The contribution of rectangularization to the secular increase of life expectancy: an empirical study.

TitreThe contribution of rectangularization to the secular increase of life expectancy: an empirical study.
Publication TypeJournal Article
Year of Publication2013
AuthorsRossi, IA, Rousson, V, Paccaud, F
JournalInt J Epidemiol
Date Published2013 Feb
Mots-clésAge Factors, Aged, Aged, 80 and over, Cause of Death, Europe, Female, Humans, Incidence, Life Expectancy, Life Tables, Longevity, Male, Middle Aged, Mortality, Sex Factors, Smoking, Survival, Survival Analysis

BACKGROUND: In low-mortality countries, life expectancy is increasing steadily. This increase can be disentangled into two separate components: the delayed incidence of death (i.e. the rectangularization of the survival curve) and the shift of maximal age at death to the right (i.e. the extension of longevity).

METHODS: We studied the secular increase of life expectancy at age 50 in nine European countries between 1922 and 2006. The respective contributions of rectangularization and longevity to increasing life expectancy are quantified with a specific tool.

RESULTS: For men, an acceleration of rectangularization was observed in the 1980s in all nine countries, whereas a deceleration occurred among women in six countries in the 1960s. These diverging trends are likely to reflect the gender-specific trends in smoking. As for longevity, the extension was steady from 1922 in both genders in almost all countries. The gain of years due to longevity extension exceeded the gain due to rectangularization. This predominance over rectangularization was still observed during the most recent decades.

CONCLUSIONS: Disentangling life expectancy into components offers new insights into the underlying mechanisms and possible determinants. Rectangularization mainly reflects the secular changes of the known determinants of early mortality, including smoking. Explaining the increase of maximal age at death is a more complex challenge. It might be related to slow and lifelong changes in the socio-economic environment and lifestyles as well as population composition. The still increasing longevity does not suggest that we are approaching any upper limit of human longevity.

Alternate URL

Alternate JournalInt J Epidemiol
Citation Key / SERVAL ID3369
PubMed ID23264509


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