Gender differential in mortality in post-reproductive age. The role of the fertility decline in Italy and Europe

Summary: In this paper, we highlight the close link between fertility decline and the emergence of the female survival advantage in post reproductive age (50 years and over). We performed an ecological analysis on the evolution of gender differentials in mortality in 16 Italian administrative regions and in 16 European countries. In both cases, we kept under control the possible confounding effects due to the spreading of smoking, the general decline of mortality, the presence of migration, the outbreak of wars and the diffusion of the obesity pandemics. Two main results emerge. First, the rise of a significant mortality differential between sexes is a relatively recent phenomenon, whose onset dates back to the birth cohorts of the last decades of the 19th century. Second, this phenomenon is associated, at the aggregate level, to the process of fertility decline.