Increasing life expectancy in Germany:: quantitative contributions from changes in age- and disease-specific mortality†

Background: Between 1962 and 2002 the average life expectancy in Germany has increased from 67.1 years to 75.6 years in men and from 72.7 years to 81.3in women. Methods: The cumulative and annual contributions of different age- and disease-groups on life expectancy were calculated using Pollards actuarial method of decomposing mortality rates. Mortality data were provided by the German Statistical Office. Results: Considering the cumulative contribution over the period of 40 years, the largest contributions came from persons with at least 65 years of age (2.9 years in men and 4.0 years in women). Reductions in cardiovascular disease mortality had the greatest cumulative impact on life expectancy (2.7 years in men and 3.0 years in women). The contribution from reduced cancer mortality on life expectancy was substantially lower (0.6 and 0.9 years, respectively). The annual contributions of several disease-groups varied considerably over time. The positive contribution from cardiovascular diseases started only after 1970, and in men it became solid only after 1980. Regarding malignant neoplasms, the largest cumulative contribution came from stomach cancer (0.4in both sexes). The annual analyses showed increasing contributions from reduced cancer mortality after 1990. These were strongly influenced by lung, stomach, prostate and colorectal cancer in men, and by breast, colorectal and stomach cancer in women. Conclusions: While life expectancy has increased by about 2.2 years per decade the observed variations in the age- and disease-specific contributions over time have implications for future health care planning and prevention strategies.