Economic Conditions in Early Life and Circulatory Disease Mortality

I test the Developmental Origins of Health and Disease hypothesis using a cohort perspective on mortality. I combine data from the National Health Interview Survey Linked Mortality Files, 1986–2006, and U.S. economic data between 1902 and 1956 (403,746 respondents and 39,439 deaths), to estimate how exposures to adverse economic conditions in utero and during the first three years of life affect circulatory disease mortality risk in adulthood. I also examine cohort‐based variation in these associations. Findings suggest that in utero exposures to poor economic conditions increased risk of death from circulatory diseases. Results are consistent with theory and evidence suggesting that developmental processes early in life are strongly associated with circulatory disease susceptibility in older adulthood. However, findings indicate that the mortality effects of these early‐life exposures have likely weakened across birth cohorts.     

Ethnic and religious differentials in Bulgarian mortality, 1993-98

We investigated ethnic/religious mortality differentials in Bulgaria during the 1990s. The analyses employed a unique longitudinal data-set covering the entire population of Bulgaria from the census of 1992 until 1998. The mortality of Roma is very high compared to all other ethnic/religious groups. The excess applies to nearly every cause of death examined and is not entirely explained by the adverse location of Roma on social and economic variables. For young men, Muslim mortality is substantially lower than that of non-Muslims when socio-economic differences are controlled. An analysis of causes of death suggests that lower consumption of alcohol may contribute to this 'Muslim paradox'. For older Turkish women, a significant mortality disadvantage remains after controls are imposed. Suicide mortality is lower for Muslims than for Christian groups of the same ethnicity. Consistent with deteriorating economic conditions over the study period, mortality was rising, particularly for women.     

Age,Period, Cohort and Early Mortality: An Analysis of Adult Mortality in Italy

Changes in adult mortality in Italy for cohorts born between 1882 and 1953 are analysed and interpreted by means of two different statistical models. The first, an Age–Period–Early Mortality (APEM) model, is employed to analyse the possible relationships between adverse conditions during the first 15 years of life and subsequent mortality. It is shown that higher mortality early in life is associated with higher mortality up to age 45 and lower mortality at latter ages. Finally, possible links between the observed decline in early mortality and the evolution of adult mortality are analysed and discussed.     

Being Born Under Adverse Economic Conditions Leads to a Higher Cardiovascular Mortality Rate Later in Life: Evidence Based on Individuals Born at Different Stages of the Business Cycle

We connect the recent medical and economic literatures on the long-run effects of early-life conditions by analyzing the effects of economic conditions on the individual cardiovascular (CV) mortality rate later in life, using individual data records from the Danish Twin Registry covering births since the 1870s and including the cause of death. To capture exogenous variation of conditions early in life, we use the state of the business cycle around birth. We find significant negative effects of economic conditions around birth on the individual CV mortality rate at higher ages. There is no effect on the cancer-specific mortality rate. From variation within and between monozygotic and dizygotic twin pairs born under different conditions, we conclude that the fate of an individual is more strongly determined by genetic and household-environmental factors if early-life conditions are poor. Individual-specific qualities come more to fruition if the starting position in life is better.     

The Future Labor Force of an Aging Taiwan: The Importance of Education and Female Labor Supply

This study uses multi-state cohort component projections and detailed vital statistics data to project the future Taiwanese population by age, sex, and education up to 2050. These are the first education-specific population projections for Taiwan, and they reveal how young highly educated cohorts during the next decades will replace older cohorts with lower levels of educational attainment. The results of the population projections enter our estimation of the future composition of the Taiwanese labor force. Incorporating education as an extra dimension in labor force projections allows us to make inferences about the quality of future labor supply in a rapidly aging Taiwan and the leverage of expanding economic activity across the life course, particularly of women. At present, women’s economic activity above age 25 in Taiwan is significantly lower than men’s and also much lower than women's in Western developed nations. Some of the expected adverse economic consequences of population aging can likely be alleviated by having a more educated and consequently more productive labor force. The overall results and conclusions of our study, though based on the Taiwanese context, apply to other Asian economies with rapidly aging populations and currently comparatively low levels of female labor force participation as well.     

Gender as a Moderator of the Relation Among Social Support Functions and Life Satisfaction in Older Malaysians

The aim of this study was to examine the moderating role of gender on relations among social support functions and life satisfaction in older Malaysians. The study sample was 1,800 older residents in a community; all were at least 60 years old. This study was a cross-sectional and corelational survey, and the data were collected by multistage stratified sampling. This study revealed that fewer social support functions, and therefore less life satisfaction, were available for females than for males. The results of moderated regression analyses demonstrated that gender interacted only on the relationship between positive social interaction support and tangible support with life satisfaction. Specifically, at a high tangible support level, females had lower life satisfaction when compared to a low tangible support level. There may be a need for new programs and services to provide other aspects of social support to older female adults to improve and maintain life satisfaction in later life.     

Diverging Trends in Female Old‐Age Mortality: The United States and the Netherlands versus France and Japan

In the most advanced countries, child mortality and adult mortality under age 65 years have fallen so low that further improvement in life expectancy relies almost completely on the decline of mortality at older ages. This phenomenon is particularly pronounced among women, who are far ahead of men in survival rates. Thus, to project the future of life expectancy, this study focuses on trends in female life expectancy at ages 65 and older. Four countries are selected for this analysis: the United States, Netherlands, France, and Japan. It is particularly interesting to understand why American and Dutch trends in female old‐age mortality have been diverging from those in France and Japan for two decades. It is shown here that most of the divergence derives from the fact that decline in cardiovascular mortality is more and more offset by increases in other causes of death in the United States and the Netherlands, while the other two countries are more successful in reducing mortality from all causes at increasingly older ages. This latter phenomenon could represent a new stage of the health transition.     

Understanding the age and cause drivers of recent longevity trends in Australia

Longevity continues to increase in Australia. The period 1979–2011 saw increases in life expectancy at birth of 6.9 years to 84.7 years for females, and 9.5 years to 80.2 years for males. A decomposition analysis reveals that the majority of the increase, particularly for females, is attributable to mortality improvement at older ages, and that gains are being made at increasingly older ages over time. Improvements in circulatory disease mortality account for a very significant component of life expectancy gains over the period—75 % for females and 60 % for males—with land transport accidents, congenital and perinatal mortality, and neoplasms also making significant positive contributions. Dementia and Alzheimer’s disease, and lung neoplasms for females, have had a negative impact. Females currently outlive males by 4.5 years on average, with ischaemic heart disease and prostate and other neoplasms the important positive contributors to this differential, and breast cancer having a negative effect. With 93 % of females and 88 % of males now surviving to age 65 in Australia, continued life expectancy improvements will depend to a large extent on success in delaying death at the older ages.     

中国女性老年人口的现状及问题分析

在快速的人口老龄化过程中,由于女性老年人寿命长于男性,因此成为一个规模快速增加的群体。女性在受教育、就业比例以及收入水平上一般要低于男性,因此她们在晚年生活中的弱势积累效应更加明显,表现为经济保障、健康医疗、婚姻家庭生活方面的困难更加突出。在当今家庭养老照料功能减弱和社会保障及社会服务能力不足的情况下,女性老年人口问题需要给以更多的关注。采用2005年全国1%抽样调查资料,对我国当前老年妇女的人口、婚姻、受教育、经济来源、职业以及健康状况给以描述和分析,以期为学术研究和政府管理工作提供必要的信息和依据。     

Estimating the Effect of Smoking on Slowdowns in Mortality Declines in Developed Countries

Declines in mortality rates for females at older ages in some developed countries, including the United States, have slowed in recent decades even as decreases have steadily continued in some other countries. This study presents a modified version of the indirect Peto-Lopez method, which uses lung cancer mortality rates as a proxy for smoking exposure, to analyze this trend. The modified method estimates smoking-attributable mortality for more-specific age groups than does the Peto-Lopez method. An adjustment factor is also introduced to account for low mortality in the indirect method’s study population. These modifications are shown to be useful specifically in the estimation of deaths attributable to smoking for females at older ages, and in the estimation of smoking-attributable mortality more generally. In a comparison made between the United States and France with the modified method, smoking is found to be responsible for approximately one-half the difference in life expectancy for females at age 65.     

Males’ Later-Life Mortality Consequences of Coresidence With Paternal Grandparents: Evidence From Northeast China, 1789–1909

In this study, we investigate the effect of early-life coresidence with paternal grandparents on male mortality risks in adulthood and older age in northeast China from 1789 to 1909. Despite growing interest in the influence of grandparents on child outcomes, few studies have examined the effect of coresidence with grandparents in early life on mortality in later life. We find that coresidence with paternal grandmothers in childhood is associated with higher mortality risks for males in adulthood. This may reflect the long-term effects of conflicts between mothers and their mothers-in-law. These results suggest that in extended families, patterns of coresidence in childhood may have long-term consequences for mortality, above and beyond the effects of common environmental and genetic factors, even when effects on childhood mortality are not readily apparent.     

Cardiovascular and Tuberculosis Mortality: The Contrasting Effects of Changes in Two Causes of Death

Tuberculosis was the largest source of deaths among younger adults, and cardiovascular disease among older adults, in the America of 1900. Decreases in deaths from tuberculosis since 1900 and cardiovascular disease since 1940 explain most of the mortality drops in those age groups over the century. This article, building on previous work by White and Preston, shows the results of increased survival from these two causes on the US population structure. Standard demographic cause-specific mortality calculations are used to generate life tables without deaths from cardiovascular disease or tuberculosis. Then fixed rates for these diseases from early in the century are assumed while all other causes of death are allowed to change as they did historically. Improvements in cardiovascular mortality and tuberculosis produce some seemingly illogical contrasts. More people are alive today because of the decrease in tuberculosis. Yet more deaths from cardiovascular disease have been prevented, and cardiovascular improvements have raised life expectancy more. Lower tuberculosis mortality had virtually no effect on the average age of the population. Lower cardiovascular mortality alone has raised that average more than all twentieth-century causes of improved mortality combined.     

Changing mortality patterns that led life expectancy in Japan to surpass Sweden’s: 1972–1982

Between 1972 and 1982, Japan caught up to and then surpassed Sweden as the country with the longest life expectancy. The contributions of different causes of death and age groups to life expectancy changes in males during this time period are examined in detail for these two countries. Even though cerebrovascular disease mortality rates remained lower in Sweden over the entire interval, the rapid gain made by Japan relative to Sweden for this cause of death was a prime factor in Japan's ending the period with a higher life expectancy. Important contributions to life expectancy improvement in Japan came from declining mortality rates in those aged 55 and older.     

The longevity of Jews in Canada, 1940–1942

A life table for the Jewish population of Canada, based upon their mortality experience during 1940–2, yielded an average length of life (expectation of life at birth) of 67–53 years for males and 69·89 years for females. These figures are greater than those for the general population of Canada by 4·58 years for males and 3·60 years for females. These margins decrease with advance in age; the expectations of life for Jews and for the total Canadian population are equal at age 25 in the case of females, and at age 35 in the case of males.

Jewish infants in Canada start life with a mortality rate, in the first year, only two-fifths of that for the general population. This advantage for Jews is observed through childhood, adolescence, and early maturity. However, the margin between the Jewish and total populations decreased with advance in age until, shortly after age 50, the Jews begin to show the higher mortality rates.

The Jewish populations of the United States and of Canada have great similarities in their social and economic structures. They also share, very largely, in their European origins, and they have come to North America during the same period. It is, therefore, a fair assumption that the longevity and mortality characteristics of the relatively small Jewish population of Canada may be indicative of what might be found for the millions of Jews in the United States, for whom such information is not available.     

Epidemiological evaluation of death risk from cardiovascular diseases among Polish population of working age

"The aim of the study was an evaluation of death risk among men and women of working age exposed to cardiovascular risk factors. The survey covered random samples of the population living in the regions of Wroclaw and Ciechanow, [Poland,] including families of all who died from cardiovascular diseases in 1988.... The results of demographic analyses [indicate] that social factors exerting a negative effect on health behaviours are responsible for high mortality in males. Moreover, difficulties of Polish life place additional stress on male population.... For each from among 18 analysed factors the risk of death from cardiovascular diseases was several times higher in exposed males than in females."     

Macroeconomic fluctuations and mortality in postwar Japan

Recent research has shown that after long-term declining trends are excluded, mortality rates in industrial countries tend to rise in economic expansions and fall in economic recessions. In the present work, co-movements between economic fluctuations and mortality changes in postwar Japan are investigated by analyzing time series of mortality rates and eight economic indicators. To eliminate spurious associations attributable to trends, series are detrended either via Hodrick-Prescott filtering or through differencing. As previously found in other industrial economies, general mortality and age-specific death rates in Japan tend to increase in expansions and drop in recessions, for both males and females. The effect, which is slightly stronger for males, is particularly noticeable in those aged 45-64. Deaths attributed to heart disease, pneumonia, accidents, liver disease, and senility--making up about 41% of total mortality--tend to fluctuate procyclically, increasing in expansions. Suicides, as well as deaths attributable to diabetes and hypertensive disease, make up about 4% of total mortality and fluctuate countercyclically, increasing in recessions. Deaths attributed to other causes, making up about half of total deaths, don't show a clearly defined relationship with the fluctuations of the economy.     

The association of childhood socioeconomic conditions with healthy longevity at the oldest-old ages in China

Based on unique data from the largest-ever sample of the Chinese oldest-old aged 80 and older, our multivariate logistic regression analyses show that either receiving adequate medical service during sickness in childhood or never/rarely suffering from serious illness during childhood significantly reduces the risk of being ADL (activities of daily living) impaired, being cognitively impaired, and self-reporting poor health by 18%-33% at the oldest-old ages. Estimates of effects for five other indicators of childhood conditions are similarly positive but mostly not statistically significant. Multivariate survival analysis shows that better childhood socioeconomic conditions in general tend to reduce the four-year period mortality risk among the oldest-old. But after additional controls for 14 covariates are put into the model, the effects are not statistically significant, thus suggesting that most of the effects of childhood conditions on oldest-old mortality are indirect-at least to the point of affecting current health status at the oldest-old ages, which itself is strongly associated with mortality. While acknowledging limitations of the present analyses due to a lack of information on childhood illness, the oldest-olds'recollection errors, and other data problems, we conclude, based on this and other studies, that policies that enhance childhood health care and children's socioeconomic well-being can have large and long-lasting benefits up to the oldest-old ages.     

New african American life tables from 1935–1940 to 1985–1990*

New life tables for African Americans are presented from 1935 through 1990. They are based on a historical series of vital statistics data on deaths that have been corrected for age misreporting, on reconstructed population counts that have been adjusted for census underenumeration, and on births that have been corrected for underregistration. The new life tables show rapid mortality declines for both African American males and females from 1935 to 1950, and relatively steady reductions thereafter for females. The smaller declines in male mortality in young adulthood and middle age since the 1950s have led to exceptionally high ratios of male to female mortality at these ages. Corrections for census undercounts lead to higher values of life expectancy than in official life tables, but to less improvement over time. Official estimates of life expectancy at age 65 appear to be about 10% too high around 1940 but only about 1.5% too high in the late 1980s.     

US mortality in an international context: age variations

Compared to other developed countries, the United States ranks poorly in terms of life expectancy at age 50. We seek to shed light on the US's low life expectancy ranking by comparing the age-specific death rates of 18 developed countries at older ages. A striking pattern emerges: between ages 40 and 75, US all-cause mortality rates are among the poorest in the set of comparison countries. The US position improves dramatically after age 75 for both males and females. We consider four possible explanations of the age patterns revealed by this analysis: (1) access to health insurance; (2) international differences in patterns of smoking; (3) age patterns of health care system performance; and (4) selection processes. We find that health insurance and smoking are not plausible sources of this age pattern. While we cannot rule out selection, we present suggestive evidence that an unusually vigorous deployment of life-saving technologies by the US health care system at very old ages is contributing to the age-pattern of US mortality rankings. Differences in obesity distributions are likely to be making a moderate contribution to the pattern but uncertainty about the risks associated with obesity prevents a precise assessment.     

Sex Ratio at Birth and Infant Mortality Rate in China: An Empirical Study

In this article, we used the data from the last three population censuses of China in 1982, 1990 and 2000, to study the dynamics of the sex ratio at birth and the infant mortality rate in China. In the late 1970s, China started its economic reform and implemented many family planning programs. Since then there has been great economic development and a dramatic decrease in fertility in most of its provinces. Along with these achievements, the sex ratio at birth of the Chinese population has increased to significantly more males to females, and in some provinces of China reached unprecedented levels. The ratio of infant mortality of the males to females for manyprovinces in China become extremely unbalanced with a much higher female infant mortality rate. In our study, we investigated the statistical relationship between the sex ratio at birth and the ratio of the infant mortality of males to female. Social and economic reasons for these unnatural trends are also discussed.