Falling Short of Highest Life Expectancy: How Many Americans Might Have Been Alive in the Twentieth Century?

Life expectancy at birth in the United States during the twentieth century was lower than in many other highly developed countries. We investigate how this mortality disadvantage in the last 100 years translates into the number of hypothetical lives lost and their sex and age structure. We estimate the hypothetical US population if it had experienced in each decade since 1900 the mortality level of the country with the then highest life expectancy and compare the results to the actual figures in 2000. By 2000, the number of additional people who could have been alive had the mortality levels in the United States been as low as those in countries with the highest life expectancy was 66 million. This number is distributed equally between males and females. Suboptimal mortality at reproductive ages is crucial for the cumulative effect of potential lives lost, resulting from premature deaths of women who could still become first‐time mothers or bear additional children. Out of the 66 million additional persons who could have been alive in 2000, 45 million are attributable to those indirect deaths. Although the differences in the composition of the population by sex and age under the two mortality regimes are minor, the majority of people who might have been alive—54 million—were of working age or younger.     

Anatomy of a Municipal Triumph: New York City's Upsurge in Life Expectancy

Over the period 1990–2010, the increase in life expectancy for males in New York City was 6.0 years greater than for males in the United States. The female relative gain was 3.9 years. Male relative gains were larger because of extremely rapid reductions in mortality from HIV/AIDS and homicide, declines that reflect effective municipal policies and programs. Declines in drug‐ and alcohol‐related deaths also played a significant role in New York City's advance, but every major cause of death contributed to its relative improvement. By 2010, New York City had a life expectancy that was 1.9 years greater than that of the US. This difference is attributable to the high representation of immigrants in New York's population. Immigrants to New York City, and to the United States, have life expectancies that are among the highest in the world. The fact that 38 percent of New York's population consists of immigrants, compared to only 14 percent in the United States, accounts for New York's exceptional standing in life expectancy in 2010. In fact, US‐born New Yorkers have a life expectancy below that of the United States itself.     

Cigarette Smoking and All-Cause and Cause-Specific Adult Mortality in the United States

This study illuminates the association between cigarette smoking and adult mortality in the contemporary United States. Recent studies have estimated smoking-attributable mortality using indirect approaches or with sample data that are not nationally representative and that lack key confounders. We use the 1990–2011 National Health Interview Survey Linked Mortality Files to estimate relative risks of all-cause and cause-specific mortality for current and former smokers compared with never smokers. We examine causes of death established as attributable to smoking as well as additional causes that appear to be linked to smoking but have not yet been declared by the U.S. Surgeon General to be caused by smoking. Mortality risk is substantially elevated among smokers for established causes and moderately elevated for additional causes. We also decompose the mortality disadvantage among smokers by cause of death and estimate the number of smoking-attributable deaths for the U.S. adult population ages 35+, net of sociodemographic and behavioral confounders. The elevated risks translate to 481,887 excess deaths per year among current and former smokers compared with never smokers, 14 % to 15 % of which are due to the additional causes. The additional causes of death contribute to the health burden of smoking and should be considered in future studies of smoking-attributable mortality. This study demonstrates that smoking-attributable mortality must remain a top population health priority in the United States and makes several contributions to further underscore the human costs of this tragedy that has ravaged American society for more than a century.     

Continued Reductions in Mortality at Advanced Ages

Mortality data for 30 mostly developed countries available in the Kannisto–Thatcher Database on Old‐Age Mortality (KTDB) are drawn on to assess the pace of decline in death rates at ages 80 years and above. As of 2004 this database recorded 37 million persons at these ages, including 130,000 centenarians (more than double the number in 1990). For men, the probability of surviving from age 80 to age 90 has risen from 12 percent in 1950 to 26 percent in 2002; for women, the increase has been from 16 percent to 38 percent. In the lowest‐mortality country, Japan, life expectancy at age 80 in 2006 is estimated to be 6.5 years for men and 11.3 years for women. For selected countries, average annual percent declines in age‐specific death rates over the preceding ten years are calculated for single‐year age groups 80 to 99 and the years 1970 to 2004. The results are presented in Lexis maps showing the patterns of change in old‐age mortality by cohort and period, and separately for men and women. The trends are not favorable in all countries: for example, old‐age mortality in the United States has stagnated since 1980. But countries with exceptionally low mortality, like Japan and France, do not show a deceleration in death rate declines. It is argued that life expectancy at advanced ages may continue to increase at the same pace as in the past.     

A Comparison of US and Canadian Mortality in 1998

On average, Americans die earlier than Canadians. An estimate based on comparing the number of actual US deaths with the number that would have obtained had Canadian age‐ and sex‐specific death rates applied to the US population shows an excess number of US deaths in 1998 amounting approximately to 253,000. Excess US deaths were especially numerous among older women, middle‐aged men, and nonwhites. Circulatory diseases were the major cause of excess deaths. Prevalences of two of the major risk factors for circulatory deaths—smoking and hypertension—were higher in Canada than in the US. But obesity was higher in the US, suggesting a likely important role that obesity plays in higher mortality in the US relative to Canada. Comparisons of the level, age pattern, and causes of US and Canadian mortality, however, raise more questions than currently available data can answer.     

The Middle East population puzzle

An overview is provided of Middle Eastern countries on the following topics; population change, epidemiological transition theory and 4 patterns of transition in the middle East, transition in causes of death, infant mortality declines, war mortality, fertility, family planning, age and sex composition, ethnicity, educational status, urbanization, labor force, international labor migration, refugees, Jewish immigration, families, marriage patterns, and future growth. The Middle East is geographically defined as Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates, Yemen, Gaza and the West Bank, Iran, Turkey, and Israel. The Middle East's population grew very little until 1990 when the population was 43 million. Population was about doubled in the mid-1950s at 80 million. Rapid growth occurred after 1950 with declines in mortality due to widespread disease control and sanitation efforts. Countries are grouped in the following ways: persistent high fertility and declining mortality with low to medium socioeconomic conditions (Jordan, Oman, Syria, Yemen, and the West Bank and Gaza), declining fertility and mortality in intermediate socioeconomic development (Egypt, Lebanon, Turkey, and Iran), high fertility and declining mortality in high socioeconomic conditions (Bahrain, Iraq, Kuwait, Qatar, Saudi Arabia, and the United Arab Emirates), and low fertility and mortality in average socioeconomic conditions (Israel). As birth and death rates decline, there is an accompanying shift from communicable diseases to degenerative diseases and increases in life expectancy; this pattern is reflected in the available data from Egypt, Kuwait, and Israel. High infant and child mortality tends to remain a problem throughout the Middle East, with the exception of Israel and the Gulf States. War casualties are undetermined, yet have not impeded the fastest growing population growth rate in the world. The average fertility is 5 births/woman by the age of 45. Muslim countries tend to have larger families. Contraceptive use is low in the region, with the exception of Turkey and Egypt and among urban and educated populations. More than 40% of the population is under 15 years of age. The region is about 50% Arabic (140 million). Educational status has increased, particularly for men; the lowest literacy rates for women are in Yemen and Egypt. The largest countries are Iran, Turkey, and Egypt.     

Who Takes Care of Whom in the United States? Time Transfers by Age and Sex

Non‐monetary transfers of time represent a largely unknown, yet pivotal component, of the support system in the United States. We map flows of time transfers, by age and sex, related to informal childcare and adult care in the US. We develop methods to estimate intra‐ and inter‐household time transfers using data from the American Time Use Survey (2011–2013). We summarize the results in matrices of time flows by age and sex for the general US population, as well as for the “sandwich generation.” Most time transfers flow downwards from parents to young children, with relevant gender differences. The time produced by the sandwich generation is directed toward a more diverse population spectrum, including substantial intra‐generational transfers to spouses. Extrapolations based on our findings reveal a projected rise in demand, relative to supply, of informal care, indicating that, to maintain current levels of care, US society will have to rely more heavily either on the market or on an increased effort of caregivers.     

Estimating Smoking-Attributable Mortality in the United States

Tobacco use is the largest single cause of premature death in the developed world. Two methods of estimating the number of deaths attributable to smoking use mortality from lung cancer as an indicator of the damage from smoking. We re-estimate the coefficients of one of these, the Preston/Glei/Wilmoth model, using recent data from U.S. states. We calculate smoking-attributable fractions for the 50 states and the United States as a whole in 2004, and estimate the contribution of smoking to the high adult mortality of the southern states. We estimate that 21% of deaths among men and 17% among women were attributable to smoking in 2004. Across states, attributable fractions range from 11% to 30% among men and from 7% to 23% among women. Smoking-related mortality also explains as much as 60% of the mortality disadvantage of southern states compared with other regions. At the national level, our estimates are in close agreement with those of the Centers for Disease Control and Prevention and Preston/Glei/Wilmoth, particularly for men, although we find greater variability by state than does CDC. We suggest that our coefficients are suitable for calculating smoking-attributable mortality in contexts with relatively mature epidemics of cigarette smoking.     

Mortality among elderly hispanics in the United States: Past evidence and new results

We used vital records and census data and Medicare and NUMIDENT records to estimate age- and sex-specific death rates for elderly non-Hispanic whites and Hispanics, including five Hispanic subgroups: persons born in Cuba, Mexico, Puerto Rico, other foreign countries, and the United States. We found that corrections for data errors in vital and census records lead to substantial changes in death rates for Hispanics and that conventionally constructed Hispanic death rates are lower than rates based on Medicare-NUMIDENT records. Both sources revealed a Hispanic mortality advantage relative to non-Hispanic whites that holds for most Hispanic subgroups. We also present a new methodology for inferring Hispanic origin from a combination of surname, given name, and county of residence.     

Long‐Term Population Projections and the US Social Security System

According to a report recently issued by the Technical Panel for the US Social Security Administration, the long‐term financial outlook for the system is worse than previously thought. The worsening projected by the panel in the long‐run funding imbalance of the Social Security System is mostly due to the recommendation by the panel to add an extra four years to the currently projected increase in life expectancy by 2075: from 81.8 years to 85.9 years. The panel recommended no change in the current intermediate projected long‐run TFR of 1.9 and net immigration of 900,000 persons per year. The recommendation to increase the projected gains in life expectancy was based on international trends as well as on historical trends in the United States and the absence of biological evidence ruling out such gains. Industrial countries have a history of under‐predicting the growth of their elderly population, and it is expected that large mortality adjustments may be needed in the projections for public pension programs also in industrial countries other than the United States.     

Paradox found (again): Infant mortality among the Mexican-origin population in the united states

Recent research suggests that the favorable mortality outcomes for the Mexican immigrant population in the United States may largely be attributable to selective out-migration among Mexican immigrants, resulting in artificially low recorded death rates for the Mexican-origin population. In this paper we calculate detailed age-specific infant mortality rates by maternal race/ethnicity and nativity for two important reasons: (1) it is extremely unlikely that women of Mexican origin would migrate to Mexico with newborn babies, especially if the infants were only afew hours or afew days old; and (2) more than 50% of all infant deaths in the United States occur during the first week of life, when the chances of out-migration are very small. We use concatenated data from the U.S. linked birth and infant death cohort files from 1995 to 2000, which provides us with over 20 million births and more than 150,000 infant deaths to analyze. Our results clearly show that first-hour, first-day, and first-week mortality rates among infants born in the United States to Mexican immigrant women are about 10% lower than those experienced by infants of non-Hispanic, white U.S.-born women. It is extremely unlikely that such favorable rates are artificially caused by the out-migration of Mexican-origin women and infants, as we demonstrate with a simulation exercise. Further, infants born to U.S.-born Mexican American women exhibit rates of mortality that are statistically equal to those of non-Hispanic white women during the first weeks of life and fare considerably better than infants born to non-Hispanic black women, with whom they share similar socioeconomic profiles. These patterns are all consistent with the definition of the epidemiologic paradox as originally proposed by Markides and Coreil (1986).     

The Census Bureau on Prospects for US Population Growth in the Twenty‐First Century

The U.S. Census Bureau periodically releases projections of the US resident population, detailed by age, sex, race, and Hispanic origin. The most recent of these, issued 13 January 2000, for the first time extend to the year 2100 and also include information on the foreign‐bom population. (Earlier projections were carried up to 2080.) The extensive tabulations presenting the new set, and detailed explanation of the methodology and the assumptions underlying the projections, are accessible at the Census Bureau's web site: http://www.census.gov . A brief summary of some of the main results of these projections is reproduced below from United States Department of Commerce News, Washington, DC 20230. (The Census Bureau is an agency of the Department of Commerce.) Uncertainties as to future trends in fertility, mortality, and net migration over a period of some 100 years are very great, as is illustrated by the massive difference in the projected size of the population for 2100 in the three variants produced. The “middle” projected population figure of 571 million (which represents a growth of some 109 percent over its current level) is bracketed by “lowest” and “highest” alternative projections of 283 million and 1.18 billion, respectively. With somewhat lesser force, the point also applies to the 50‐year time span considered in the well‐known country‐by‐country projections of the United Nations. These projections are also detailed in three variants: low, middle, and high. The UN projections (last revised in 1998) envisage less rapid growth in the United States during the first part of the twenty‐first century than do the Census Bureau's. The projected population figures for 2050 in the three variants (low, middle, and high) are as follows (in millions):

Geographic Divergence in Mortality in the United States

The United States trails other developed countries in adult mortality, a process that has become more pronounced over the past several decades. However, comparisons are complicated by substantial geographic variations in mortality within the United States. The second half of the twentieth century was characterized by a substantial divergence in adult mortality between the South and the rest of the United States. The article examines trends in US geographic variation in mortality between 1965 and 2004, in particular the aggregate divergence in mortality between the southern states and states with more favorable mortality experience. Relatively high smoking‐attributable mortality in the South explains 50–100 percent of the divergence for men between 1965 and 1985 and up to 50 percent for women between 1985 and 2004. There is also a geographic correspondence between the contribution of smoking and other factors, suggesting that smoking may be one piece of a more complex health‐related puzzle.     

两人群引力模型框架下的中国死亡率预测①--结合美国相应数据

Lee－Carter系列模型是对一个人群的死亡率动态建模和预测的模型。由于中国死亡率抽样数据的质量问题导致模型预测的效果不如国外文献所反映的那么精确。本文在两人群引力模型框架下结合中国和美国同期死亡率数据建模，并将结果与相应的单人群模型比较。研究表明，引力模型与APC模型相结合取得了最好的效果，在此基础上本文预测2025年老年抚养比会急剧上升到23．32％，2030年的婚配男性人口超出女性约2079万，婴幼青少年20年间累计死亡人数约293万。     

Two Decades of Negative Educational Selectivity of Mexican Migrants to the United States

Immigration is commonly considered to be selective of more educated individuals. Previous US studies comparing the educational attainment of Mexican immigrants in the United States to that of the Mexican resident population support this characterization. Upward educational‐attainment biases in both coverage and measurement, however, may be substantial in US data sources. Moreover, differences in educational attainment by place size are very large within Mexico, and US data sources provide no information on immigrants' places of origin within Mexico. To address these problems, we use multiple sources of nationally representative Mexican survey data to re‐evaluate the educational selectivity of working‐age Mexican migrants to the United States over the 1990s and 2000s. We document disproportionately rural and small‐urban‐area origins of Mexican migrants and a steep positive gradient of educational attainment by place size. We show that together these conditions induced strongly negative educational selection of Mexican migrants throughout the 1990s and 2000s. We interpret this finding as consistent with low returns to education among unauthorized migrants and few opportunities for authorized migration.     

Projecting the Effect of Changes in Smoking and Obesity on Future Life Expectancy in the United States

We estimate the effects of declining smoking and increasing obesity on mortality in the United States over the period 2010–2040. Data on cohort behavioral histories are integrated into these estimates. Future distributions of body mass indices are projected using transition matrices applied to the initial distribution in 2010. In addition to projections of current obesity, we project distributions of obesity when cohorts are age 25. To these distributions, we apply death rates by current and age-25 obesity status observed in the National Health and Nutrition Examination Survey, 1988–2006. Estimates of the effects of smoking changes are based on observed relations between cohort smoking patterns and cohort death rates from lung cancer. We find that changes in both smoking and obesity are expected to have large effects on U.S. mortality. For males, the reductions in smoking have larger effects than the rise in obesity throughout the projection period. By 2040, male life expectancy at age 40 is expected to have gained 0.83 years from the combined effects. Among women, however, the two sets of effects largely offset one another throughout the projection period, with a small gain of 0.09 years expected by 2040.     

The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007

Black–white mortality disparities remain sizable in the United States. In this study, we use the concept of avoidable/amenable mortality to estimate cause-of-death contributions to the difference in life expectancy between whites and blacks by gender in the United States in 1980, 1993, and 2007. We begin with a review of the concept of “avoidable mortality” and results of prior studies using this cause-of-death classification. We then present the results of our empirical analyses. We classified causes of death as amenable to medical care, sensitive to public health policies and health behaviors, ischemic heart disease, suicide, HIV/AIDS, and all other causes combined. We used vital statistics data on deaths and Census Bureau population estimates and standard demographic decomposition techniques. In 2007, causes of death amenable to medical care continued to account for close to 2 years of the racial difference in life expectancy among men (2.08) and women (1.85). Causes amenable to public health interventions made a larger contribution to the racial difference in life expectancy among men (1.17 years) than women (0.08 years). The contribution of HIV/AIDS substantially widened the racial difference among both men (1.08 years) and women (0.42 years) in 1993, but its contribution declined over time. Despite progress observed over the time period studied, a substantial portion of black–white disparities in mortality could be reduced given more equitable access to medical care and health interventions.     

Fertility of the american negro in 1830 and 1850

Abstract A comparison of the proportionate age distributions for negroes enumerated in the decennial censuses of the United States in the first half of the rorh century indicates that by 1850, negro fertility apparently had been declining for at least 20 years. This paper develops the relationship of the age distribution of a declining fertility population, where the decline has persisted for less than 25 years, to the stable population with the same current schedules of fertility and mortality. This relationship is used to estimate the negro birth rate and total fertility as of 1850. In turn, these estimates and the relationship of the age distributions of two stable populations with different fertility are used to estimate the negro birth rate and total fertility as of 1830.     

Hidden in Plain Sight: Global Labor Force Exchange in the Chinese American Population, 1880–1940

Despite a once‐conspicuous presence in the Western United States, little is known demo‐graphically about the Chinese in the late nineteenth and early twentieth century in the United States. The widely accepted model of a declining male “sojourner society,” beset by draconian restrictions on immigration and the impossibility of family formation, is seemingly contradicted by the continuous economic vitality of urban Chinatowns in the United States. This article tests the largely unexamined demographic structure of the Chinese population in the United States through the application of cohort‐component projection on census data from 1880 through 1940, including data recently made available as part of the Integrated Public Use Microdata Series (IPUMS). The results fail to support the model of passive population decline, suggesting instead that the Chinese actively engaged in a collective strategy of long‐distance labor exchange to maximize economic productivity among Chinese workers in the United States.