Measuring the relative progress of mortality improvement (RPM) to evaluate stagnation and sudden increase of life expectancy in the Netherlands 1970-2009

Wilma Nusselder, Erasmus Medical Centre, Rotterdam
Frederik Peters, Erasmus Medical Centre, Rotterdam
Johan P. Mackenbach, Erasmus Medical Centre, Rotterdam

Between 1970 and 2001 the Netherlands, formerly being a country with one of the highest life expectancy in the world, experienced a long period of stagnating or even increasing mortality levels followed by a sudden increase in life expectancy more recently. Using the two measures period life expectancy and cross-sectional average length of life (CAL) we compute a measure indicating the relative progress of mortality improvement (RPM), which we compare between the Dutch pattern with other countries and the record levels. Our analysis shows that the RPM is in particular a sensitive indicator of sudden period changes, and thereby seems to relate closely to public health policy. While smoking as a determinant of longevity operates more gradually over time, major reforms in health care seem to have a direct and large impact on period life expectancy. RPM thereby works as magnifier helping to identify effects and there relative size. We utilize this indicator for evaluating the trend in life expectancy in countries that experienced comparable patterns of stagnation and resumption, as Norway and Denmark. We conclude that health care policy has a direct and sustainable impact on longevity and need to be taken into account if variations in life expectancy between are explored.