ment. During 1984-1987, almost all causes contribute to the large improvement in both male and female life expectancy. For males, this improvement is spectacular, its largest component being a decrease in mortality from injury and poisoning (+1.8 year). Secondary roles are played by cardiovascular diseases (+0.7 year) and respiratory diseases (+0.5 year). Changes in infectious and digestive diseases are favorable, but with much less impact. Only cancer has a negative impact, but almost negligible. If the progress observed among females is less significant, this is due mainly to a lesser impact of the decline in mortality from injury and poisoning. The decline in mortality from cardiovascular, respiratory, and infectious diseases results in rather similar gains for both sexes (0.9 year for women and 1.3 for men), while the decline in injury and poisoning results in a gain of only 0.4 year for women, as opposed to 1.8 for men.

The role of injury and poisoning is prominent in the deterioration of the years 1987-1992. It is again much more important among men (-2.2 years) than among women (-0.6), but for women it is almost the only cause of deterioration, while for men cardiovascular mortality again plays a rather important role (-0.5 year).

The sudden deterioration observed in 1993 is fundamentally different: injury and poisoning still play an important role, but the impact of increasing mortality from cardiovascular diseases is as important for men and even more so for women. Furthermore, while in 1987-1992 the trends in some causes (infectious and digestive diseases) are still favorable, in 1992-1993 all causes contribute to the decline in life expectancy.

In brief, we could say that until 1984, trends in cardiovascular diseases were the most important cause of negative changes in life expectancy, while more recently, injury and poisoning is the main causal category responsible for both the spectacular improvement of 1984-1987 and the dramatic deterioration of 19871992. However, the role of cardiovascular diseases once more assumes prominence in the 1993 decline.

Cause Components by Age


Figures 2-3 and 2-4 divide into age groups the cause components of changes in life expectancy during four main periods (1970-1980, 1980-1987, 1987-1992, and 1992-1993) for males and females, respectively. During the first three periods, infant mortality is associated with an increase in life expectancy, even though overall life expectancy is declining because of the contributions of other age categories. The two main causes of change are infectious and respiratory diseases. During 1970-1980, the role of infectious diseases has a negative impact on life expectancy, but this is balanced by the positive impacts of respiratory diseases and other causes. In the following periods, both infectious and respiratory diseases change favorably. In 1980-1987, these changes result in a non-negligible proportion of the total increase in life expectancy (0.2 year of the

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