期刊
JOURNAL OF EPIDEMIOLOGY
卷 24, 期 2, 页码 117-124出版社
ELSEVIER SCIENCE INC
DOI: 10.2188/jea.JE20130059
关键词
life expectancy; socioeconomic and health factors; low- and lower-middle-income countries; path analysis
资金
- Laboratory of Computational Statistics and Operations Research, Institute for Mathematical Research (INSPEM)
- University Putra Malaysia (UPM)
Background: We attempted to identify the pathways by which demographic changes, socioeconomic inequalities, and availability of health factors influence life expectancy in low- and lower-middle-income countries. Methods: Data for 91 countries were obtained from United Nations agencies. The response variable was life expectancy, and the determinant factors were demographic events (total fertility rate and adolescent fertility rate), socioeconomic status (mean years of schooling and gross national income per capita), and health factors (physician density and human immunodeficiency virus [HIV] prevalence rate). Path analysis was used to determine the direct, indirect, and total effects of these factors on life expectancy. Results: All determinant factors were significantly correlated with life expectancy. Mean years of schooling, total fertility rate, and HIV prevalence rate had significant direct and indirect effects on life expectancy. The total effect of higher physician density was to increase life expectancy. Conclusions: We identified several direct and indirect pathways that predict life expectancy. The findings suggest that policies should concentrate on improving reproductive decisions, increasing education, and reducing HIV transmission. In addition, special attention should be paid to the emerging need to increase life expectancy by increasing physician density.
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