Sixty-five million inhabitants: a decade of stable growth

1The total population of France on 1 January 2011 is estimated at 65 million, of whom 63.1 million in metropolitan France (mainland France and Corsica) (Pla and Beaumel, 2011) and 1.9 million in the overseas départements (départements d’outre-mer, DOM). Réunion accounts for the largest share of the DOM population with 44% of the total, followed by Guadeloupe and Martinique with 22% each. French Guiana is the least populated DOM, with 12%.

2In 2010, the total population rose by 354,000, of whom 337,000 in metropolitan France (Pla and Beaumel, 2012). The increase was slightly larger than in 2009 due to a rise in births (+8,200) that was higher than that of deaths (+2,600), and a small gain in estimated net migration (+5,000).

3The total growth rate is estimated at 5.5 per 1,000 in 2010. For metropolitan France, the increase is estimated at 5.4 per 1,000, mostly due to natural growth (4.2 per 1,000), and, more marginally, to net migration (Appendix Table A.1). [1] The growth rate has held fairly steady for the past ten years, peaking at 6 per 1,000 in 2004 and 2006. Population growth is steeper in the DOMs, at 11.2 per 1,000, notably because of higher birth rates and fertility, although fertility has fallen very rapidly in recent decades (see below). As in recent years, therefore, France registered one of the highest growth rates in Europe (Prioux et al., 2010).

4France (metropolitan France and DOMs) ranks 21^st in the world for population size, ahead of the United Kingdom and Italy (Pison, 2011). It is one of the 14 countries with a population of 50-100 million inhabitants; nine countries have 100-400 million, and India and China have 1.2 billion and 1.3 billion, respectively.

Seventeen thousand centenarians: eight women to one man

5The French population is ageing slowly but steadily, for the most part in the oldest age groups. On 1 January 2011, 10 million people were aged over 65, of whom 6 million women. The gender imbalance among the elderly is visible in the population pyramid (Figure 1, metropolitan France), with twice as many women as men aged over 80. Dependency affects men and women differently. Because of the age gap between spouses and male excess mortality, men are more likely to be living with a partner in old age, whereas the oldest women are more likely to be widowed and living alone. The male and female roles become even more imbalanced at those ages, with women having to act as carers in most cases (Bonnet et al., 2011). France (metropolitan France and DOMs) had almost 17,000 centenarians on 1 January 2011 (slightly fewer than 2,000 men versus almost 15,000 women), many of whom still live at home. According to 2007 census data, 68% of centenarian men and 46% of centenarian women do not live in institutions, even though the vast majority who are in their own home face major difficulties in daily living (Blanpain, 2010). While the number of centenarians is currently rising at a moderate pace each year, it is expected to surge by 2050, when the baby-boom cohorts enter this age group.

Figure 1

Population pyramid of metropolitan France on 1 January 2011

Population pyramid of metropolitan France on 1 January 2011

Ageing less pronounced but faster in the DOMs

6In terms of population ageing, France occupies an intermediate position relative to other European countries. Nearly 17% of its population was aged 65 or above on 1 January 2011 (Appendix Table A.2, metropolitan France), a figure slightly above the European average of 15.7%. By 2040, the proportion is projected to be nearly identical in all European countries, with retired persons accounting for one-quarter of the total population (Avdeev et al., 2011).

Table 1

Population of the French overseas départements on 1 January 1999 and 2009 and distribution by age groups

Département Total population on 1 January Distribution by age on 1 January Below 15 Below 20 20-59 60+ 75+ 1999 Guadeloupe 385,609 24.7 32.7 53.4 13.9 4.5 Martinique 380,863 23.3 30.6 53.4 15.9 5.1 French Guiana 155,760 35.6 44.4 49.9 5.6 1.5 Réunion 703,820 28.8 37.7 52.8 9.5 2.5 Overseas départements 1,626,052 27.2 35.5 52.8 11.7 3.5 2009 Guadeloupe 403,257 22.4 30.2 51.7 18.1 6.0 Martinique 398,733 20.0 27.7 52.5 19.8 6.8 French Guiana 225,751 35.1 44.4 49.4 6.2 1.6 Réunion 821,168 25.6 34.4 53.7 11.9 3.2 Overseas départements 1,848,909 24.8 33.3 52.5 14.3 4.4 Population: French overseas départements (provisional estimate for 2009).

Population of the French overseas départements on 1 January 1999 and 2009 and distribution by age groups

7The DOM population is younger than that of metropolitan France. One-third of the population is aged under 20 versus only one-quarter in metropolitan France (Table 1). There is also a wide gap in median ages. One-half of the DOM population is under 35, compared with a median age of nearly 40 in metropolitan France. However, the swift and steep decline in fertility, especially in Guadeloupe, Martinique and Réunion, will lead to rapid population ageing in the years ahead, further accentuated by migration. The DOM population displays a characteristic age structure: the young population is still quite large, but the population pyramid narrows sharply around age 30 (Figure 2), reflecting the fact that a massive proportion of the young adult population resides in metropolitan France. Mobility towards metropolitan France differs by sex and social category. Young men emigrate in greater numbers than young women, and the highly educated more so than the less educated, with many young adults going to metropolitan France to complete their education. Roughly one-third of the native DOM population aged 20-34 lives in metropolitan France. More than one-third of the most highly educated population resides there, and the same pattern is observed among persons in employment. The young men and women who stay in the DOMs are far more frequently low-educated and unemployed (Temporal et al., 2011). However, part of the migration flow is temporary, as nearly 40% of DOM residents are “returned DOM native-borns” (ibid.).

Figure 2

Population pyramid of the overseas départements on 1 January 2011

Population pyramid of the overseas départements on 1 January 2011

8While the DOM age structure is still relatively young, the decline in fertility and the departure of young adults to metropolitan France, combined with return migration of older adults, means that the ageing process is well under way. The age structures have been evolving rapidly since the 1950s (Rallu and Diagne, 2005; Sandron, 2007), with only that of French Guiana being less affected by the shortage of young adults (Breton et al., 2009). Under the medium-term projections produced by INSEE (French National Institute of Statistics and Economic Studies) the share of the population aged 60 and over in 2040 will reach 40% in Guadeloupe and Martinique, compared with a more modest 31% in metropolitan France (Léon, 2010). The situation in French Guiana is different because its age structure is younger (Rallu, 2009) due to high fertility and immigration. According to the INSEE projections, the share of the population aged 60 and over will barely exceed 12% in 2040.

Fertility slightly higher and less delayed in the DOMs

12The number of recorded births rose again in 2010 to reach a total of 832,800, of which over 800,000 in metropolitan France (Beaumel and Pla, 2011b). This was the largest number in thirty years (more than 800,000 births were recorded in 1980, and more than 805,000 in 1981).

13Fertility also increased. The total fertility rate (TFR) exceeded two children (2.01) in metropolitan France (Appendix Table A.4; Pla and Beaumel, 2011) and reached 2.4 children per woman in the DOMs. The uptrend in metropolitan France was mainly due to women over age 30 (Table 2), as fertility rose by more than 2% at ages 30-40 and by 5% after age 40.

14Despite their gradual increase, births among women aged 40 or over still account for fewer than 4% of births in metropolitan France (3.6% for all of France). The share of births in this age group remains well below the level observed in the early twentieth century, when it exceeded 6% (Daguet, 1999 and 2002). However, the family situations associated with late childbearing today are rather different from those of the past. A larger proportion of late births are now first children, or births in a reconstituted family where the parents already have children from a previous union (Bessin et al., 2005). Nevertheless, fertility is still heavily concentrated at ages 25-35 (Davie and Mazuy, 2010), and both early and late childbearing remain infrequent.

15The stronger fertility in the French overseas territories is mainly due to much higher fertility among younger women and slightly higher fertility after age 35. The fertility rates up to age 23 are at least twice as high in the DOMs as in metropolitan France (Figure 3), where fertility exceeds that of the DOMs only in the 28-35 age group (at these ages, the rates in metropolitan France are no more than 1.2 times higher). Moreover, although the average number of children is higher in the DOMs (the total fertility rate was 2.4 children per woman in 2010), the mean age at childbearing is 28.5 years, versus 30 years in metropolitan France. This means that women begin their reproductive life at younger ages, on average, than in metropolitan France, where fertility is higher at ages 30-35. The two childbearing profiles remain distinct, therefore, more in terms of timing than in terms of completed fertility, and it is the higher rates at younger ages in the DOMs that explain the difference in completed fertility with respect to metropolitan France. Childbearing before age 25 is not uncommon in the DOMs, especially in Réunion, where early fertility is a distinctive feature. Réunionese women born before 1985 had an average of 0.8 children before age 25 (Breton, 2007). Another specific trait of fertility in the DOMs is the prevalence of non-marital births, which represent more than three-quarters of total births, compared with 54.9% in metropolitan France (Table 3).

Figure 3

Age-specific fertility rates in metropolitan France and in the overseas départements in 2010 (per 1,000 women)

Age-specific fertility rates in metropolitan France and in the overseas départements in 2010 (per 1,000 women)

Table 3

Total fertility rate, mean age at childbearing and proportion of non-marital births in the overseas départements, 1999 and 2008

Département 1999 2008 Total fertility rate (children per woman Mean age at childbearing (years) Percentage of non-marital births Total fertility rate (children per woman Mean age at childbearing (years) Percentage of non-marital births Guadeloupe 2.1 28.9 65.3 2.2 29.3 74.4 Martinique 1.9 28.9 68.3 2.1 29.2 72.5 French Guiana 3.9 27.1 81.9 3.6 27.7 87.9 Réunion 2.3 27.9 60.1 2.5 28.4 69.5 Overall 2.3 28.2 66.2 2.5 28.6 74.4 Population: French overseas départements (provisional estimate for 2008).

Total fertility rate, mean age at childbearing and proportion of non-marital births in the overseas départements, 1999 and 2008

16This sustained high level of fertility in both metropolitan France and the DOMs in 2010 has kept France at the top of the European ranking. Only Ireland and Iceland recorded higher rates of 2.07 and 2.20 children per woman, respectively, in 2010 (Appendix Table A.6). The trend towards stability or increase mainly concerns northern and western Europe. In southern Europe, the TFR is levelling off at around 1.4 children per woman. In central/eastern Europe it is still declining, especially in Hungary and Latvia, where the rate is nearing 1.2 children per woman.

17The completed fertility of French cohorts is not expected to fall below 2 children per woman, and the mean age at childbearing should stabilize at around 30 years (Appendix Tables A.5 and A.7).

The number of abortions remained stable in 2008 and 2009

18According to statistics from the Direction de la recherche, de l’évaluation et des statistiques (Directorate for Research, Assessment and Statistics, DREES, Ministry of Labour and Social Affairs), slightly over 220,000 induced abortions were performed in 2008 (222,805) and 2009 (222,137), down slightly from 227,050 in 2007 (Vilain, 2009; Vilain and Mouquet, 2011). The decline between 2007 and 2008 was concentrated in metropolitan France, where the number fell by 2% in 2008 then levelled off in 2009 (Table 4 and Appendix Table A.8). In the overseas départements as a whole, the number remained stable in 2007 and 2008, then decreased by 5% in 2009 (Table 4). For all of France, this mild decline in induced abortions since 2006 reflects a fall in the rate among women under age 30, especially the youngest women (Vilain and Mouquet, 2011). This marks a break with the rising trend in teenage abortions observed since the 1990s (Rossier et al., 2009).

Abortion more frequent in the DOMs

19Induced abortions are much more frequent in the DOMs than in metropolitan France, whatever the indicator used. The overall abortion rate stands at 27.8 per 1,000 women aged 15-49 on average in 2005-2009, nearly twice the figure of 14.6 per 1,000 for metropolitan France. The total abortion rate came to 1.01 abortions per woman versus 0.52, respectively, in the same period. The ratio of abortions to live births, at 41.3 and 26.7 per 100 live births, respectively, was 55% higher in the same period (Table 4). However, there are wide differences between individual overseas départements. In 2008 and 2009, the total abortion rate averaged 40.2 per 1,000 women in Guadeloupe, nearly twice that of Réunion (20.4 per 1,000). French Guiana had nearly the same rate as Guadeloupe (36.2 per 1,000), whereas the figure for Martinique was close to that of Réunion, at 23.9 per 1,000 women (Vilain and Mouquet, 2011). But sharp disparities exist in metropolitan France as well. The frequency varies by a factor of almost two between the regions of Pays de la Loire (10.5 per 1,000 on average in 2008-2009) and Provence-Alpes-Côte d’Azur (PACA; 20.9 per 1,000). The abortion rate for Réunion is very similar to that of certain regions of metropolitan France including PACA but also Corsica, Île-de-France (Paris region) and Languedoc-Roussillon, the last three having rates of between 18 per 1,000 and 19 per 1,000.

Table 4

Numbers of abortions and total abortion rate in metropolitan France and the overseas départements since 2005

Year Metropolitan France Overseas départements (overall) Number of abortions Per 100 live births Per 1,000 women aged 15-49 Total abortion rate (per woman) Number of abortions Per 100 live births Per 1,000 women aged 15-49 Total abortion rate (per woman) 2005 206,311 26.6 14.2 0.51 13,111 40.4 27.7 1.00 2006 215,390 27.0 14.9 0.53 13,455 41.5 28.3 1.02 2007 213,382 27.1 14.7 0.53 13,668 41.8 28.5 1.03 2008 209,247 26.3 14.5 0.52 13,558 41.9 28.0 1.03 2009 209,268 26.4 14.6 0.52 12,869 41.2 26.5 0.98

Numbers of abortions and total abortion rate in metropolitan France and the overseas départements since 2005

20The total abortion rate, or sum of age-specific abortion rates, is a better indicator of the change in frequency, as it does not depend on the age structure of the population at risk. [3] Like any indicator measuring the frequency of a repeatable event, it can also be broken down by order, to better analyse the characteristics of women undergoing induced abortion. The statistical notification forms, analysed by INED, were used to obtain an estimated breakdown by order in metropolitan France and the DOMs for the 2007-2009 period (Table 5). As the statistics compiled from the forms are not yet available for 2009, [4] we used the mean distribution by order [5] observed at each age for 2006-2008, which we applied to the mean abortion rates for 2007-2009, calculated from the age-specific statistics of the DREES database (Programme de médicalisation des systèmes d’informations, PMSI).

Table 5

Distribution by order of the total abortion rate in metropolitan France and the overseas départements in 2007-2009 (3-year average, per 100 women)

Abortion order Order-specific total abortion rate (per 100 women) Distribution by order (%) Metropolitan France Overseas départements Metropolitan France Overseas départements First 36.2 60.4 68.8 59.5 Second 11.9 27.5 22.6 27.1 Third or higher 4.5 13.6 8.6 13.4 Total 52.6 101.5 100.0 100.0

Distribution by order of the total abortion rate in metropolitan France and the overseas départements in 2007-2009 (3-year average, per 100 women)

21The total abortion rate in the DOMs averages slightly over one abortion per woman versus 0.53 in metropolitan France. This very high value is due to a greater frequency of both first abortions and repeat abortions. If the data in Table 5 were observed in a single cohort, they would imply that 60% of women residing in the DOMs undergo at least one abortion in their life (versus 36% in metropolitan France), and 27.5% at least two (12% in metropolitan France), with 33% (i.e. 60.4% – 27.5%) having just one (24% in metropolitan France).

A higher proportion of pregnancy terminations in the DOMs, except among the youngest women

22This greater frequency of first abortions and repeat abortions is reflected in age-specific abortion rates, which are distinctly higher than in metropolitan France, particularly at the youngest ages (Figure 4). Before age 20, abortion rates in the DOMs are at least twice as high, and at age 14 almost four times as high. By that age, slightly more than 7 women per 1,000 residing in the DOMs have undergone an abortion, versus fewer than 2 in metropolitan France. This is because conception rates [6] in the DOMs are far higher among the young (Figure 4): they are at least twice as frequent until age 21, and up to 6 times as frequent at age 14, an age at which slightly more than 14 women per 1,000 in the DOMs become pregnant. Conception rates in the DOMs and metropolitan France do not converge until around age 30 (between ages 27 and 33). After age 35, they are once again substantially higher (70% higher on average) in the DOMs.

Figure 4

Age-specific abortion and conception rates^(a) in metropolitan France and in the overseas départements, 2007-2009 (per 1,000 women)

Age-specific abortion and conception rates^(a) in metropolitan France and in the overseas départements, 2007-2009 (per 1,000 women)

23Yet the proportion of pregnancies ending in termination in the DOMs is lower than in metropolitan France among young women up to age 21, whereas it is higher after age 21 and until around age 40 (Figure 5). The ratio of abortions to conceptions in the DOMs is less differentiated by age, but it bottoms out at around age 30 in both the DOMs and metropolitan France. The highest proportion of wanted births is therefore probably found in that age group. The high value of the ratio at young ages indicates that abortion more frequently contributes to the increase in the age at first childbirth in metropolitan France than in the DOMs, where adolescent fertility is certainly less stigmatized. The upturn in the abortion ratio after age 35 shows that abortion no doubt also plays a role in reducing completed fertility. The higher abortion rates in the DOMs between ages 21 and 40 contribute to the reduction in fertility at these ages and to its convergence with the fertility of metropolitan France, as noted earlier.

Figure 5

Percentage of conceptions^(a) ending in termination at each age in metropolitan France and in the overseas départements, 2007-2009

Percentage of conceptions^(a) ending in termination at each age in metropolitan France and in the overseas départements, 2007-2009

24The high frequency of abortion in the DOMs is therefore due both to higher conception rates at almost all ages, especially among the young, and to more frequent unwanted pregnancies. The proportion of terminated pregnancies is high, except at very young ages, as the fertility of adolescent girls and young women under 20 remains traditionally high in the DOMs, especially in French Guiana and Réunion. The proportion of women having undergone at least one abortion in their life is therefore substantially greater, as is the percentage of women having undergone multiple abortions. These major differences with respect to metropolitan France in regard to abortion are due to a lesser use of contraception (Halfen et al., 2006). This, in turn, is determined by several factors: “cultural resistance” to contraception (Clair, 2004), difficulties in accessing it, and information that is inadequate or unsuited to the local context, leading to more frequent contraceptive failures (Moreau et al., 2010). Moreover, sexual attitudes and behaviours differ from those of metropolitan France (Halfen et al., 2006).

A stable number of marriages and a slower rise in PACS civil partnerships

25The steady decline in the number of marriages recorded throughout the 2000s (except 2005) did not persist in 2010 in either metropolitan France or the DOMs. A total of 251,654 marriages were registered in 2010, of which 245,334 in metropolitan France and 6,383 in the DOMs, versus 245,151 and 6,300, respectively, in 2009. It is too soon, however, to take these figures as evidence that the drift away from marriage has stopped. The frequency of first marriages also levelled off in 2010. The total first marriage rate (the sum of age-specific marriage rates for single persons) was unchanged in 2010 from 2009 (Appendix Table A.9). The mean age at first marriage was 30.0 years for women and 31.8 years for men, a difference that reflects the age gap between spouses, analysed in greater detail below (for marriages and PACS civil partnerships combined). The mean age at first marriage is therefore still rising rapidly. In 2000, it stood at 28.0 years for women and 30.1 years for men. The mean age at first marriage by cohort is following the same trend with a slight lag (Appendix Table A.10). We estimate it at 28.9 years for women born in 1975 and 30.6 years for men born in 1973, an increase of around 2.5 years (2.6 years for women, 2.4 years for men) in 10 cohorts. In the same cohorts, we estimate the proportion of persons married by age 50 at 65% for women and 63% for men, a decline of 10 and 9 points, respectively, in 10 cohorts.

26The number of new PACS civil partnerships has been rising steadily since their introduction in December 1999, reaching 205,596. However, the pace of increase started slowing sharply in 2009. The number of new PACS partners rose by 43% in 2008, 20% in 2009 and 18% in 2010. While their number is growing in the DOMs, the PACS remains a marginal type of union there. Only 1,640 were signed in the DOMs in 2010 (Table 6), a mere 20% of all registered unions (marriages and PACS partnerships), as compared with 45% of all new registered unions in metropolitan France in the same year. The DOMs are among the départements with the lowest proportion of PACS partnerships (Prioux and Mazuy, 2009; Figure 5).

Table 6

PACS registered and PACS dissolved since 2007

2007 2008 2009 2010 PACS registered (total) 102,023 146,030 174,562 205,596 Including PACS in the DOMs 953 1,182 1,443 1,640 PACS concluded by sex of partners Male-male 3,708 4,780 4,895 5,209 Female-female 2,510 3,423 3,542 3,937 Male-female 95,707 137,820 166,120 196,441 Not known 98 7 5 9 Number of dissolutions (total) 22,782 23,657 26,933 35,060 Reason for dissolution Mutual consent 10,847 12,776 16,273 20,779 Unilateral request by one partner 747 715 913 1,144 Marriage 10,783 9,790 9,426 12,758 Death 371 351 293 350 Other reasons and not known 34 25 28 29 Population : Whole of France.

PACS registered and PACS dissolved since 2007

27Almost 200,000 heterosexual couples (196,441) formed a PACS in 2010, representing 95% of the total (the proportions in the DOMs and metropolitan France are identical). The trends in recent years suggested that the number of PACS unions would equal the number of marriages by 2012-2013. However, this might not happen if the slowdown in PACS growth persists [7] and if the number of marriages remains stable for several years in a row.

28PACS dissolutions increased as well, rising to around 35,000 in 2010. Of the total 911,094 PACS unions formed between 15 December 1999 and 31 December 2010, approximately 150,000 have been dissolved (including through marriage), according to statistics from the Ministry of Justice and Civil Liberties. These figures may underestimate the number of PACS dissolutions, however. Using data from a survey on taxable income and welfare benefits, INSEE estimates the number of PACS partners in metropolitan France on 1 January 2010 at one million (Davie, 2011).

Married partners and PACS partners are of similar age

29Legislative changes regarding the recording of data on PACS unions mean that fuller information on the partners’ characteristics is now available. [8] We can now calculate age-specific and total PACS formation rates. [9] The pattern of age-specific heterosexual PACS formation rates is fairly similar to that of the age-specific marriage rates [10] (Figure 6A). Figure 6B shows the age distribution of these rates (summed to 100%). For both men and women, the curves are very similar for those who marry and those who form a PACS, while for same-sex couples, the timing of PACS formation is spread over a longer period and later mean ages. As they are not able to marry, all same-sex couples are potential candidates for PACS civil partnerships (except those already living in PACS unions). Among heterosexual couples, by contrast, a percentage is already married, especially in the older cohorts for whom the PACS did not exist. For same-sex couples, the PACS therefore concerns a potentially older population. Moreover, the Act of 21 August 2007 provided for a convergence between the PACS and marriage in terms of tax status. Both married and PACS couples are now exempt from inheritance tax, and gift tax rates are identical. For older gay and lesbian couples, the PACS is the only way to protect a partner if the other partner dies. For this protection to apply, however, the partners must have prepared wills, as the PACS does not confer automatic inheritance rights on the surviving partner. For all these reasons, it is not surprising that same-sex new PACS partners are older than heterosexual ones.

Figure 6

Marriages in 2009 and PACS in 2009-2010 by age and sex

Marriages in 2009 and PACS in 2009-2010 by age and sex

30The mean age at PACS formation in 2009-2010, determined from the age-specific rates, was 38.2 years for women and 39.2 years for men in same-sex couples. Among heterosexual couples the mean age was 32.2 years for women and 34.8 years for men. Same-sex PACS unions, therefore, are formed at significantly older ages. The mean ages at marriage are very close to these figures. In 2009, women married at 32.6 years, men at 35. In other words, the French marry or form PACS unions at the same age.

A smaller age gap between partners in PACS unions

31The age gap between PACS partners varies substantially by type of union. The mean absolute gap [11] is 3.7 years for heterosexual couples. It is distinctly wider for same-sex couples: 5 years for female couples and 7 years for male couples. As noted earlier, the union timing of same-sex couples follows a different pattern, with some partners forming PACS unions at advanced ages. This no doubt partly explains the observed differences in age gaps. It would be interesting to have more detailed information on homosexual unions in general, registered or otherwise, to see whether partners with a wide age gap more frequently register their union in order to safeguard their future, or whether, generally speaking, same-sex partners – particularly men – form unions that are less homogamous in age terms.

32Age gaps between partners are smaller for heterosexual couples, and they are slightly smaller in PACS unions than for married couples. The mean absolute gaps are 3.7 and 4.4 years, respectively. The mean male-female gaps are 2.1 and 2.7 years, respectively, i.e. 0.6 years wider for married partners. The proportion of couples where the man was born at least 4 years before his partner is consistently larger among married couples, whereas a greater percentage of PACS partners are of the same age or very close in age (both born in the same year or in two contiguous years) (Figure 7). It is known that PACS partners have a higher educational level (Davie, 2011), and opportunities for meeting in educational institutions may be a factor in the similarity of partners’ ages. PACS partners also tend to form couples that are more “egalitarian” than married couples (Rault et al., 2010), and this trend is reflected in the narrower age gap between partners – in contrast with marriage where the age gap is a firmly anchored factor of domination (Bozon, 1991) – although the age gap has in fact narrowed slightly for all types of union (Vanderschelden, 2006).

Figure 7

Distribution of age differences between male and female partners, unions registered in 2009

Distribution of age differences between male and female partners, unions registered in 2009

33The age-specific patterns of PACS and marriage formation are nonetheless quite similar. A large majority of women who marry or form PACS unions at a young age have a partner at least two years older than themselves (Figure 8). Among women who marry before age 55, the majority have a husband at least two years older, whereas that is not the case for PACS unions. By age 30, only a minority of women form PACS unions with men more than one year their senior. For marriages, the proportion of unions with age gaps of two years or more does not fall below 50% for women until age 55 and above. The male profile is different. By age 30, the majority of men who marry or form PACS unions are at least two years older than their partners, and this pattern holds at all successive ages.

Figure 8

Percentage of men who are at least two years older than their partner, by the woman’s age and the man’s age at entry into union

Percentage of men who are at least two years older than their partner, by the woman’s age and the man’s age at entry into union

Divorces up slightly in 2010

34After several consecutive years of decline, the number of divorces rose again in 2010. The courts pronounced 133,909 divorces (including direct divorces and conversions of legal separations), a 2.5% rise from 130,601 in 2009. The increase concerned both the DOMs (3,099 divorces in 2010, up 2.5% on the previous year) and metropolitan France (130,810 divorces, up 2.5%) (Appendix Table A.9).

35This new uptrend is a sign that the “automatic” effects of the new legislation are coming to an end. By shortening proceedings for divorce by mutual consent and allowing spouses who have been living apart for only two years (as against six previously) to petition for divorce unilaterally, the new law triggered a surge in divorces pronounced in 2005, and a gradual decrease in the following years. With the end of this “timing effect”, the number of divorces appears to be rising again despite the downtrend in marriages.

Figure 9

Probabilities of divorce by duration of marriage, 1980-2010 (per 1,000)

Probabilities of divorce by duration of marriage, 1980-2010 (per 1,000)

36The way in which couples divorce is still slowly evolving (Prioux et al., 2010). Fault-based divorces are still declining, and now account for slightly under 10% of proceedings ending in divorce in 2010, versus more than 40% ten years earlier. While the share of divorces by mutual consent is stabilizing at around 54%, two categories of contested divorce are growing: divorces requested by one spouse and accepted by the other (14% of proceedings in 2000, 25% in 2010), and divorces for de facto separation (up from less than 2% of proceedings to nearly 11%). In this respect, the DOMs diverge from metropolitan France as a very large majority of divorces there are still contested. In 2010, just 30% of divorces were pronounced by mutual consent, and almost as many for de facto separation (30%) or at the request of one spouse accepted by the other (29%). The proportion of fault-based divorces (slightly over 10%) is comparable in relative terms to metropolitan France.

Table 7

Proportion of marriages ending in divorce (per 100 initial marriages)

Year of marriage Proportion of marriages dissolved after: Final proportion(a) 5 years 10 years 15 years 20 years 25 years 30 years minimum maximum 1965 2.9 7.5 11.6 15.4 18.5 20.5 23.3 23.4 1970 4.0 10.4 15.9 20.7 24.4 27.0 30.3 30.7 1975 5.4 12.7 18.7 23.6 27.5 30.2 33.6 34.3 1980 6.5 14.3 20.7 26.0 30.3 33.2 36.5 37.6 1985 7.1 15.8 22.7 28.4 33.0 39.2 41.0 1990 8.3 18.4 25.5 31.6 42.1 44.6 1995 7.6 17.9 25.7 42.5 44.8 2000 10.0 20.7   2005 9.6   (a) Estimates based on stable unobserved marriage probabilities (minimum), or a 10-year continuation of the mean trend over the last 10 observed years from 2011 to 2020, followed by stabilization (maximum). Population: Metropolitan France.

Proportion of marriages ending in divorce (per 100 initial marriages)

Risks remain highest five years after marriage

37The 2.5% increase in the number of divorces reflects an even sharper rise in the divorce rate, owing to the gradual decrease in the number of marriages at risk. In metropolitan France, the total divorce rate rose by 3.3% from 44.7 divorces per 100 marriages in 2009 to 46.2 per 100 in 2010 [12] (Appendix Table A.9). The increase in divorce risk is particularly high among couples who have been married for 10-30 years (up by an average 5%-6%; Figure 9A). The increase is smaller for longer marriage durations (up 3.5% for marriages lasting more than 30 years) and shorter ones (up 2% at 5-10 years of marriage), and does not concern the most recent marriages (down 2% for couples married for less than 5 years). However, the 30-year pattern of changes in the risk of divorce by marriage duration shows an uptrend that is all the stronger, in relative terms, for longer marriage durations. Since 1980, the risk of divorce has risen by “only” 63% in the first 5 years of marriage, but has doubled at 10-15 years of marriage, and has been multiplied by 3.5 at 20-25 years of marriage and by 4.5 for marriage durations of over 30 years. [13]

38However, the increase in the divorce rate in the past thirty years has not fundamentally altered the distribution of risk by marriage duration (as observed year after year), and the probability of divorce remains highest at around five years of marriage [14] (Figure 9B). In 2010, 2.9% of still-married couples who had married five years earlier (in 2005) got divorced, versus 1.5% in 1980 (couples married in 1975). Beyond that duration, the probability gradually diminishes, but the risk is high today at very long durations, since couples need to reach at least 34 years of marriage – compared with 20 years in 1980 – before the risk [15] falls below 5 per 1,000. These sharply higher probabilities concern couples who married in the 1960s and early 1970s, relatively few of whom divorced early in their marriages – people married “for life”, divorcing only in the event of serious marital breakdown – but who now have fewer qualms about ending their union. This rise in the frequency of late divorces explains the increase in the mean duration of marriage at the time of divorce, from 11.9 years in 1980 to 14.4 years in 2010.

Table 8

Infant mortality rates in the overseas départements (DOM) and in metropolitan France (per 1,000)

Year 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Guadeloupe 6.9 7.3 6.8 7.7 8.7 7.5 7.2 9.7 6.1 6.9 8.7 Martinique 6.8 7.1 7.4 6.3 6.3 5.1 9.3 8.2 8.8 7.5 9.3 French Guiana 10.2 12.4 14.0 10.2 11.0 10.4 10.7 12.6 12.1 13.6 10.4 Réunion 6.0 5.5 6.9 6.3 7.3 6.6 7.9 6.6 6.1 8.0 7.6 Overseas départements 7.0 7.2 8.1 7.3 8.1 7.2 8.5 8.6 7.7 8.8 8.6 Metropolitan France 4.3 4.4 4.5 4.1 4.0 3.9 3.6 3.6 3.6 3.6 3.7 Whole of France 4.4 4.5 4.6 4.2 4.2 4.0 3.8 3.8 3.8 3.8 3.9 Difference DOM - met. France 2.7 2.8 3.6 3.2 4.1 3.3 4.9 5.0 4.1 5.2 4.9

Infant mortality rates in the overseas départements (DOM) and in metropolitan France (per 1,000)

Table 9

Life expectancy at birth (in years) by sex in the overseas départements (DOM) and in metropolitan France

Year 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Males Guadeloupe 73.7 74.6 74.7 73.9 75.4 75.4 75.1 75.0 76.2 75.6 Martinique 75.4 75.3 75.6 75.7 76.1 76.3 77.0 76.2 76.9 77.6 French Guiana 71.5 72.1 72.9 73.3 72.3 73.4 74.6 74.4 75.5 74.8 Réunion 70.9 72.0 72.7 72.0 72.6 74.1 72.7 73.1 74.7 74.6 Overseas départements 72.6 73.4 73.8 73.4 74.0 74.8 74.4 74.3 75.6 75.5 Metropolitan France 75.0 75.3 75.5 75.8 75.9 76.7 76.8 77.2 77.4 77.6 Whole of France 74.9 75.2 75.4 75.7 75.8 76.7 76.7 77.1 77.4 77.6 Difference met. France - DOM 2.4 1.9 1.7 2.4 1.9 1.9 2.4 2.9 1.8 2.1 Females Guadeloupe 81.6 81.6 82.2 81.9 82.6 82.9 82.6 82.7 83.2 83.4 Martinique 82.3 82.2 81.5 83.2 82.5 83.9 83.2 84.5 83.2 83.8 French Guiana 78.3 80.2 79.0 80.0 80.7 80.7 80.9 81.0 81.2 81.2 Réunion 79.9 80.2 80.7 80.6 80.6 81.1 80.5 80.8 81.9 82.1 Overseas départements 80.7 81.0 81.1 81.5 81.5 82.1 81.6 82.1 82.4 82.7 Metropolitan France 82.5 82.8 82.9 83.1 83.0 83.9 83.9 84.2 84.4 84.4 Whole of France 82.5 82.8 82.9 83.0 82.9 83.8 83.8 84.2 84.4 84.3 Difference met. France - DOM 1.8 1.8 1.8 1.6 1.5 1.8 2.3 2.1 2.0 1.7

Life expectancy at birth (in years) by sex in the overseas départements (DOM) and in metropolitan France

Do more than 45% of marriages end in divorce?

39The risk of divorce by marriage duration observed in 2010 effectively concerns persons who married between 2010 (duration 0) and 1965 (duration 45), or even earlier. What can we conclude today about the divorce rate in these successive marriage cohorts, and what estimates can we offer for the final proportion of divorced couples? The probability of divorce for marriage durations exceeding 15 years has been rising steadily since the 1980s (Figure 9A), with the exception of the 2005-2008 period, which saw a break in the trend due to the new legislation. We may reasonably assume, therefore, that the uptrend will last a few more years. If the mean trend of the past ten years persists for another decade (Table 7, last column), the final proportion of divorced couples should nearly double between the marriage cohorts of 1965 (23.4%) and 1990 (44.6%), then level off in the 1995 cohort (44.8%). But the minimum assumption, based on a stabilization of the probability of divorce, yields values that are barely less high. We can already conclude, therefore, that the proportion of divorces will exceed 40% among couples married in the early 1990s and will very likely approach 45%.

40After a temporary stabilization at that level in the 1990-1995 cohorts, the rise is expected to resume in the later cohorts. Among the couples married in 2000, one in five has already divorced after 10 years of marriage (20.7%), a proportion comparable to that of the 1980 cohort after 15 years of marriage, and similar to that of the 1970 cohort after 20 years of marriage. This pattern reflects the impact of the new legislation, which resulted in an exceptional frequency of divorces in 2005, during the fifth year of marriage for the 2000 cohort. The probability reached 3.4 divorces per 100 marriages, far more than the number in a “normal” year (Figure 9B). After 5 years of marriage, as the probability of divorce has not decreased with respect to earlier cohorts (except in 2006), the final proportion of divorces in the 2000 cohort will almost certainly exceed 45%.

Figure 10

Mortality trends at each age from 1997-1999 to 2007-2009 (ratio of age-specific probabilities smoothed over 3 ages, except at age 0)

Mortality trends at each age from 1997-1999 to 2007-2009 (ratio of age-specific probabilities smoothed over 3 ages, except at age 0)

Figure 11

Excess male mortality at each age in 1997-1999 and 2007-2009 (ratio of male/female probabilities smoothed over 3 ages, except at age 0)

Excess male mortality at each age in 1997-1999 and 2007-2009 (ratio of male/female probabilities smoothed over 3 ages, except at age 0)

41These estimates of the frequency of divorce in marriage cohorts are distinctly higher than those established in the early 2000s, when the stabilization of behaviour in the second half of the 1990s suggested that the figure might not exceed 38 divorces per 100 marriages (Prioux, 2003). In less than 10 years, the frequency of divorce has thus risen sharply in France, although without reaching the levels observed in Sweden or the United States, where over half of all marriages are dissolved.

Steady progress

42The number of deaths in 2010 is provisionally estimated at 551,200 for all of France, of which 540,500 in metropolitan France and 10,700 in the overseas départements (Pla and Beaumel, 2012). The crude death rate was 8.5 per 1,000 inhabitants. For metropolitan France, as for all of France, life expectancy at birth is estimated at 78.0 years for men and 84.7 years for women, a gain of more than three months for both sexes. The gender gap remains unchanged at 6.7 years (Appendix Table A.11).

43If the provisional estimates by INSEE are confirmed, male life expectancy at birth in metropolitan France will have gained 2.7 years between 2000 and 2010. This represents a mild acceleration relative to the two previous decades, during which the gains totalled 2.6 years from 1980 to 1990, and likewise from 1990 to 2000. For women, the trend has been less favourable. The 1.9 year gain in 2000-2010 is not insignificant, however, coming after 2.6 years in 1980-1990 but only 1.8 years in 1990-2000. In other words, female life expectancy has been increasing more slowly than in the decades before 1990. Throughout the second half of the twentieth century, female mortality fell far more sharply than male mortality. Only in the 1980s did the speed of the decline in male mortality catch up with that of female mortality, before outpacing it in the more recent period.

44Mortality decreased among all socio-occupational categories in the past decade, continuing a trend observed since the 1970s. The pace of the decline is similar for all social classes, and major gaps in life expectancy persist. A recent INSEE study shows that life expectancy at age 35 for persons in higher-level occupations currently exceeds that of manual workers by 6.5 years for men and 3.0 years for women (Blanpain, 2011).

France in the European average

45In 2009, the most recent year for which comparative data are available, France remained at the European average for life expectancy at birth (Appendix Table A.12) and infant mortality (Appendix Table A.13), with no notable change on 2008. France continues to occupy a very favourable position at the top of the female ranking (84.4 years), [16] just behind Italy (84.5 years), Switzerland (84.6 years) and Spain (84.9), but its world ranking has deteriorated slightly. Until 2003, only Japan outranked France, but female life expectancy in France has been rising more slowly since the 1990s.

46The French ranking is still less favourable for men (life expectancy at birth of 77.7 years in 2009 for all of France). [17] Nearly all countries of western Europe (Germany, Luxembourg, Netherlands, Switzerland and United Kingdom), those of northern Europe (Iceland, Norway and Sweden) and even certain countries of southern Europe (Greece, Italy and Spain), after years of lagging behind France, now have a higher male life expectancy (Avdeev et al., 2011). Only the countries of eastern Europe and some other countries in a relatively favourable economic position, such as Austria, Belgium, Denmark, Finland and Ireland, have shorter male life expectancies than France.

47The 6.7 year gender gap in life expectancy remains wider than in most other European countries, except those of eastern Europe (where it varies from 6.7 years in Slovenia to 11.2 years in Lithuania) and Finland (6.9 years).

Table 10

Contribution of age groups to life expectancy gains (in years)

Age group Period 1977-79 to 1987-89 1987-89 to 1997-99 1997-99 to 2007-09 1977-79 to 1987-89 1987-89 to 1997-99 1997-99 to 2007-09 Males Females 0-14 0.06 0.07 0.02 0.05 0.05 0.02 15-24 0.07 0.06 0.04 0.05 0.04 0.02 25-44 0.16 0.22 0.18 0.13 0.11 0.09 45-64 0.48 0.50 0.47 0.30 0.20 0.16 65-79 0.91 0.87 0.99 0.72 0.47 0.41 80+ 0.71 0.78 1.15 1.18 1.11 1.30 Total 2.41 2.50 2.83 2.43 1.98 2.00 Life expectancy at end of period 72.3 74.8 77.6 80.5 82.4 84.4 Population: Metropolitan France.

Contribution of age groups to life expectancy gains (in years)

Persistent gaps between the DOMs and metropolitan France

48INSEE publishes estimates of infant mortality in each overseas département (DOM) for 1994-2009, and male and female life expectancies at birth for 1999-2008. However, the coverage of the civil registration system in the DOMs may be incomplete, especially in French Guiana, so mortality in these overseas territories may be underestimated.

49Based on the data in Table 8, infant mortality does not appear to have declined significantly in the DOMs in the past ten years, despite being substantially higher than in metropolitan France. The gap between the DOMs and metropolitan France has thus gradually widened. The infant mortality rate in the DOMs exceeded that of the other French départements by 60% in 1999. Today, it is almost 2.5 times as high. The DOM with the highest child mortality rate is French Guiana, where mortality still exceeds 10 deaths per 1,000 births (almost triple the rate of metropolitan France). However, the stagnation concerns all DOMs. [18] To a certain extent, it reflects the lack of progress also observed in the past five years in metropolitan départements, where the infant mortality rate is holding steady at 3.6 deaths per 1,000 births (Appendix Table A.11; Niel, 2011).

Table 11

Standardized mortality rates by major age groups in 2008* (per 100,000) and distribution by cause of death (%)

Cause of death Age group 0-14 15-24 25-44 45-64 65-79 80+ All ages Males Standardized rates, all causes (per 100,000) 4 6 13 69 240 1157 675 Infectious diseases 2.8 0.9 2.9 1.8 1.7 2.1 1.9 Cancers 7.4 9.8 17.1 47.4 46.4 24.6 36.6 Cardiovascular diseases 2.9 4.3 11.9 17.3 24.3 35.8 25.2 Respiratory diseases 1.3 1.1 2.2 2.9 5.9 10.0 6.2 Cancers of the digestive organs 0.6 1.0 4.8 8.4 5.1 3.8 5.4 Other diseases 72.1 9.1 12.7 10.2 11.4 18.3 14.3 Death from external causes 12.9 73.7 48.5 12.0 5.2 5.4 10.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Females Standardized rates, all causes (per 100,000) 3 2 6 31 114 769 361 Infectious diseases 3.0 2.5 2.5 1.7 1.9 2.2 2.0 Cancers 7.2 16.1 40.3 56.7 45.8 17.6 34.8 Cardiovascular diseases 3.9 7.5 11.2 12.0 22.7 39.6 26.5 Respiratory diseases 1.8 1.6 2.1 2.5 4.6 7.7 5.3 Cancers of the digestive organs 1.1 1.0 4.7 6.8 4.9 4.3 4.9 Other diseases 72.8 18.3 13.1 10.8 15.4 23.4 19.0 Death from external causes 10.1 52.9 26.2 9.6 4.7 5.2 7.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 * These rates are slightly different from those of Appendix Table A.14 because of the calculation method used. Ill-defined causes have been distributed across other causes. For a definition of the major groups of causes and the method used to distribute ill-defined causes, see Meslé (2006). Population: Metropolitan France

Standardized mortality rates by major age groups in 2008* (per 100,000) and distribution by cause of death (%)

50The trend in life expectancy at birth is more positive (Table 9). Between 1999 and 2008 in all DOMs combined, it rose from 72.6 to 75.5 years for men and from 80.7 to 82.7 years for women. As a result, the gap with the rest of France remains stable, averaging 2.1 years for men and 1.8 years for women over the period. Guadeloupe and, especially, Martinique are in a better position than Réunion and French Guiana. The maximum life expectancy gap with respect to the rest of France in the four départements was 3 years for men and 2.6 years for women in 2008.

Mortality trends that vary by age and sex

51Using INSEE’s detailed multi-year life tables for metropolitan France, the mortality gains achieved in the past ten years can be determined by age group and by sex.

52Figure 10 illustrates the changes in age-specific mortality by sex, measured by the ratios of the age-specific probabilities of dying for 2007-2009 to those of 1997-1999. Generally speaking, the largest relative gains concern children of both sexes and young adults, among whom progress is stronger for men than for women. The relative gains are weakest in the oldest age groups, where, by contrast, women are at a greater advantage. However, several age groups stand out from the trend. In the period studied, mortality fell less sharply at the youngest ages than in subsequent age groups. Maximum gains were registered at ages 10-25. Gains were weaker among women aged 40-70 and men aged 50-65 than in the surrounding age groups. Resistance to decline is particularly strong in the 50-59 group, especially among women.

53Table 10 shows each age group’s contribution in years to life expectancy gains achieved for each sex in the past thirty years. Less than 10% of the male gains between 1997-1999 and 2007-2009 and barely more than 5% of female gains are due to the decline in mortality under age 45, despite the major progress achieved at those ages. Mortality decline among the young has an ever weaker impact on the change in life expectancy at birth, as the probabilities of dying at those ages are now very low. Over 75% of the years of life gained by men and over 85% of those gained by women in the same period are due to gains achieved beyond age 65 and especially beyond age 80 (40% and 65%, respectively, of total years gained).

54Figure 11 gives the male/female ratios of the probabilities of dying by age in 1997-1999 and 2007-2009. It shows that male mortality consistently exceeds female mortality at all ages. [19] Excess male mortality is particularly high at ages 20-35 and in the 50-70 age group, for whom probabilities are twice as high for men as for women. This second excess mortality peak has been slightly eroded in the past decade owing to slower mortality decline at these ages among women relative to men. By contrast, the first peak is just as sharp in 2007-2009 as it was ten years earlier, with male mortality at least three times as high as female mortality at ages 20-25. The examination of mortality by medical cause of death sheds light on these differential trends in mortality by sex and age.

Changes in cause-specific mortality

55The distribution of deaths by medical cause can be analysed using the statistics compiled by the National Institute of Health and Medical Research (INSERM) until 2008, the most recent year for which data are available. With respect to the situation since 1990, the standardized mortality rate has decreased for both sexes for all seven major groups of medical causes of death: cancers, cardiovascular diseases, infectious diseases, respiratory diseases, other diseases, ill-defined causes, and external causes (Appendix Table A.14). However, significant variations appear when the situation is examined by sex and age group, and when causes of death are classified in greater detail, notably for the two leading causes, cardiovascular diseases and cancers.

Success in the fight against cardiovascular diseases

56The steepest decline concerns deaths from cardiovascular diseases. The standardized rate fell by 30% between 1998 and 2008, and has dropped by almost 50% since 1988. This is due in equal measure to fewer deaths from ischaemic heart diseases and cerebrovascular diseases, each of which has declined as a cause of death by approximately 35% in the past ten years (versus 20% for other heart diseases but nearly 40% for other diseases of the circulatory system). The main beneficiaries of the downtrend are adults aged 65-80, with a nearly 40% decrease, compared with 25% for the 45-65s and for persons aged 80 and over.

57The decrease was similar for both sexes, but women began from a much lower initial level. The standardized rate of mortality from cardiovascular diseases stands at 169 and 95 per 100,000 for men and women, respectively (Appendix Table A.14), versus 239 and 136 per 100,000 ten years earlier. As overall female mortality is also lower than that of men, the share of mortality from cardiovascular diseases in overall mortality is very similar for both sexes, accounting for approximately one-quarter of the standardized rate in 2008 (Table 11).

Uneven gains in the fight against cancer

58Cancer mortality has also declined but to a far lesser degree. Cancer deaths have decreased by only 12% since 1998 and 20% since 1988, and cancers are now the leading medical cause of death in France, accounting for 36% of the standardized mortality rate from all causes. This is the only major cause of death that declined much less for women than for men, by 5% versus 16%, respectively, over the period 1998-2008. This pattern is especially visible in the over-45 age group, and partly explains the resistance to decline of female mortality at those ages.

59The trend difference between the sexes is due mainly to divergences in smoking behaviour. While the proportion of regular smokers among men has been declining steadily since the Second World War, it has been rising continuously among women. The proportion among men has fallen from 70% in the mid-1950s to 30% today, whereas the proportion among women has risen from less than 10% to more than 20% in the same period (Hill and Laplanche, 2005). In consequence, mortality from cancers of the larynx, lung, or bronchus – the main causes of tobacco-related death – has risen by 37% among women in the past 10 years (and by more than 80% in the past 20), while among men it has fallen by 18% in 10 years (and by 23% since 1988). The proportion of current or former smokers is still far higher among men than among women, however. As a result, the male standardized mortality rate for these types of cancer is still four times as high as the female rate. Similarly, cancers of the upper aerodigestive tract and oesophagus – also heavily influenced by smoking – are decreasing less quickly for women (a 12% decrease for both since 1998) than for men (a 38% decrease in cancers of the upper aerodigestive tract and 31% in oesophageal cancers).

60Trends for other cancers have been very encouraging, however, particularly for stomach cancer, whose standardized mortality rate has fallen by 27% since 1998 (25% for men and 29% for women), and prostate cancer (for men), down by 24% in the same period.

Sharp drop in accidental deaths but weak decline in suicides and homicides

61Accidental mortality has fallen sharply in the past ten years, decreasing by 50% both for road-traffic accidents (which mostly involve young adults) and for accidental falls (which mainly affect the elderly). Mortality due to other accidents declined by 14%. By contrast, deaths due to suicide decreased by only 9% (the rate increases with age) and deaths due to homicide by only 7%. The homicide mortality rate actually rose very slightly among men in this period but remains below 8 per 100,000, a figure too low to influence the overall trend in deaths from external causes.

Other diseases

62The most worrying situation – in addition to the trend in female cancer mortality – concerns mortality due to mental disorders and diseases of the nervous system, which has risen sharply in the past 10 years. These diseases affect older adults in particular. Deaths due to Alzheimer’s disease have increased by an estimated 70% in the past decade or so (Aouba et al., 2011). However, as the disease was not recorded in the statistics until 1979, and concerns an age group frequently affected by multiple pathologies which make the underlying cause of death hard to identify, its increase may be due partly to advances in diagnosis, medical practices and certification.

63Mortality rates from infectious diseases, diseases of the digestive system, and diseases of the respiratory system are still falling, very slowly for the first category but significantly for the second (down 23% since 1998) and third (almost 40%). However, their share of overall mortality has become very small. These three types of diseases now account for only 2%, 5% and 6% of overall mortality, respectively, with minimal differences between the sexes (Table 11).