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.

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.

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.

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.

During the 2010s, progress in life expectancy (LE) in low-mortality countries slowed, fuelling debate over the possible limits of human longevity. Within the framework of health transition models, this slowdown raises questions about changes in health patterns and about how progress is distributed across social groups. If a common model of transition toward high longevity exists, can the currently longest-living groups be considered “vanguards”? And can further gains in LE occur through the diffusion of these groups’ advantages to others? To address these questions, we analysed trends in disability and disability-free life expectancy (DLE and DFLE) by occupational class (OC) for overlapping three-year periods from 2011–13 to 2017–19, using the Sullivan method applied to census-linked mortality data and the French EU-SILC survey. The female highly skilled OC—our “vanguard” group—continued to gain LE at older ages but also experienced an expansion of DLE. Female skilled workers caught up with the vanguards’ situation observed in the early 2010s through a compression of DLE. However, other OCs displayed divergent trajectories once they reached similar levels of LE. These preliminary findings suggest that there is no shared model of transition to longer life, with vanguards being progressively followed by lagging groups. While they do not contradict the possibility of future longevity gains, they underline the importance of recognising the diversity of health trajectories and needs across social groups in an ageing society.