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Mortality and causes of death

Modified on 2013/05/16 15:12 by Haoyi Chen Paths: Read in Order Categorized as Chapter 2 - Health
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 household surveys

Population censuses combined with civil registration system or household surveys; population registers
Are adult women more likely or less likely than adult men to die of communicable diseases or any other cause of death? Deaths by sex, age and cause of death

Population by sex and age
Civil registration system
Health administrative sources

Population censuses, combined with civil registration system 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 system
Health administrative sources
What types of cancer cause the highest number of deaths among women? Among men? Deaths by sex and cause of death Civil registration system
Health administrative sources

  • + 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 one hand, and social and economic factors, on the other. The female advantage is lower in countries with overall high mortality (United Nations, 2000; 2010a). In particular, countries with high level of maternal mortality and high prevalence of HIV/AIDS have a smaller difference between the female and the 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 discrimination and abuse. By comparison, in countries with low levels of mortality, women have a considerable biological advantage, exceeding the life expectancy of men by many years (United Nations, 2000; 2010a). 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 Russian Federation and the former Soviet republics, where lifestyle factors such as the harmful use of alcohol, smoking and injuries considerably reduce the life span of men (United Nations, 2010a).

      Although life expectancy at birth tends to be higher for women than 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 section on child mortality, 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 ages 15 and 50 than men (United Nations, 2010b). The top causes of death in a country may be different for women than for men. At 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 for men varies by region and by country (WHO, 2011). For example, in sub-Saharan Africa, HIV/AIDS alone has a similar death toll as cardiovascular diseases, ranking number 1 for women of all ages and number 3 for men of all ages. The contribution to total deaths of respiratory infections is also high, ranking as number 1 for men and number 3 for women.

      For adult ages (15-59) and at 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 the causes of death and the gender gap in adult mortality due to specific causes of death (WHO, 2011). For example, in Africa, the number 1 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 of 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 1 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, 2010a; 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 than women died of lung cancer. Gender gap in lung cancer mortality has narrowed in many developed countries, reflecting women’s later uptake in smoking in post-war birth cohorts. Both stomach and liver cancers caused significantly more deaths to men than to women as well. 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 cancer and prostate, have a relatively better prognosis than other cancers, particularly in the more developed regions, due to early detection and treatment options (United Nations, 2010a).

  • + Data needed
    • Deaths by sex and age

      Deaths by cause of death, sex and age

      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 collect data on sex and age for all individuals. They may also collect data on recent deaths in the last 12 or last 24 months by sex and age, which, in combination 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 mother, and data on age gap between husbands and wives to obtain indirect estimates of mortality rates.

      Household surveys can provide data on sex and age distribution of 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 sample may also collect data on recent deaths, and causes of death data may be obtained by using additional questions on causes of death, following a verbal autopsy approach.

      Health administrative sources 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 system. 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 or suicide may be intentionally misreported when social stigma is 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 the death certificate is filed.

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