The U.S. elderly experience shorter lifespans and greater variability in age at death than their Canadian peers. In order to gain insight on the underlying factors responsible for the Canada-U.S. old-age mortality disparities, we propose a cause-of-death analysis. Accordingly, the objective of this paper is to compare levels and trends in cause-specific modal age at death (M) and standard deviation above the mode (SD(M +)) between Canada and the U.S. since the 1970s. We focus on six broad leading causes of death, namely cerebrovascular diseases, heart diseases, and four types of cancers. Country-specific M and SD(M +) estimates for each leading cause of death are calculated from P-spline smooth age-at-death distributions obtained from detailed population and cause-specific mortality data. Our results reveal similar levels and trends in M and SD(M +) for most causes in the two countries, except for breast cancer (females) and lung cancer (males), where differences are the most noticeable. In both of these instances, modal lifespans are shorter in the U.S. than in Canada and U.S. old-age mortality inequalities are greater. These differences are explained in part by the higher stratification along socioeconomic lines in the U.S. than in Canada regarding the adoption of health risk behaviours and access to medical services.

与加拿大同龄人相比，美国老年人寿命较短，死亡时的年龄变异更大。为了深入了解造成加拿大-美国老年人死亡率差异的根本因素，我们提出了死亡原因分析。因此，本文的目的是比较 自1970年代以来加拿大和美国之间因特定原因而死亡的模态年龄（M）和高于模式的标准偏差（SD（M +））的水平和趋势。我们专注于六种主要的死亡主要原因，即脑血管疾病，心脏病和四种类型的癌症。 每个死亡原因的特定国家/地区的M和SD（M +）估算值均根据以下公式计算P样条曲线可从详细的人口和特定病因死亡率数据获得死亡时的平稳年龄分布。我们的研究结果表明 ，两国之间大多数原因的M和SD（M +）的水平和趋势相似，但乳腺癌（女性）和肺癌（男性）除外，两者之间的差异最为明显。在这两种情况下，美国的模态寿命都比加拿大短，美国的老年死亡率不平等也更大。这些差异部分是由于在采用健康风险行为和获得医疗服务方面，美国在社会经济方面的分层远高于加拿大。