Rectangularization of the survival curve in the Netherlands, 1950-1992

In this article we determine whether rectangularization of the survival curve occurred in the Netherlands in the period 1950-1992. Rectangularization is defined as a trend toward a more rectangular shape of the survival curve due to increased survival and concentration of deaths around the mean age at death. We distinguish between absolute and relative rectangularization, depending on whether an increase in life expectancy is accompanied by concentration of deaths into a smaller age interval or into a smaller proportion of total life expectancy. We used measures of variability based on Keyfitz' H and the standard deviation, both life table-based. Our results show that absolute and relative rectangularization of the entire survival curve occurred in both sexes and over the complete period (except for the years 1955-1959 and 1965-1969 in men). At older ages, results differ between sexes, periods, and an absolute versus a relative definition of rectangularization. Above age 60 1/2, relative rectangularization occurred in women over the complete period and in men since 1975-1979 only, whereas absolute rectangularization occurred in both sexes since the period of 1980-1984. The implications of the recent rectangularization at older ages for achieving compression of morbidity are discussed.