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« Mortality and causes of death »

Modified on 2015/05/26 09:54 by Sean Zheng Paths: Read in Order Categorized as Chapter 2 - Health
Table II.28

From gender issues to gender statistics on mortality and causes of death: illustrative examples


Policy-relevant questions Data needed Sources of data
Do women or men have a longer life expectancy? Do adult women have the same mortality risk as adult men? Deaths by sex and age.



Population by sex and age.
Civil registration systems. Population censuses or demographic and health surveys.

Population censuses combined with civil registration systems and/or household surveys.
Population registers.
Are adult women more likely or less likely than adult men to die of communicable diseases or as a result of any other cause of death? Deaths by sex, age and cause of death.


Population by sex and age.
Civil registration systems.
Health administrative records.

Population censuses combined with civil registration systems and/or household surveys.
Population registers.
Do main causes of death rank the same for women and for men? Deaths by sex and cause of death. Civil registration systems.
Health administrative records.
What types of cancer cause the highest number of deaths among women? Among men? Deaths by sex and cause of death. Civil registration systems.
Health administrative records.

  • + Gender issues
    • Women tend to live longer than men. Sex differences in life expectancy, although always in favour of women, vary in magnitude across countries and reflect a combination of biological factors, on the one hand, and social and economic factors, on the other. The female advantage is lower in countries with high mortality overall (United Nations, 2000, 2010). In particular, countries with a high level of maternal mortality and a high prevalence of HIV/AIDS see a smaller difference between female and male life expectancy. A smaller difference in life expectancy may also be observed in countries where girls and women have a lower status and suffer from discrimination and abuse. By comparison, in countries with low levels of mortality, women have a considerable biological advantage, with women’s life expectancy exceeding that of men by many years (United Nations, 2000, 2010). In many countries, the advantage of women is not only biological. For example, large gender differences in life expectancy are observed in countries such as the Russian Federation and the former Soviet republics, where lifestyle factors such as harmful use of alcohol, smoking and injuries considerably reduce the lifespan of men (United Nations, 2010).

      Although life expectancy at birth tends to be higher for women than for men, in some life stages and in certain contexts, women may have a higher probability of dying than men. For example, as shown in the subsection on health and nutrition of children above, in some countries in Asia, girls may be more at risk of dying than boys. As another example, in adult ages, in several African countries facing HIV epidemics and high maternal mortality, women have a higher probability of dying between the ages of 15 and 50 than men (United Nations, 2011).

      The top causes of death in a country may be different for women than for men. At the global level, for women and men of all ages, cardiovascular diseases are the leading cause of death, followed by infectious and parasitic diseases (including diarrhoea and HIV/AIDS) and cancers (WHO, 2011). The overall mortality rates due to cardiovascular diseases are the same for women and men. For the second and third leading causes, men have higher mortality rates than women. However, the ranking of causes of death for women and men varies by region and country (WHO, 2011). For example, in sub-Saharan Africa, HIV/AIDS alone has a similar death toll as cardiovascular diseases, ranking number one for women of all ages and number three for men of all ages. The contribution of respiratory infections to total deaths is also high, ranking number one for men and number three for women.

      For adults (persons aged 15 to 59) and at the global level, the top causes of death are different for women than for men (WHO, 2011). The three top causes of death for adult women are infectious and parasitic diseases, cancers and cardiovascular diseases. The three top causes of death for adult men are injuries, cardiovascular diseases and infectious and parasitic diseases. Adult men have higher mortality rates than adult women for all these causes of death with the exception of cancers, where male and female rates are similar. Across regions and countries, there are variations in the ranking of causes of death and the gender gap in adult mortality due to specific causes of death (WHO, 2011). For example, in Africa, the number one cause of death for both women and men is HIV/AIDS and women have a higher adult mortality rate from this cause than men. The second most prevalent cause of death is other infectious and parasitic diseases, where adult men have a higher mortality rate than adult women. The third cause of death is injuries for men and maternal and nutritional conditions for women. As another example, in low- and middle-income countries in the Americas, the leading cause of death for adult women is cancers, from which they have a higher mortality rate than men. For adult men, the number one cause of death is injuries, from which their rate of mortality is several times higher than women’s.

      Breast cancers are the leading cause of cancer deaths among women, followed by lung cancers, colon and rectum cancers and stomach cancers (United Nations, 2010; WHO, 2011). In addition, cancers of other reproductive organs, including cervical cancer, ovarian cancer and uterine cancer, cause hundreds of thousands of deaths in women worldwide each year. Among men, lung cancers are the leading cause of cancer deaths. In 2008, for example, at the global level, more than twice as many men as women died of lung cancer. Gender gap in lung cancer mortality has narrowed in many developed countries, reflecting women’s later uptake of smoking in post-war birth cohorts. In addition, both stomach and liver cancers caused significantly more deaths to men than to women. Compared to the other types of cancer, deaths due to reproductive cancers were relatively rare in men. For both women and men, the distribution of cancer deaths by site compared to the distribution of new cancers by site suggests that some cancers of the reproductive systems, such as breast and prostate cancer, have a relatively better prognosis than other cancers, particularly in the more developed regions, owing to early detection and treatment options (United Nations, 2010).

  • + Data needed
    • Data needed to analyse mortality and causes of death are:

      (a) Deaths by sex and age;

      (b) Deaths by sex, age and cause of death;

      (c) Distribution of population by sex and age (for the calculation of rates and other indicators).


  • + Sources of data
    • Civil registration systems with complete coverage are the preferred source of data on deaths and causes of death.

      Population censuses are used to collect data on sex and age for all individuals. They may also be used to collect data on recent deaths (deaths in the past 12 or 24 months) by sex and age. These data, combined with data on population by sex and age, can be used to obtain direct estimates of death rates. Data on survival of parents or survival of siblings may be used in combination with data by age and sex, data on live births by age of the mother and data on age gap between husbands and wives in order to obtain indirect estimates of death rates.

      Household surveys can provide data on the sex- and age-distribution of the population. Demographic and health surveys can also provide data on survival of siblings and parents that can be used to estimate mortality. Selected health-related surveys with large samples may also be used to collect data on recent deaths, while causes of death data may be obtained by using additional questions on causes of death, following the verbal autopsy approach.

      Health administrative records may provide some data on cause of death.

      Population registers can provide data on population distribution by sex and age.

  • + Conceptual and measurement issues
    • Some sex-selective underreporting of deaths may occur in countries with less developed statistical systems. At younger ages, deaths of girls may be more likely to be underreported. At adult ages, deaths of temporary migrants, among whom men are overrepresented, may be more likely to be underreported when collecting data on survival of siblings. In general, male respondents in population censuses and household surveys are more likely than female respondents to underreport the number of deaths, the number of children ever born and the number of children surviving, with possible sex-selective omissions.

      Causes of death are often not reported or misreported, for both women and men. Some causes of death, such as AIDS and suicide, may be intentionally misreported when there is social stigma attached to them. Homicide, which tends to affect men disproportionately, may be underreported as a result of delays in forensic investigations, which may not be complete at the time that the death certificate is filed.

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