contributor to the life expectancy increase in Korea, gradually decreased over this period. The contribution of cardiovascular diseases to the life expectancy increase was 0.506 years in 2003-2006, but this contribution decreased to 0.218 years in 2015-2018. The positive contributions of ill-defined causes and external causes to life expectancy increase detected in previous periods were not evident in 2015-2018. Diseases of the respiratory system made the largest negative contribution both between 2015 and 2018 and between 2017-2018. The life expectancy stagnation in 2018 could be understood as the combined effect of (a) decreasing momentum in the increase of life expectancy and (b) a chance event in 2018 involving life expectancy. Currently, it is difficult to judge whether the stagnation of life expectancy in 2018 is temporary, and further analyses of life expectancy and contributing causes of death in the future are needed.

Age- and cause-specific contributions to the life expectancy gap between Medical Aid recipients and National Health Insurance beneficiaries in Korea, 2008-2017

Recipients of Medical Aid, a government-funded social assistance program for the poor, have a shorter life expectancy than National Health Insurance beneficiaries in Korea. This study aims to explore the contributions of age and major causes of death to the life expectancy difference between the two groups. We used the National Health Information Database provided by the National Health Insurance Service individually linked to mortality registration data of Statistics Korea between 2008 and 2017. Annual abridged life tables were constructed and Arriaga’s life expectancy decomposition method was employed to estimate age- and cause-specific contributions to the life expectancy gap between National Health Insurance beneficiaries and Medical Aid recipients. The life expectancy difference between National Health Insurance beneficiaries and Medical Aid recipients was 14.5 years during the period of 2008–2017. The age groups between 30 and 64 years accounted for 78.7% and 67.5% of the total life expectancy gap in men and women, respectively. Cancer was the leading cause of death contributing to excess mortality among Medical Aid recipients compared to National Health Insurance beneficiaries. More specifically, alcohol-attributable deaths (such as alcoholic liver disease, liver cancer, liver cirrhosis, and alcohol/substance abuse), suicide, and cardiometabolic risk factor–related deaths (such as cerebrovascular disease, ischemic heart disease, and diabetes) were the leading contributors to the life expectancy gap. To decrease excess deaths in Medical Aid recipients and reduce health inequalities, effective policies for tobacco and alcohol regulation, suicide prevention, and interventions to address cardiometabolic risk factors are needed.