Why are Northern Europeans falling behind in life expectancy? An international comparison of age and cause of death, 1970-2009

Alyson A. van Raalte, Max-Planck Institute for Demographic Research
Vladimir M. Shkolnikov, Max-Planck Institute for Demographic Research and New Economic School, Russia

In 1970, Sweden, Norway and Denmark (males only) had the highest known period life expectancy in the world. By 2009 the life expectancy of the three countries had fallen to average or below average among western developed countries, with Denmark having fallen way behind. This decline in rankings occurred alongside the development of generous and universalistic social welfare policies, which are often thought to be the most beneficial to population health. In this paper we analyze the age and cause of death patterns behind these changes with life table analyses and newly developed decomposition techniques. The hypotheses that we investigate, which are not mutually exclusive, include: (1) a failure to reduce mortality at older ages, (2) a move toward a comparatively shorter-lived cause of death structure than in comparison countries, (3) cohort effects from the survival of frail or less selected individuals due to a less lethal early life environment, and (4) cohort effects from smoking. The objective is to uncover whether there is a common narrative to the decline in rankings among the four countries, albeit to different final levels, or whether the three countries have followed different pathways.