Differences in Life Expectancy and Age-Specific Mortality between the Large Cities of Ukraine

Abstract

The aim of this paper is to identify the age-specifi c characteristics of the mortality in the large cities of Ukraine and their contributions to the changes in life expectancy in these cities. The article presents the results of a comparative analysis of the dynamics of life expectancy from 2002 through 2019 in six cities: Kyiv, Kharkiv, Odesa, Dnipro, and Donetsk. It is shown that most of the large cities have generally experienced higher life expectancy than other urban settlements in Ukraine, but there is a signifi cant variation in the levels and changes in life expectancy across cities. Overall, the study established the vanguard position of Lviv and Kyiv in terms of life expectancy, although these cities, as well as Kharkiv, showed a slower increase in life expectancy in 2002-2019. In contrast, Dnipro and Odesa, as well as Donetsk (up to 2014) having lower life expectancy and wider diff erences by sex demonstrated the pronounced improvement in life expectancy during that period. In recent years, there has been a trend towards narrowing the gap between cities, and this convergence is occurring more rapidly among men than among women. In 2002, the gap between cities with the highest and lowest life expectancy was 5.4 years for males and 2.6 years for females while in 2019 it was reduced to 2 years for men and 1.6 years for women. We made a decomposition of diff erences in life expectancy at birth between the cities in 2002 and 2019 to assess the age-specifi c mortality contributions into disparities between urban areas. The results have revealed that across almost all cities these diff erences are mainly driven by excess mortality in working ages. Also, we found that excess mortality in the middle working ages and under 1 year of age appeared to be the important factors of lower life expectancy in Donetsk compared to Lviv and Kyiv. Odesa and Dnipro are lagging behind by survival rate not only in the older but also in young working age groups, and Kharkiv has slightly higher mortality among older people (in comparison to Lviv and Kyiv). Th e conclusion is made that the main gradient of diff erences in life expectancy between the large cities has been determined mainly by deaths in working ages, i.e. mostly driven by health-related behavior and lifestyle. Nevertheless, a gradual shift in urban life expectancy diff erences is now taking place towards mortality in older age groups, i.e. more determined by the eff ectiveness of treatment of chronic diseases. Th e issue of data quality is also considered. In particular, the confi dence interval of the probability of dying in the fi rst year of life in the six selected cities is estimated to determine the accuracy of these indicators.