From a theoretical perspective, the ‘epidemiological transition theory’ relates changing patterns of population distributions to leading causes of death from one predominant group of infectious diseases in developing nations to what Abdel Omran referred to ‘ degenerative and man-made diseases’ in developed nations. Although the factors which explain life expectancy gains are multifaceted, previous studies have demonstrated that this has largely resulted from improvements in effectiveness and coverage of healthcare. Recent life expectancy gains in high-income Asia-pacific countries, as classified by the IMF, including Australia, New Zealand, Japan, Hong Kong SAR, Republic of Korea, Taiwan Province of China and Singapore, are largely the result of enhanced longevity at older ages, and this trend leads to rapid population ageing in those countries. Although the gaps in old-age life expectancy between high-income Asia-pacific countries are primarily attributed to mortality changes in non-communicable diseases, these countries should also identify potential emerging threats of communicable diseases and injuries along with demographic ageing in pursuit of healthy life years in old age. ConclusionsĪge- and cause- specific contributions to changes in old-age life expectancy can differ between high-income Asia-pacific countries. However, increased mortality from Alzheimer and dementia, lower respiratory tract disease, self-harm and falls in South Korea widened the gaps by 0.41 years. More specifically, mortality reductions from cardiovascular diseases (stroke, ischaemic and hypertensive heart disease) and cancers (stomach, liver, lung, pancreatic cancers) in South Korea contributed to the decreased gap by 1.34 and 0.41 years, respectively. Decomposition analysis showed that mortality reductions from non-communicable diseases in South Korea were the leading causes of death contributing to the decreased gaps in old-age life expectancy between the two countries. South Korea experienced rapid population ageing, and the gaps in life expectancy at 60 years old between South Korea and Japan were reduced by 2.47 years during 19. This study used Pollard’s actuarial method of decomposing life expectancy to compare age- and cause-specific contributions to changes in old-age life expectancy between South Korea and Japan during 19. This study compared and quantified age- and cause-specific contributions to changes in old-age life expectancy in two high-income Asia-pacific countries with ageing populations, South Korea and Japan. Recent life expectancy gains in high-income Asia-pacific countries have been largely the result of postponement of death from non-communicable diseases in old age, causing rapid demographic ageing.

Mind the gap geography