Changing life expectancy in European countries 1990–2021: a subanalysis of causes and risk factors from the Global Burden of Disease Study 2021
Abstrak
Summary: Background: Decades of steady improvements in life expectancy in Europe slowed down from around 2011, well before the COVID-19 pandemic, for reasons which remain disputed. We aimed to assess how changes in risk factors and cause-specific death rates in different European countries related to changes in life expectancy in those countries before and during the COVID-19 pandemic. Methods: We used data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to compare changes in life expectancy at birth, causes of death, and population exposure to risk factors in 16 European Economic Area countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden) and the four UK nations (England, Northern Ireland, Scotland, and Wales) for three time periods: 1990–2011, 2011–19, and 2019–21. Changes in life expectancy and causes of death were estimated with an established life expectancy cause-specific decomposition method, and compared with summary exposure values of risk factors for the major causes of death influencing life expectancy. Findings: All countries showed mean annual improvements in life expectancy in both 1990–2011 (overall mean 0·23 years [95% uncertainty interval [UI] 0·23 to 0·24]) and 2011–19 (overall mean 0·15 years [0·13 to 0·16]). The rate of improvement was lower in 2011–19 than in 1990–2011 in all countries except for Norway, where the mean annual increase in life expectancy rose from 0·21 years (95% UI 0·20 to 0·22) in 1990–2011 to 0·23 years (0·21 to 0·26) in 2011–19 (difference of 0·03 years). In other countries, the difference in mean annual improvement between these periods ranged from –0·01 years in Iceland (0·19 years [95% UI 0·16 to 0·21] vs 0·18 years [0·09 to 0·26]), to –0·18 years in England (0·25 years [0·24 to 0·25] vs 0·07 years [0·06 to 0·08]). In 2019–21, there was an overall decrease in mean annual life expectancy across all countries (overall mean –0·18 years [95% UI –0·22 to –0·13]), with all countries having an absolute fall in life expectancy except for Ireland, Iceland, Sweden, Norway, and Denmark, which showed marginal improvement in life expectancy, and Belgium, which showed no change in life expectancy. Across countries, the causes of death responsible for the largest improvements in life expectancy from 1990 to 2011 were cardiovascular diseases and neoplasms. Deaths from cardiovascular diseases were the primary driver of reductions in life expectancy improvements during 2011–19, and deaths from respiratory infections and other COVID-19 pandemic-related outcomes were responsible for the decreases in life expectancy during 2019–21. Deaths from cardiovascular diseases and neoplasms in 2019 were attributable to high systolic blood pressure, dietary risks, tobacco smoke, high LDL cholesterol, high BMI, occupational risks, high alcohol use, and other risks including low physical activity. Exposure to these major risk factors differed by country, with trends of increasing exposure to high BMI and decreasing exposure to tobacco smoke observed in all countries during 1990–2021. Interpretation: The countries that best maintained improvements in life expectancy after 2011 (Norway, Iceland, Belgium, Denmark, and Sweden) did so through better maintenance of reductions in mortality from cardiovascular diseases and neoplasms, underpinned by decreased exposures to major risks, possibly mitigated by government policies. The continued improvements in life expectancy in five countries during 2019–21 indicate that these countries were better prepared to withstand the COVID-19 pandemic. By contrast, countries with the greatest slowdown in life expectancy improvements after 2011 went on to have some of the largest decreases in life expectancy in 2019–21. These findings suggest that government policies that improve population health also build resilience to future shocks. Such policies include reducing population exposure to major upstream risks for cardiovascular diseases and neoplasms, such as harmful diets and low physical activity, tackling the commercial determinants of poor health, and ensuring access to affordable health services. Funding: Gates Foundation.
Topik & Kata Kunci
Penulis (617)
Nicholas Steel
Clarissa Maria Mercedes Bauer-Staeb
John A Ford
Cristiana Abbafati
Mohammed Altigani Abdalla
Atef Abdelkader
Parsa Abdi
Roberto Ariel Abeldaño Zuñiga
Olugbenga Olusola Abiodun
Hassan Abolhassani
Eman Abu-Gharbieh
Hana J Abukhadijah
Ahmed Abu-Zaid
Isaac Yeboah Addo
Giovanni Addolorato
Victor Adekanmbi
Juliana Bunmi Adetunji
Temitayo Esther Adeyeoluwa
Emilie E Agardh
Williams Agyemang-Duah
Danish Ahmad
Anisuddin Ahmed
Ayman Ahmed
Syed Anees Ahmed
Karolina Akinosoglou
Mohammed Ahmed Akkaif
Salah Al Awaidy
Syed Mahfuz Al Hasan
Omar Ali Mohammed Al Zaabi
Robert W Aldridge
Abdelazeem M Algammal
Adel Ali Saeed Al-Gheethi
Abid Ali
Mohammed Usman Ali
Syed Shujait Ali
Waad Ali
Gianfranco Alicandro
Sheikh Mohammad Alif
Adel Al-Jumaily
Peter Allebeck
Ahmad Alrawashdeh
Rami H Al-Rifai
Mohammed A Alsabri
Najim Z Alshahrani
Deborah Oyine Aluh
Mohammad Al-Wardat
Walid A Al-Zyoud
Sohrab Amiri
Deanna Anderlini
Catalina Liliana Andrei
Abhishek Anil
Saeid Anvari
Anayochukwu Edward Anyasodor
Seth Christopher Yaw Appiah
Michele Aquilano
Jalal Arabloo
Mosab Arafat
Demelash Areda
Abdulfatai Aremu
Keivan Armani
Benedetta Armocida
Johan Ärnlöv
Muhammad Asaduzzaman
Thomas Astell-Burt
Avinash Aujayeb
Marcel Ausloos
Sina Azadnajafabad
Shahkaar Aziz
Ahmed Y Azzam
Giridhara Rathnaiah Babu
Andreea Corina Badache
Ashish D Badiye
Saeed Bahramian
Atif Amin Baig
Jennifer L Baker
Hansi Bansal
Till Winfried Bärnighausen
Mark Thomaz Ugliara Barone
Amadou Barrow
Sandra Barteit
Shahid Bashir
Hameed Akande Bashiru
João Diogo Basso
Mohammad-Mahdi Bastan
Sanjay Basu
Kavita Batra
Matteo Bauckneht
Bernhard T Baune
Massimiliano Beghi
Maryam Beiranvand
Yannick Béjot
Michelle L Bell
Olorunjuwon Omolaja Bello
Luis Belo
Apostolos Beloukas
Alice A Beneke
Paulo J G Bettencourt
Akshaya Srikanth Bhagavathula
Neeraj Bhala
Sonu Bhaskar
Francesca Bisulli
Tone Bjørge
Aadam Olalekan Bodunrin
Alejandro Botero Carvajal
Souad Bouaoud
Carol Brayne
Hermann Brenner
Adam D M Briggs
Nikolay Ivanovich Briko
Raffaele Bugiardini
Danilo Buonsenso
Reinhard Busse
Yasser Bustanji
Florentino Luciano Caetano dos Santos
Mehtap Çakmak Barsbay
Angelo Capodici
Giulia Carreras
Andrea Carugno
Felix Carvalho
Márcia Carvalho
Joao Mauricio Castaldelli-Maia
Giulio Castelpietra
Alberico L Catapano
Maria Sofia Cattaruzza
Luca Cegolon
Edina Cenko
Ester Cerin
Sonia Cerrai
Anis Ahmad Chaudhary
Bryan Chong
Sonali Gajanan Choudhari
Dinh-Toi Chu
Isaac Sunday Chukwu
Sheng-Chia Chung
Iolanda Cioffi
Joao Conde
Samuele Cortese
Rosa A S Couto
Michael H Criqui
Natalia Cruz-Martins
Omid Dadras
Mary Anne Teresa Dallat
Emanuele D'Amico
Lucio D'Anna
Samuel Demissie Darcho
Paul I Dargan
Saswati Das
Alejandro de la Torre-Luque
Cristian Del Bo'
Andreas K Demetriades
Nikolaos Dervenis
Brecht Devleesschauwer
Arkadeep Dhali
Kuldeep Dhama
Mostafa Dianatinasab
Michael J Diaz
Deepa Dongarwar
Mario D'Oria
Ojas Prakashbhai Doshi
Robert Kokou Dowou
Senbagam Duraisamy
Oyewole Christopher Durojaiye
Arkadiusz Marian Dziedzic
David Edvardsson
Kristina Edvardsson
Terje Andreas Eikemo
Michael Ekholuenetale
Temitope Cyrus Ekundayo
Rabie Adel El Arab
Frank J Elgar
Muhammed Elhadi
Chadi Eltaha
Francesco Esposito
Natalia Fabin
Adeniyi Francis Fagbamigbe
Omotayo Francis Fagbule
Aliasghar Fakhri-Demeshghieh
Luca Falzone
Carla Sofia e Sá Farinha
Pawan Sirwan Faris
Folorunso Oludayo Fasina
Patrick Fazeli
Timur Fazylov
Alireza Feizkhah
Ginenus Fekadu
Xiaoqi Feng
Seyed-Mohammad Fereshtehnejad
Daniela Ferrante
Pietro Ferrara
Nuno Ferreira
Getahun Fetensa
Florian Fischer
Marco Fonzo
Arianna Fornari
Daniela Fortuna
Celia Fortuna Rodrigues
Matteo Foschi
Sebastian S Fox
Alberto Freitas
Takeshi Fukumoto
Muktar A Gadanya
Silvano Gallus
Lucia Galluzzo
Balasankar Ganesan
Mohammad Arfat Ganiyani
Xiang Gao
MA Garcia-Gordillo
Federica Gazzelloni
Miglas Welay Gebregergis
Teferi Gebru Gebremeskel
Delaram J Ghadimi
Khalid Yaser Ghailan
Nermin Ghith
Ehsan Gholami
Alessandro Gialluisi
Paramjit Singh Gill
Tara Gillam
Giorgia Giussani
James C Glasbey
Scott D Glenn
Laszlo Göbölös
Mohamad Goldust
Mahaveer Golechha
Pouya Goleij
Davide Golinelli
Giuseppe Gorini
Simon Matthew Graham
Robert Griebler
Ashna Grover
Stefano Guicciardi
Sasidhar Gunturu
Vijai Kumar Gupta
Roberth Steven Gutiérrez-Murillo
Awoke Derbie Habteyohannes
Nils Haep
Nguyen Hai Nam
Sebastian Haller
Rifat Hamoudi
Senad Handanagic
Josep Maria Haro
Hamidreza Hasani
Md Saquib Hasnain
Rasmus J Havmoeller
Simon I Hay
Jeffrey J Hebert
Behzad Heibati
Henk B M Hilderink
Yuta Hiraike
Nguyen Quoc Hoan
Mehdi Hosseinzadeh
Sorin Hostiuc
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Junjie Huang
Andrew Hughes
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Sheikh Mohammed Shariful Islam
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Dler H Hussein Kadir
Rajesh Kamath
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Neeti Kapoor
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Ibraheem M Karaye
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Faham Khamesipour
Ajmal Khan
Shaghayegh Khanmohammadi
Khaled Khatab
Moawiah Mohammad Khatatbeh
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Majid Khosravi
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Min Seo Kim
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Sezer Kisa
Ann Kristin Skrindo Knudsen
Gerbrand Koren
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Ilari Kuitunen
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Carlo La Vecchia
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Tea Lallukka
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Berthold Langguth
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Wei-Chen Lee
Daniel Lindholm
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José Francisco López-Gil
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Alessandra Lugo
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Medha Mathur
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Soroush Najdaghi
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Pavanchand H Shetty
Premalatha K Shetty
Mika Shigematsu
Aminu Shittu
Ivy Shiue
Seyed Afshin Shorofi
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Roman Shrestha
Emmanuel Edwar Siddig
João Pedro Silva
Luís Manuel Lopes Rodrigues Silva
Soraia Silva
Puneetpal Singh
Surjit Singh
Jussi O T Sipilä
Anna Aleksandrovna Skryabina
Anton Sokhan
Soroush Soraneh
Joan B Soriano
Ireneous N Soyiri
Michael Spartalis
Paschalis Steiropoulos
Leo Stockfelt
Jing Sun
Johan Sundström
David Sunkersing
Katharina S Sunnerhagen
Chandan Kumar Swain
Lukasz Szarpak
Sree Sudha T Y
Payam Tabaee Damavandi
Rafael Tabarés-Seisdedos
Seyyed Mohammad Tabatabaei
Celine Tabche
Ramin Tabibi
Jabeen Taiba
Manoj Tanwar
Nathan Y Tat
Nuno Taveira
Mohamad-Hani Temsah
Rasiah Thayakaran
Tenaw Yimer Tiruye
Mathilde Touvier
Marcos Roberto Tovani-Palone
Jasmine T Tran
Ngoc Ha Tran
Thang Huu Tran
Domenico Trico
Samuel Joseph Tromans
Evangelia Eirini Tsermpini
Lorainne Tudor Car
Munkhtuya Tumurkhuu
Saeed Ullah
Brigid Unim
Asokan Govindaraj Vaithinathan
Mario Valenti
Jef Van den Eynde
Orsolya Varga
Tommi Juhani Vasankari
Balachandar Vellingiri
Massimiliano Veroux
Dominique Vervoort
Jorge Hugo Villafañe
Francesco S Violante
Giuseppe Vizzielli
Alice Vodden
Stein Emil Vollset
Theo Vos
Hatem A Wafa
Yanzhong Wang
Emebet Gashaw Wassie
Kosala Gayan Weerakoon
Ronny Westerman
Nuwan Darshana Wickramasinghe
Peter Willeit
Marcin W Wojewodzic
Axel Walter Wolf
Charles D A Wolfe
Grant M A Wyper
Xiaoyue Xu
Yuichi Yasufuku
Sanni Yaya
Saber Yezli
Arzu YiÄŸit
Dong Keon Yon
Chuanhua Yu
Fathiah Zakham
Aurora Zanghì
Michael Zastrozhin
Mohammed G M Zeariya
Liqun Zhang
Zhiqiang Zhang
Claire Chenwen Zhong
Bin Zhu
Makan Ziafati
Magdalena Zielińska
Elric Zweck
Sa'ed H Zyoud
John N Newton
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Cek di sumber asli →- Tahun Terbit
- 2025
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- DOI
- 10.1016/S2468-2667(25)00009-X
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