August 2001

 

Sharp Gender Differences
Longevity in Missouri
Art Schneider, schneidera@missouri.edu

Recently, the Missouri Department of Health and Aging released fascinating information on longevity and the changing age structure of Missourians.

Today, nearly one in three Missourians lives to age 85—that’s seven times the percentage just 89 years earlier! Average life expectancy increased from 53 years in 1911 to 75.7 years in 1999. Purer food and water, better nutrition, antibiotics and vaccines have been major factors stimulating this increase.

At the turn of the 20^th century, many women died from childbirth or complications associated with it. With better pre-natal care and follow-up, death is now relatively rare from childbirth or its complications. As a result, we see a growing imbalance between the number of males and the number of females reaching age 85. Only 25% of males live to age 85 while 40% of females reach age 85. Males are more susceptible to disease and are more likely to die from risky behavior. As a result, over age 85 widows far outnumber widowers in Missouri—36,748 widows to 9,908 widowers. More than 40% of men over age 85 are married when a spouse dies, but only 6% of females. (It is interesting that even though men die earlier, the typical first marriage has a groom about two years older than the bride. The wife typically will experience more than a decade of widowhood.)

Also of interest is the difference in longevity between African-Americans and Euro-Americans. Those African-Americans who live to age 85 have a similar survival rate to Euro-Americans. However, the odds of living to age 85 are much less for African-Americans. The death rate for African-American infants and children is nearly three times that of Euro-Americans! At age 15 to 44 the rate is 2.1 to 1, diminishing further to 1.8 at age 45 to 64 to 1.2 age 75 to 84.

The Heath Department compared the causes of death in 1980 and 1999 for those age 85 and older. There have been significant changes. Cancer as a cause grew from 9% to 11%. Heart disease remains the single major cause, but it actually declined as the major reason for death from 49% to 41%. Stroke fell from 14% to 10%. All other diseases now account for 38% of deaths.

Another change is where death occurs. At the turn of the century, it likely was at home. In 1980 only 9% of age 85 and older died at home, but it increased to 12% in 1999—perhaps suggesting people being a bit healthier or having supports such as home health enabling them to stay at home longer. Most aged 85 and over died in hospitals in 1980, but only 37% in 1999. Nursing homes are now the primary location where death takes place for those age 85 and older.

Unfortunately death certificates do not provide information on how much people contributed to their own deaths (such as from smoking, diet, reckless driving, inactivity or over activity) and do not give us a picture of the quality of life just prior to death.

As longevity increases—especially with the baby boomers (1946-1962)—we may expect to see considerable emphasis placed on activities that promote not only longer life spans, but also a higher quality of life, through diet, exercise, work and learning.

Source: "Focus---Deaths of Missourians Age 85 and Over," Missouri Monthly Vital Statistics, March 2001.