Causes of death contributing to changes in life expectancy in New York City between 1983 and 1992

Recent changes in life expectancy among race and sex groups in New York City were evaluated by analyzing the relative effects of different causes of death in 1983 and 1992, a period in which life expectancy at birth declined by 1.1 years among white males, remained unchanged among black males, and increased 1.2 years among white and black females. Heart disease was found to be the leading cause of death making positive contributions to changes in life expectancy regardless of race or sex, and HIV/AIDS was the leading negative contributor. Overall, deaths from infectious diseases and external causes are becoming more important compared to degenerative conditions in explaining trends in life expectancy in New York City. Past improvements in survival due to reductions in infant deaths are being reversed due to an increase in deaths from preventable causes such as violence and AIDS. Future gains in longevity may require a greater emphasis on policies and programs emphasizing conflict resolution and HIV prevention.     

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.     

Probabilistic population projections for countries with generalized HIV/AIDS epidemics

In 2015, the United Nations (UN) issued probabilistic population projections for all countries up to 2100, by simulating future levels of total fertility and life expectancy and combining the results using a standard cohort component projection method. For the 40 countries with generalized HIV/AIDS epidemics, the mortality projections used the Spectrum/Estimation and Projection Package (EPP) model, a complex, multistate model designed for short-term projections of policy-relevant quantities for the epidemic. We propose a simpler approach that is more compatible with existing UN projection methods for other countries. Changes in life expectancy are projected probabilistically using a simple time series regression and then converted to age- and sex-specific mortality rates using model life tables designed for countries with HIV/AIDS epidemics. These are then input to the cohort component method, as for other countries. The method performed well in an out-of-sample cross-validation experiment. It gives similar short-run projections to Spectrum/EPP, while being simpler and avoiding multistate modelling.     

Has the HIV Epidemic Peaked?

This study reviews the highly diverse regional and country patterns of HIV epidemics and discusses possible causes of the geographic variation in epidemic sizes. Past trends and projections of the epidemics are presented and the peak years of epidemics are estimated. The potential future impact of new prevention technologies is briefly assessed. A final section summarizes the future impact of the epidemic on key demographic variables. The main finding of this analysis is that the HIV epidemic reached a major turning point over the past decade. The peak years of HIV incidence rates are past for all regions, and the peaks of prevalence rates are mostly in the past except in Eastern Europe, where they are expected to peak in 2008. But owing in part to the life‐prolonging effect of antiretroviral therapy and to sustained population growth, the absolute number of infected individuals is expected to keep growing slowly in sub‐Saharan Africa and to remain near current levels worldwide, thus posing a continuing challenge to public health programs. No country is expected to see a decline in its population size between 2005 and 2050 that is attributable to high mortality related to AIDS.     

Mortality in Ghana: Evidence from the cape coast project data

Abstract This paper deals with the estimation of mortality for a rural community of about 20,000 persons in the rain-forest area of south-west Ghana. Specifically, infant, child and adult mortality estimates have been obtained by the application of a wide range of direct and indirect methods of measuring mortality from the different statistics collected by a longitudinal mortality and fertility project conducted during 1974-7. It was noted that infant and childhood mortality rates obtained from death registrations were consistent with those rates yielded by pregnancy histories and child survival statistics. However, the adult mortality estimates derived from orphanhood statistics tended to be lower than those suggested by death registrations. The analysis revealed an infant mortality rate of 100 for boys and 84 for girls, equal childhood mortality rates for boys and girls (85-6), a lower expectation of life at birth for men (45.8 years) than for women (52.8), and a much more severe incidence of mortality among men aged over 40 than for women at the corresponding ages.     

Mortality in Ghana: Evidence from the cape coast project data

This paper deals with the estimation of mortality for a rural community of about 20,000 persons in the rain-forest area of south-west Ghana. Specifically, infant, child and adult mortality estimates have been obtained by the application of a wide range of direct and indirect methods of measuring mortality from the different statistics collected by a longitudinal mortality and fertility project conducted during 1974–7. It was noted that infant and childhood mortality rates obtained from death registrations were consistent with those rates yielded by pregnancy histories and child survival statistics. However, the adult mortality estimates derived from orphanhood statistics tended to be lower than those suggested by death registrations. The analysis revealed an infant mortality rate of 100 for boys and 84 for girls, equal childhood mortality rates for boys and girls (85–6), a lower expectation of life at birth for men (45.8 years) than for women (52.8), and a much more severe incidence of mortality among men aged over 40 than for women at the corresponding ages.     

Parental survival data: Some results of the application of Ledermann's model life tables

Summary Ledermann's one- and two-parameter model life tables are used in order to summarize and compare adult mortality estimates derived from parental survival data, and also to link parental survival with child survival data. The Ledermann models provide an alternative to the logit model used by Brass and Hill. Examination of life tables derived from actual child and adult mortality estimates reveals that although the two types of models yield similar overall levels of mortality, they show marked differences in the estimated patterns by sex and age. It has not been possible to disentangle completely how much of this divergence is due to the models themselves and how much to inadequacies in the data available. Finally, we question whether it is always wise to establish a full life table from child and adult mortality estimates when these are based on data which refer to different periods of exposure to the risk of dying, without allowance for possible distortions resulting from mortality change.     

Aids and population growth in sub-Saharan Africa: Assessing the sensitivity of projections

Despite different models to project the course of the AIDS pandemic and a scarcity of data to provide standard input parameters for those models, a limited consensus emerges from distinct sets of population projections. In sub-Saharan Africa, population growth rates are projected to remain positive in spite of the pandemic over the next few decades. To investigate this conclusion, alternative projections of an HIV/AIDS epidemic and its related mortality are first produced from different sets of input parameters and assumptions. Their incorporation into the population projections of a fast-growing country illustrates the robustness of projected population growth rates under very different scenarios of the future epidemic but with the common assumption that it will not affect the mortality of the uninfected population, fertility nor migration. This paper then shows that the projected growth rates are much less robust when interactions between the epidemic and the demographic regime are allowed and identifies several potential mechanisms for such interactions. In particular, it suggests that improving our confidence in the medium-term projections of the demographic impact of AIDS in the region requires less a refinement of the projections of the epidemic than a better understanding of its impact on the timing of the postulated fertility decline.     

Comparative analysis of the index of our population life quality]

A comprehensive method of calculating and measuring a country's or an area's health and literacy levels is examined. The method, known as population quality life inference (PQLI), was used to determine which of China's provinces has the highest and the lowest degree of population quality. The PQLI indicates infant mortality, average life expectancy of 1 year olds, and literacy rates of those 15 years and older. Because developing countries traditionally have high rates of infant mortality and illiteracy and low life expectancy rates during their industrialization, measuring the degree of population quality of life improvement of such countries during this period was found to be significant. These factors (infant mortality, illiteracy, and life expectancy) will improve substantially as industrialization continues. In order to compare various areas, these 3 factors must be changed into "inferences" 0-100, "0" representing the lowest population quality and "100" the highest. These 3 inferences must then be averaged in order to calculate the PQLI. For example: life expectancy value 77 (highest in the world) minus 38 (lowest)/100 = .39. In order to measure the value of India's life expectancy: value of 1-year-old's life expectancy = 56 (1-year-old's life expectancy in India) minus 38/.39 = 46. The value of adult illiteracy does not need to be changed. Thus, the actual comparison will be based on the values of the 3 inferences. Using this method of calculation, it is concluded that the PQLI analysis indicated that Peking (93.04) is the highest in China and Yumnan Province (60.72) is the lowest.     

Steep increase in best-practice cohort life expectancy

We analyze trends in best-practice life expectancy among female cohorts born from 1870 to 1950. Cohorts experience declining rather than constant death rates, and cohort life expectancy usually exceeds period life expectancy. Unobserved mortality rates in non-extinct cohorts are estimated using the Lee-Carter model for mortality in 1960–2008. Best-practice cohort and period life expectancies increased nearly linearly. Across cohorts born from 1870 to 1920 the annual increase in cohort length of life was 0.43 years. Across calendar years from 1870 to 2008, the annual increase was 0.28 years. Cohort life expectancy increased from 53.7 years in the 1870 cohort to 83.8 years in the 1950 cohort. The corresponding cohort/period longevity gap increased from 1.2 to 10.3 years. Among younger cohorts, survival to advanced ages is substantially higher than could have been anticipated by period mortality regimes when these cohorts were young or middle-aged. A large proportion of the additional expected years of life are being lived at ages 65 and older. This substantially changes the balance between the stages of the life cycle.     

Changes in world inequality in length of life: 1970–2000

Previous research has revealed much global convergence over the past several decades in life expectancy at birth and in infant mortality, which are closely linked. But trends in the variance of length of life, and in the variance of length of adult life in particular, are less well understood. I examine life-span inequality in a comprehensive panel of 180 countries observed in 1970 and 2000. Convergence in infant mortality has unambiguously reduced world inequality in total length of life starting from birth, but world inequality in length of adult life has remained largely unchanged. Underlying both of these observations is a growing share of total inequality attributable to between-country variation. Especially among developed countries, the absolute level of between-country inequality has risen over time. The sources of widening inequality in length of life between countries remain unclear, but signs point away from changes in income, leaving patterns of knowledge diffusion as a likely candidate.     

Do Standards of Living Converge? A Cross-country Study

Cross-country convergence in `standards ofliving' is an important phenomenon thatattracted the researchers in Economics for along period. These studies take into accountthe growth of per capita gross domesticproduct or labor productivity as a measure ofstandard of living. The present study measuresthe standard of living in terms of theindicators reflecting the quality of life ofthe inhabitants of the country rather thanincome or productivity and examines whetherstandards of living converge across economiesover a fairly long period of time, such as 35years (1960–1995). In this connection, the paperfollows the straightforward approach to testinter-country convergence which relates therate of growth of income (GDP) per capita withinitial income. The convergence tests for theindicators reflecting quality of life of humanbeings, such as, infant survival rate, lifeexpectancy at birth, adult literacy rate,calorie intake as percentage of requirement forthe full sample as well as for three incomegroups indicate that in almost for all thecases for all the indicators divergence isobserved rather than convergence. For infantsurvival rate and life expectancy for the highincome group no definite indication issuggestive. Divergence is also observed forper capita real gross domestic product for alltypes of sample.     

Spatial Inequality in Mortality in France over the Past Two Centuries

This article analyzes the evolution of spatial inequalities in mortality across 90 French territorial units since 1806. Using a new database, we identify a period from 1881 to 1980 when inequalities rapidly shrank while life expectancy rose. This century of convergence across territories was mainly due to the fall in infant mortality. Since 1980, spatial inequalities have levelled out or occasionally widened, due mainly to differences in life expectancy among the elderly. The geography of mortality also changed radically during the century of convergence. Whereas in the 19th century high mortality occurred mainly in larger cities and along a line from North-west to South-east France, it is now concentrated in the North, and Paris and Lyon currently enjoy an urban advantage.     

Impact of Road Traffic Deaths on Expected Years of Life Lost and Reduction in Life Expectancy in Brazil

The road traffic crash burden is significant in Brazil; calculating years of life lost and life expectancy reduction quantifies the burden of road traffic deaths to enable prioritization of this issue. Years of life lost and reduction in life expectancy were calculated using 2008 population/crash data from Brazil’s ministries of health and transport. The potential for reduction in crash mortality was calculated for hypothetical scenarios reducing death rates to those of the best-performing region and age category. In Brazil, road traffic deaths reduce the at-birth life expectancy by 0.8 years for males and by 0.2 years for females. Many years of life lost for men and woman could be averted—270,733 and 123,986, respectively—if all rates matched those of the lowest-risk region and age category. This study further characterizes the burden of motor vehicle deaths in Brazil and quantifies the potential health benefits of policies/interventions that reduce road traffic death rates to those of the best-performing subpopulations.     

预期寿命增长、年龄结构改变与我国国民储蓄率

人口年龄结构趋于老龄化和人均预期寿命逐步增长是目前我国人口发展的两个典型特征,而年龄阶段不同,个人的收入、消费与储蓄行为也不同。基于生命周期理论,在选定相关分析指标的基础上,文章使用我国省际平衡面板数据,实证分析了我国人口预期寿命增长和年龄结构改变对国民储蓄率的影响。分析结论表明,人口预期寿命增长提高了我国国民储蓄率;不考虑时间效应时,幼年人口负担比提高会减少国民储蓄率,而老年人口负担比提高会增加国民储蓄率;在考虑时间效应时,幼年人口负担比提高会增加国民储蓄率,而老年人口负担比提高会减少国民储蓄率。对此,文章给出了合理的解释。通过使用多种估计方法,我们发现所得到的结论是基本稳健的。     

The Contribution of Drug Overdose to Educational Gradients in Life Expectancy in the United States, 1992–2011

Since the mid-1990s, the United States has witnessed a dramatic rise in drug overdose mortality. Educational gradients in life expectancy widened over the same period, and drug overdose likely plays a role in this widening, particularly for non-Hispanic whites. The contemporary drug epidemic is distinctive in terms of its scope, the nature of the substances involved, and its geographic patterning, which influence how it impacts different education groups. I use vital statistics and National Health Interview Survey data to examine the contribution of drug overdose to educational gradients in life expectancy from 1992–2011. I find that over this period, years of life lost due to drug overdose increased for all education groups and for both males and females. The contribution of drug overdose to educational gradients in life expectancy has increased over time and is greater for non-Hispanic whites than for the population as a whole. Drug overdose accounts for a sizable proportion of the increases in educational gradients in life expectancy, particularly at the prime adult ages (ages 30–60), where it accounts for 25 % to 100 % of the widening in educational gradients between 1992 and 2011. Drug overdose mortality has increased more rapidly for females than for males, leading to a gender convergence. These findings shed light on the processes driving recent changes in educational gradients in life expectancy and suggest that effective measures to address the drug overdose epidemic should take into account its differential burden across education groups.     

The cost of uncertain life span

Much uncertainty surrounds the length of human life. The standard deviation in adult life span is about 15 years in the USA, and theory and evidence suggest that it is costly. I calibrate a utility-theoretic model that shows that 1 year in standard deviation is worth about half a life year. Differences in variance exacerbate health inequalities between and among rich and poor countries. Accounting for the cost of life-span variance appears to amplify recently discovered patterns of convergence in world average human well-being because the component of variance due to infant mortality has exhibited even more convergence than life expectancy.     

‘Closing the Gap’ in Indigenous life expectancies: what if we succeed?

In 2007–2008 the Council of Australian Governments agreed to six ambitious targets for addressing longstanding disparities between Indigenous and other Australians in health, education and employment outcomes. The ‘National Integrated Strategy for Closing the Gap on Indigenous Disadvantage’ (colloquially ‘Closing the Gap’) includes the goal of eliminating life expectancy gaps within a generation. This policy says nothing about what changes in the demographic structure of the population might be expected should there be even partial success towards this ambitious target. Information is required to analyse age and sex shifts for their effects on service demand and provision. In this study we apply cohort component projections modelling to the Northern Territory, the Australian jurisdiction with the largest Indigenous component in its population and the largest life expectancy gaps, to assess the demographic effects of closing the gap within a generation. Three scenarios are modelled: (1) No changes to Indigenous life expectancies from those estimated in 2010; (2) Complete success in closing the gap within a generation; and (3) A continuation of current forecasts about how Indigenous life expectancies will change into the future. Although closing the gap would only produce a small increase in the size of the next generation’s Indigenous population, over and above that projected with lower life expectancy scenarios, it would result in substantial changes in age compositions, with associated shifts in various demographic indices. These are pertinent to the planning and funding of core services into the future.     

The health expectancies of older Australians

Health expectancies of the states ‘Disability-free’ and ‘Disabled’ are estimated for Australian females and males aged 60 and over, both by cohort from 1980 and current for survey years 1981, 1988, 1993 and 1998. Modifications of recently developed logistic regression techniques are used rather than the standard 1971 method due to Sullivan. Results from the three later surveys are broadly similar and differ in important respects from those of the 1981 survey. Based on the last three surveys our estimates support the view that, depending on age, two-thirds or more of the increase in female life expectancy over the decade 1988–1998 is spent in the Disabled state. The situation is worse for elderly men, for whom all of the increased years of expected life are estimated to be spent in the Disabled state. The findings do not support rectangularization of the survival curve or Disability-free survival curve.     

Shifting Childrearing to Single Mothers: Results from 17 Western Countries

We investigate how recent changes in the Western family have affected childhood living arrangements. For 17 developed countries, we use multistate life table techniques to estimate childhood trajectories of coresi‐dence with biological fathers versus other maternal partners. In all countries childhood exposure to single parenting is more often caused by parental separation than out‐of‐partnership childbearing. Both exposure to single parenting and expectancy of childhood spent with a single non‐cohabiting mother vary widely across countries, with the United States exhibiting the highest levels of each at early 1990s rates. The greatest international variations concern parental cohabitation—its prevalence, durability, and the degree to which its increase has compensated for a decrease in the expectancy of childhood spent with married parents. Overall, we find little evidence of international convergence in childrearing arrangements, except that in countries where parental marriage has declined over time, childrearing has predominantly shifted to single mothers.