Causes of life expectancy extension in Singapore, 2004–2022: Bridging past and present

Abstract

Abstract Background Six decadesafter independence, Singapore saw a rapid unfolding of the demographic transition, reflecting the nation’s stellar economic rise. The evolution of age-cause contributions to recent lifespan extension and to its sex differentials is the central focus of the study. Method Applying the Arriaga method to World Health Organization data, this study decomposes Singapore’s resident life expectancy by age and by cause during the 2004–2022 period. Results Singapore’s resident female and male life expectancy increased from 82.0 to 77.1 to 85.2 and 80.7 years at birth between 2004 and 2022, and from 20 to 16.5 to 22.3 and 19 years at age 65, respectively. The reduction in mortality among middle-aged and older adults, particularly among 50–to-64-year-old males, enabled this growth. By 2022, coronavirus pandemic losses among females and males erased 0.76 and 0.65 life years. The greatest contributors to life expectancy growth were ischemic heart disease, cerebrovascular disease, and respiratory causes. Relative to the 2004 baseline, by 2019, these major groups were responsible for 2.31 of 4.08 years (57%) and 1.99 out of 3.02 years (66%) gained at birth and at age 65, respectively. The share of lifespan gains attributable to reduction in cancer mortality almost tripled from 12.3% in 2004–2010 to 34.2% in 2015–2019. The reduction in lung cancer alone contributed over one-half of all gains due to neoplasms. Ischemic heart disease and respiratory causes of death sustained the sex disparity, representing over half of the annual difference. Between 2004 and 2022, the longevity gap at birth decreased by 0.36 years, whereas at age 65 it remained unchanged. Ischemic heart disease, respiratory causes, and non-breast cancers were the dominant contributors to persistent sex differentials at birth and at age 65. Conclusion This study identifies the causes of underlying mortality changes attributed to recent growth in longevity and its sex differentials among Singapore residents. Ischemic heart disease, cerebrovascular disease, and respiratory diseases and infections were the top 3 causes of longevity extension. Ischemic heart disease, respiratory diseases and infections, and non-breast cancers were also the main causes behind persistent mortality differentials by sex. Clinical trial number Not applicable.