Longevity and Lifespan Variation by Educational Attainment in Spain: 1960–2015

For a long time, studies of socioeconomic gradients in health have limited their attention to between-group comparisons. Yet, ignoring the differences that might exist within groups and focusing on group-specific life expectancy levels and trends alone, one might arrive at overly simplistic conclusions. Using data from the Spanish Encuesta Sociodemográfica and recently released mortality files by the Spanish Statistical Office (INE), this is the first study to simultaneously document (1) the gradient in life expectancy by educational attainment groups, and (2) the inequality in age-at-death distributions within and across those groups for the period between 1960 and 2015 in Spain. Our findings suggest that life expectancy has been increasing for all education groups but particularly among the highly educated. We observe diverging trends in life expectancy, with the differences between the low- and highly educated becoming increasingly large, particularly among men. Concomitantly with increasing disparities across groups, length-of-life inequality has decreased for the population as a whole and for most education groups, and the contribution of the between-group component of inequality to overall inequality has been extremely small. Even if between-group inequality has increased over time, its contribution has been too small to have sizable effects on overall inequality. In addition, our results suggest that education expansion and declining within-group variability might have been the main drivers of overall lifespan inequality reductions. Nevertheless, the diverging trends in longevity and lifespan inequality across education groups represent an important phenomenon whose underlying causes and potential implications should be investigated in detail.     

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.     

Lifespan Variation by Occupational Class: Compression or Stagnation Over Time?

Cross-sectional analyses of adult lifespan variation have found an inverse association between socioeconomic position and lifespan variation, but the trends by social class are unknown. We investigated trends in lifespan variation over four decades (1971–2010) by occupational social class (manual, lower nonmanual, upper nonmanual, other) using Finnish register data. We performed age and cause-of-death decompositions of lifespan variation for each sex (a) by occupational class over time and (b) between occupational classes at a shared level of life expectancy. Although life expectancy increased in all classes, lifespan variation was stable among manual workers and decreased only among nonmanual classes. These differences were caused by early-adult mortality: older-age lifespan variation declined for all the classes, but variation in early-adult mortality increased for all classes except the highest. The manual class’s high and stagnant lifespan variation was driven by declines in circulatory diseases that were equally spread over early mortality-compressing and older mortality-expanding ages, as well as by high early-adult mortality from external causes. Results were similar for men and women. The results of this study, which is the first to document trends in lifespan variation by social class, suggest that mortality compression is compatible with increasing life expectancy but currently achieved only by higher occupational classes.     

Divergence in Age Patterns of Mortality Change Drives International Divergence in Lifespan Inequality

In the past six decades, lifespan inequality has varied greatly within and among countries even while life expectancy has continued to increase. How and why does mortality change generate this diversity? We derive a precise link between changes in age-specific mortality and lifespan inequality, measured as the variance of age at death. Key to this relationship is a young–old threshold age, below and above which mortality decline respectively decreases and increases lifespan inequality. First, we show for Sweden that shifts in the threshold’s location have modified the correlation between changes in life expectancy and lifespan inequality over the last two centuries. Second, we analyze the post–World War II (WWII) trajectories of lifespan inequality in a set of developed countries—Japan, Canada, and the United States—where thresholds centered on retirement age. Our method reveals how divergence in the age pattern of mortality change drives international divergence in lifespan inequality. Most strikingly, early in the 1980s, mortality increases in young U.S. males led to a continuation of high lifespan inequality in the United States; in Canada, however, the decline of inequality continued. In general, our wider international comparisons show that mortality change varied most at young working ages after WWII, particularly for males. We conclude that if mortality continues to stagnate at young ages yet declines steadily at old ages, increases in lifespan inequality will become a common feature of future demographic change.     

Educational Attainment and Mortality in the United States: Effects of Degrees,Years of Schooling,and Certification

Researchers have extensively documented a strong and consistent education gradient for mortality, with more highly educated individuals living longer than those with less education. This study contributes to our understanding of the education–mortality relationship by determining the effects of years of education and degree attainment on mortality, and by including non-degree certification, an important but understudied dimension of educational attainment. We use data from the mortality-linked restricted-use files of the Panel Study of Income Dynamics (PSID) sample (N = 9821) and Cox proportional hazards models to estimate mortality risk among U.S. adults. Results indicate that more advanced degrees and additional years of education are associated with reduced mortality risk in separate models, but when included simultaneously, only degrees remain influential. Among individuals who have earned a high school diploma only, additional years of schooling (beyond 12) and vocational school certification (or similar accreditation) are both independently associated with reduced risks of death. Degrees appear to be most important for increasing longevity; the findings also suggest that any educational experience can be beneficial. Future research in health and mortality should consider including educational measures beyond a single variable for educational attainment.     

The Nonlinear Relationship Between Education and Mortality: An Examination of Cohort, Race/Ethnic, and Gender Differences

Researchers investigating the relationship between education and mortality in industrialized countries have consistently shown that higher levels of education are associated with decreased mortality risk. The shape of the education–mortality relationship and how it varies by demographic group have been examined less frequently. Using the U.S. National Health Interview Survey-Linked Mortality Files, which link the 1986 through 2004 NHIS to the National Death Index through 2006, we examine the shape of the education–mortality curve by cohort, race/ethnicity, and gender. Whereas traditional regression models assume a constrained functional form for the dependence of education and mortality, in most cases semiparametric models allow us to more accurately describe how the association varies by cohort, both between and within race/ethnic and gender subpopulations. Notably, we find significant changes over time in both the shape and the magnitude of the education–mortality gradient across cohorts of women and white men, but little change among younger cohorts of black men. Such insights into demographic patterns in education and mortality can ultimately help increase life expectancies.     

近50年来世界人口期望寿命的演变轨迹

进入21世纪以来,全球人口已经突破60亿,但是人口增长速度明显减慢。许多国家已经完成了人口转变,其总和生育率在更替水平以下。与此同时,人口健康状况得到明显改善,死亡水平显著降低,期望寿命在不断提高。本文利用联合国人口司发布的192个国家人口死亡信息,系统分析了世界人口平均期望寿命在过去50年里的演变态势、区域差异以及演变模式。结果显示世界人口期望寿命经历了半个多世纪的持续增长,有50%以上的人口或国家平均期望寿命达到了70岁。演变轨迹呈多样化的发展模式,区域发展不平衡。欠发达地区总体上较发达地区增幅大,人口比重上升幅度也很显著。人均期望寿命增幅最大的是亚洲国家,非洲国家与世界不同步,而且区域内差异较大。     

Lifespan Dispersion in Times of Life Expectancy Fluctuation: The Case of Central and Eastern Europe

Central and Eastern Europe (CEE) have experienced considerable instability in mortality since the 1960s. Long periods of stagnating life expectancy were followed by rapid increases in life expectancy and, in some cases, even more rapid declines, before more recent periods of improvement. These trends have been well documented, but to date, no study has comprehensively explored trends in lifespan variation. We improved such analyses by incorporating life disparity as a health indicator alongside life expectancy, examining trends since the 1960s for 12 countries from the region. Generally, life disparity was high and fluctuated strongly over the period. For nearly 30 of these years, life expectancy and life disparity varied independently of each other, largely because mortality trends ran in opposite directions over different ages. Furthermore, we quantified the impact of large classes of diseases on life disparity trends since 1994 using a newly harmonized cause-of-death time series for eight countries in the region. Mortality patterns in CEE countries were heterogeneous and ran counter to the common patterns observed in most developed countries. They contribute to the discussion about life expectancy disparity by showing that expansion/compression levels do not necessarily mean lower/higher life expectancy or mortality deterioration/improvements.     

Forecasting differences in life expectancy by education

Forecasts of life expectancy (LE) have fuelled debates about the sustainability and dependability of pension and healthcare systems. Of relevance to these debates are inequalities in LE by education. In this paper, we present a method of forecasting LE for different educational groups within a population. As a basic framework we use the Li–Lee model that was developed to forecast mortality coherently for different groups. We adapted this model to distinguish between overall, sex-specific, and education-specific trends in mortality, and extrapolated these time trends in a flexible manner. We illustrate our method for the population aged 65 and over in the Netherlands, using several data sources and spanning different periods. The results suggest that LE is likely to increase for all educational groups, but that differences in LE between educational groups will widen. Sensitivity analyses illustrate the advantages of our proposed method.     

Does schooling protect sexual health? The association between three measures of education and STIs among adolescents in Malawi

While multiple studies have documented shifting educational gradients in HIV prevalence, less attention has been given to the effect of school participation and academic skills on infection during adolescence. Using the Malawi Schooling and Adolescent Study, a longitudinal survey that followed 2,649 young people aged 14–17 at baseline from 2007 to 2013, we estimate the effect of three education variables: school enrolment, grade attainment, and academic skills—numeracy and Chichewa literacy—on herpes simplex virus type 2 (HSV-2) and HIV incidence using interval-censored survival analysis. We find that grade attainment is significantly associated with lower rates of both HSV-2 and HIV among girls, and is negatively associated with HSV-2 but not HIV among boys. School enrolment and academic skills are not significantly associated with sexually transmitted infections (STIs) for boys or girls in our final models. Efforts to encourage school progression in high-prevalence settings in sub-Saharan Africa could well reduce, or at least postpone, acquisition of STIs.     

Differentials in Adult Mortality and Activity Limitation by Years of Education in the United States at the End of the 1990s

This study examines mortality differentials and health disparities between educational groups within the 1998 adult population (ages 25 and older) in the United States. Mortality differentials are measured using average life expectancy and health disparities by expected years without activity limitation. The results indicate that for both sexes, higher education is associated with higher life expectancy. Those with higher levels of education also have higher life expectancy without activity limitation. Adults with higher education can also expect to enjoy a greater percentage of their expected lives free of any form of activity limitation. At each level of education, adult females have a higher level of activity limitation compared to adult males. At the same level of education, adult females expect to enjoy smaller percentages of their remaining lives free of activity limitation compared to adult males of the same age.     

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.     

Patterns of Active Life Among Older Women: Differences Within and Between Groups

SUMMARY

This study examines the distribution of total, unimpaired, and impaired life for several groups of older women defined by race, education, and marital history. Using data from the 1984–1990 Longitudinal Study of Aging, we model transitions among functional statuses using discrete-time Markov chains, and use microsimulation to produce summary indices of active life. Remaining years of life and the proportion of remaining years with disability vary substantially, both within each group of women studied and between pairs of groups. Of all groups studied, never-married, more-educated white women live the longest, healthiest lives. Ever-married nonwhite women with low education have the shortest life expectancy, and experience the most disability. Our findings show that life expectancy is an incomplete indicator of the time women, in particular sub-groups, can expect to live with and without impairment. These findings highlight the heterogeneity of disability processes and life expectancy for older women.     

The effect of polytechnic reform on migration

This paper examines the effect of the polytechnic reform on geographical mobility. A polytechnic, higher education reform took place in Finland in the 1990s. It gradually transformed former vocational colleges into polytechnics and also brought higher education to regions that did not have a university before. This expansion of higher education provides exogenous variation in the regional supply of higher education. The reform raised the mobility of high school graduates across local labour markets in the years after they had completed their secondary studies, which indicated increased mobility between high school and post-secondary education. We estimate that the reform enhanced the annual migration rate of high school graduates by 1.2 percentage points over a 3-year follow-up period. This represents a substantial increase, because their baseline migration rate is 3.7 %. The effect fades several years after the completion of secondary studies.     

A Realist View of Aging,Mortality, and Future Longevity

Differences in methodology and philosophy have led scientists analyzing the same mortality data to arrive at very different conclusions about the behavior of mortality trajectories, the nature of aging, and the future of human longevity. This note describes the authors’views on these issues, which taken together can be termed a “realist” position. In this view, life expectancy is unlikely to exceed an average of 85 years absent significant advances in the control of aging. We identify a number of myths that have been attached to our work: 1) Reaching an average life expectancy of 85 years is a pessimistic outlook for human longevity, 2) Species possess an intrinsic mortality schedule that cannot be modified by human intervention, 3) Realist scenarios of the future course of human longevity are based on notions of biological determinism, 4) Realists assert that there is an age beyond which there can be no survivors, 5) Hypothesized biological barriers to longer life spans have been scientifically studied and refuted, and 6) Realists claim that life expectancy at birth cannot exceed 85 years. In dispelling these myths, we hope to provide a more accurate representation of our school of biodemographic thought.     

Human Capabilities Versus Human Capital: Guaging the Value of Education in Developing Countries

The purpose of this study is to defend the view that education should be evaluated in terms of the capability to achieve valued functionings, rather than mental satisfaction or resources. In keeping with Amartya Sen’s capabilities approach we argue that mental satisfaction provides an inaccurate metric of well-being because of the phenomenon of adaptive preferences. Equally, resources cannot be used as a metric of well-being because of inequalities in the ability to convert income and commodities into valued functionings. Hence, interpreting education as a means to create human capital is also impoverished because it evaluates education solely in terms of the accumulation of resources. In order to provide evidence in support of the human capabilities approach we statistically examine the channels through which educational attainment affects the health functionings implied by life expectancy. Using panel data analysis for 35 developing countries for the years 1990, 1995 and 2000 we compare the health functionings (as indicated by life expectancy) that are achieved by the income growth generated by educational attainment, with the total health functionings that are achieved by educational attainment. We find that educational attainment (as indicated by average years of schooling) has a significant effect on life expectancy independently of its effect by way of income growth. A 1% increase in per capita income increases life expectancy by 0.073954% while a 1% increase in average years of schooling directly increases life expectancy by 0.055324%. Because it shows that income underestimates the health functionings achieved by educational attainment, our empirical findings lend support to the claim that the value of education should be measured in terms of the capability for functioning, rather than resources.     

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.     

Potential support ratios: Cohort versus period perspectives

The ‘prospective potential support ratio’ has been proposed by researchers as a measure that accurately quantifies the burden of ageing, by identifying the fraction of a population that has passed a certain measure of longevity, for example, 17?years of life expectancy. Nevertheless, the prospective potential support ratio usually focuses on the current mortality schedule, or period life expectancy. Instead, in this paper we look at the actual mortality experienced by cohorts in a population, using cohort life tables. We analyse differences between the two perspectives using mortality models, historical data, and forecasted data. Cohort life expectancy takes future mortality improvements into account, unlike period life expectancy, leading to a higher prospective potential support ratio. Our results indicate that using cohort instead of period life expectancy returns around 0.5 extra younger people per older person among the analysed countries. We discuss the policy implications implied by our cohort measures.     

Patterns of active life among older women: differences within and between groups

This study examines the distribution of total, unimpaired, and impaired life for several groups of older women defined by race, education, and marital history. Using data from the 1984-1990 Longitudinal Study of Aging, we model transitions among functional statuses using discrete-time Markov chains, and use microsimulation to produce summary indices of active life. Remaining years of life and the proportion of remaining years with disability vary substantially, both within each group of women studied and between pairs of groups. Of all groups studied, never-married, more-educated white women live the longest, healthiest lives. Ever-married nonwhite women with low education have the shortest life expectancy, and experience the most disability. Our findings show that life expectancy is an incomplete indicator of the time women, in particular sub-groups, can expect to live with and without impairment. These findings highlight the heterogeneity of disability processes and life expectancy for older women.     

Education,race/ethnicity and out-migration from a border city

Through a combination of high immigration rates and differential fertility, communities along the U.S.-Mexico border have become overwhelmingly Hispanic. El Paso, Texas, located across the border from Ciudad Juárez, forms part of the world’s largest urban center on a land border. El Paso ranks among the bottom 10 large U.S. metropolitan areas with the smallest proportion of college-educated adults, causing concerns among policy makers regarding its prospects for economic development. Local discourse suggests that low educational levels result from the out-migration of educated groups that find higher wages or better jobs elsewhere. Two sources of data are used to explore the association between education, race/ethnicity, and out-migration: the five percent 2000 PUMS and a survey conducted among students at the University of Texas at El Paso. We find that between 1995 and 2000 a large net outflow of non-Hispanic whites and blacks of all educational levels took place. Among Mexicans and Mexican Americans, college graduates were more likely to leave compared to high school graduates, but place of birth and language preference influenced these odds. Student data confirmed that non-Hispanics are significantly more likely to plan to leave compared to students of Mexican origin or descent. Among Mexicans and Mexican Americans, those who prefer English and mentioned jobs and lifestyle as the most important factors in choosing a place to live and work were more likely to have plans to leave upon graduation. Policy implications are discussed regarding the future of border communities.