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Subnational Life Expectancy Disparities in Low and Middle-Income Countries: Measurement and Determinants

Author

Listed:
  • Andreas Kyriacou

    (Departament d’Economia, Universitat de Girona (Spain))

  • Ronald Miranda-Lescano

    (Departamento de Métodos Cuantitativos and Departamento de Economía, Universidad de la República (Uruguay), and EMANES fellow)

  • Leonel Muinelo-Gallo

    (Departamento de Economía and Instituto de Economía, Universidad de la República (Uruguay))

  • Oriol Roca-Sagales

    (Departament d’Economia Aplicada, Universitat Autònoma de Barcelona (Spain))

Abstract

This article constructs new indicators of subnational disparities in life expectancy for up to 101 low- and middle-income countries (LMICs) from 2000 to 2021, offering critical insights into health inequalities within countries. The findings reveal that subnational disparities in life expectancy are markedly higher in Sub-Saharan Africa compared to other LMIC world regions throughout the period. Moreover, while subnational disparities in life expectancy have decreased in most regions, Sub-Saharan Africa stands out as an exception, with persistently high disparities alongside rising average life expectancy. A country-level analysis indicates that subnational disparities in life expectancy declined in 61 countries, increased in 30, and remained unchanged in 10. A gender-specific analysis highlights that, while women generally live longer than men across all countries studied, subnational life expectancy disparities are greater for women. Sub-Saharan Africa exhibits the largest disparities in female life expectancy and the widest gap in disparities between men and women. Regression analysis identifies factors influencing life expectancy disparities. Variables such as good governance and public health spending help reduce disparities, while decentralization, larger country size, geographic diversity and ethnic fractionalization tend to increase them. Subnational disparities in income and education emerge as the most significant drivers of life expectancy inequalities, with disparities in female education playing a particularly critical role. These findings emphasize the need for targeted policies aimed at reducing subnational education inequalities, particularly for women, as a key strategy for addressing life expectancy disparities.

Suggested Citation

  • Andreas Kyriacou & Ronald Miranda-Lescano & Leonel Muinelo-Gallo & Oriol Roca-Sagales, 2025. "Subnational Life Expectancy Disparities in Low and Middle-Income Countries: Measurement and Determinants," Working Papers wpdea2501, Department of Applied Economics at Universitat Autonoma of Barcelona.
  • Handle: RePEc:uab:wprdea:wpdea2501
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    References listed on IDEAS

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    Keywords

    subnational disparities; life expectancy; inequality measurement; inequality determinants;
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