Stagnation in old age mortality among Finnish women: cause-of-death decomposition of life expectancy trends by income.

Aims: The decline in old age mortality and subsequent increase in life expectancy among older women has stalled in some high-income countries. The contribution of causes of death to and sub-group variations in these trends are generally not well understood. We assess trends in mortality and cause-of-death decomposition of life expectancy by income over the past 30 years in Finland.

Methods: We obtained total population, annual register-based data on individuals (aged 30-89 years) residing in Finland in 1991-2020. We examined the trends in age-specific mortality rates and decomposed the contribution of various causes of death to changes in partial life expectancy among women aged 65-79 years over time and within each income quintile. In addition, we estimated life expectancy trends for the total population and by income quintile with and without causes related to alcohol consumption and smoking.

Results: Our results indicate stagnation in mortality development among women in Finland aged 65-79 years. The slowdown of improvements in circulatory and heart disease mortality contributed substantially to the observed stagnation, although similar trends were observed in virtually all the causes of death we studied. The lowest income groups experienced the most adverse developments during the study period.

Conclusions: The stagnating life expectancy observed among Finnish women cannot be attributed solely to one cause of death. In contrast to findings on the topic from many other developed countries, smoking-related causes of death were of little significance. The stagnation is linked to growing inequality in mortality development among older women in Finland, which affects the overall trend.