Contributions of the life expectancy gap reduction between urban and rural areas to the increase in overall life expectancy in South Korea from 2000 to 2019

Abstract

Abstract Background This study aimed to quantify the contribution of narrowing the life expectancy gap between urban and rural areas to the overall life expectancy at birth in Korea and examine the age and death cause-specific contribution to changes in the life expectancy gap between urban and rural areas. Methods We used the registration population and death statistics from Statistics Korea from 2000 to 2019. Assuming two hypothetical scenarios, namely, the same age-specific mortality change rate in urban and rural areas and a 20% faster decline than the observed decline rate in rural areas, we compared the increase in life expectancy with the actual increase. Changes in the life expectancy gap between urban and rural areas were decomposed into age- and cause-specific contributions. Results Rural disadvantages of life expectancy were evident. However, life expectancies in rural areas increased more rapidly than in urban areas. Life expectancy would have increased 0.3–0.5 less if the decline rate of age-specific mortality in small-to-middle urban and rural areas were the same as that of large urban areas. Life expectancy would have increased 0.7–0.9 years further if the decline rate of age-specific mortality in small-to-middle urban and rural areas had been 20% higher. The age groups 15–39 and 40–64, and chronic diseases, such as neoplasms and diseases of the digestive system, and external causes significantly contributed to narrowing the life expectancy gap between urban and rural areas. Conclusion Pro-health equity interventions would be a good strategy to reduce the life expectancy gap and increase overall life expectancy, particularly in societies where life expectancies have already increased.