Work in progress
Work in progress
Who lives longer in Paris? Dynamics of spatial and socioeconomic inequalities in longevity across Parisian districts, 1881--2019 (with C.-G. Camarda and C. Torres).
We combine newly digitized historical sources with modern statistical modeling to reconstruct continuous sex-specific lifetables for Paris and its 20 districts from 1881 to2023. First, we challenge the notion of “urban penalty”: by the late 19th century, life expectancy at birth (e0) was 13–14 years higher in the five best-performing districts than in the five worst-performing ones, and exceeded the national average. Second, we reveal that these gaps reflected social stratification: the five most affluent districts enjoyed e0 11-12 years higher than the five least affluent. Over subsequent decades, disparities narrowed, reaching a historical low by the mid-20th century. Yet these inequalities have widened again since the 1970s, with affluent districts regaining a clear survival advantage. Paris thus emerges from our study as a highly divided ‘longevity capital’ at the end of the 19th century, where health and life chances were deeply shaped by social geography.
Rise and Fall of the Deaths of Despair Burden across European Regions, 2002–2019. (with I. Alliger, C.-G. Camarda, F. Meslé, M. Mühlichen, E. Perdrix, P. Grigoriev).
Concerns about stagnating life expectancy in the United States (US) have recently focused on the burden of “deaths of despair”. While extensively studied in this country, evidence for Europe remains fragmented and mostly national. We present the first systematic regional analysis of despair-related mortality across 20 European countries from 2002–2019, using age-standardized years of life lost (YLL) to capture the burden of premature deaths. We estimate trends by sex, age, and cause, identify statistically significant regional increases or declines, and compare our findings to the US as a benchmark. Our preliminary results suggest that the overall European picture is less alarming than in the US, but worrying sub-patterns emerge. Acute alcohol mortality has risen sharply in many Northern and Eastern European regions among older adults, while deaths from drugs and toxic substances have increased among younger adults in Germany, the Netherlands, the UK, Sweden, and Spain.
A Unified Innovation–Diffusion Theory of Fertility Transitions: New Insights from French Regional Fertility, 1853-2023 (with S. Florian).
We propose a theoretical framework that unifies the narratives of fertility trends into a single model with two successive innovation–diffusion processes: the spread of lower fertility (quantum) and delayed fertility (tempo), both proceeding through four phases and originating in wealthier regions before diffusing to lower-income ones. We test this framework using a new French dataset, analyzing trends in income per capita and Total Fertility Rates (TFR) by region from 1855 to 2023, decomposing TFRs into age-specific fertility rates (ASFR). During 1855–1945, TFRs were higher in poorer regions, as richer regions experienced earlier fertility decline. From 1970s, delayed fertility emerged first in high-income regions, increasing ASFRs at older ages, producing a rapid rise in mean age at birth (MAB), while poorer regions lagged behind. By 2023, results suggest that France has not yet entered the third phase of the tempo innovation, in which MAB converges across regions.
Spatial Disparities in Disability Prevalence at the District Level in Sub-Saharan African Countries. (with A Simo-Fotso and J. Martin).
Abstract: The World Health Organization reports the highest prevalence of disability under age 60 in sub-Saharan Africa, yet evidence remains scarce due to limited and non-comparable measurements. To address this gap, we estimate subnational disability prevalence using harmonized data from 26 countries, collected between 2016 and 2022 through Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Both surveys assess functional limitations in vision, hearing, mobility, cognition, communication, and self-care. We focus on adults aged 18–49 and generate estimates at the second subnational administrative level. Because direct survey estimates are often unstable at this scale, we apply small area estimation methods that borrow strength across age groups and geographic units. From these results, we derive age-standardized prevalence rates to facilitate cross-regional and cross-country comparison. Our findings reveal that 682 subnational units show prevalence above 2.5%, 233 above 5%, and 31 above 10%. The highest-burden areas cluster along the Ghana–Togo and Central African Republic–Democratic Republic of the Congo borders, in southern Democratic Republic of the Congo, and in parts of Madagascar. These patterns call for greater attention from national and international policymakers to the most affected areas.
Exploring the Contribution of Educational Composition on Life Expectancy Changes in the United States, 2010-2018. (with J. V. Antunes Lopes, C.-G. Camarda, M. P. Bergeron Boucher, T. Riffe).
This study examines how changes in educational attainment composition contributed to trends in life expectancy (LE) at age 30 in the United States between 2010 and 2018. We ask two main questions: (1) How much of the change in LE can be attributed to shifts in the educational composition of the population? (2) How much is due to changes in mortality within educational groups? Using Horiuchi (2008)'s decomposition approach, we find that both factors played a role. The increase in the share of adults with higher education had a positive impact on LE, but rising mortality within some educational groups, especially the less educated, offset part of these gains. These results show the importance of considering both population composition and group-specific mortality trends to understand recent LE stagnation and decline in the US.
Trends in Heath Expectancies in France: to what extent the (social) cards have been reshuffled over the 2010's? (with E. Cambois).