Cause-of-death determinants of lifespan inequality

We propose a novel decomposition approach that breaks down the levels and trends of lifespan inequality as the sum of cause-of-death contributions. The suggested method shows whether the levels and changes in lifespan inequality are attributable to the levels and changes in (1) the extent of inequality in the cause-specific age-at-death distribution (the ‘Inequality’ component), (2) the total share of deaths attributable to each cause (the ‘Proportion’ component), and (3) the cause-specific mean age at death (the ‘Mean’ component). This is the so-called ‘Inequality-Proportion-Mean’ (or IPM) method. We apply the IPM method to 10 low-mortality countries in Europe. Our findings suggest that the most prevalent causes of death (in our setting ‘Circulatory system’ and ‘Neoplasms’) do not necessarily contribute the most to overall levels of lifespan inequality. In turn, ‘Perinatal and congenital’ causes are the strongest drivers of lifespan inequality declines. The contribution of the IPM components to changes in lifespan inequality varies considerably across causes, sexes and countries. Among the three, the ‘Proportion’ component is the one that explains the least lifespan inequality dynamics – suggesting that shifts in the structure of causes of death alone contributed little to change lifespan inequality.