Mortality in China 1964-2000

This paper uses data from censuses and surveys to re-estimate mortality levels and trends in China from the 1960s to 2000. We use the General Growth Balance method to evaluate the completeness of death reporting above the youngest ages in three censuses of the People's Republic of China from 1982 to 2000, concluding that reporting quality is quite high, and revisit the completeness of death recording in the 1973-75 Cancer Epidemiology Survey. Estimates of child mortality from a variety of direct and indirect sources are reviewed, and best estimates arrived at. Our estimates show a spectacular improvement in life expectancy in China: from about 60 years in the period 1964-82 to nearly 70 years in the period 1990-2000, with a further improvement to over 71 years by 2000. We discuss why survival rates continue improving in China despite reduced government involvement in and increasing privatization of health services, with little insurance coverage.     

Retrospect and prospect of China's population

This discussion of the population of China covers the reproductive pattern and fertility rate, the death pattern and mortality, age-sex structure of the population, population and employment, urbanization, migration, and the aging of the population. During the 1949-83 period, China almost doubled her population with an annual natural growth rate of 19/1000. China's reproductive pattern developed from early childbearing, short birth spacing and many births to later childbearing, longer birth spacing and fewer births. China's total fertility rate (TFR) was 5.8 in 1950 and 2.1 in 1983 with an annual decrease of 3%. The annual national income grew at a rate of 7.1%, while the annual growth rate of population 1.9% from 1950-82. Consequently, the national income per capita increased from 50 yuan in 1950 to 338 yuan in 1982. The major factor responsible for the changes is the remarkable decline in the rural fertility rate. The crude death rate dropped from 27.1/1000 in 1963 to 7.1 in 1983 and the infant mortality rate from 179.4/1000 live births in 1936 to 36.6 in 1981. There was also a significant change in the causes of death. Population aged 0-14 in China account for 33.6%, 15-49 for 51.3%, and 50 and over for 15.1% of the total population. China is in the process of transition from an expansive to a stationary population. The age-dependency ratio declined from 68.6% in 1953 and 79.4% in 1964 to 62.6% in 1982. Sex ratios recorded in the 3 population censuses are 105.99 in 1953, 105.45 in 1964, and 105.46 in 1982. Employment in both collective and individual economies did not expand until 1978. Sectoral, occupational, and industrial structures of population started to change rationally with the adjustment and reform of economic management system in 1978. The strategic stress on the employment of China's economically active population should be shifted from farming to diversified economy and urban industry and commerce, from sectors of industrial-agricultural production to those of non-material production, and from expansion of employment to the rise of employment efficiency. The proportion of urban population in China accounted for 20.8% in 1982 with an annual growth rate of 4% during the 1949-82 period. The 1982 population census reveals that 94.4% of China's population resides on the southeast side of Aihui-Tengchong Line. Compared with the statistics in 1953, there was no notable change of the unbalanced population distribution on each side of the Line over the last 50 years. China is comparatively young in its population age structure. 1982 census data show that there were 49.29 million people at age 65 and over in 1982, representing 4.91% of the whole population. It is estimated from the age composition of 1982 and age-specific mortality rate of 1981 that there will be 88 million elderly persons by 2000, 150 million by 2020, and about 300 million as a maximum around 2040.     

Our experience with population censuses in 1953 and 1964]

We have accumulated some valuable experience through 2 successful population censuses in 1953 and 1964. A series of special census committees were established at each administrative level--from central government to local areas. Periodic 2-way telephone communication between higher and lower offices was planned. The census was conducted on the basis of permanent population in 1953 and 1964. A standard time of June 30, midnight was used in both cases. Census items must be clear, easy to use, and standardized. Name, relationship to head of household, sex, age, race, and present address were listed in 1954. Birth date, class, educational level, and occupation were added in 1964. For accurate data census districts and their boundaries must be clearly marked. Registering the whole family by head of household at the nearby temporary census station was found to be convenient, efficient, and accurate. Door-to-door visits by census clerks were also used. To complete such a cumbersome task in a short period of time high-quality census personnel were trained to fully understand the significance, the regulations, and the technical details of the task. Nationwide education and propaganda about the census were important for success. 3 levels of reporting (county, province, and central) in 1953 and 4 levels in 1964 were used to check results and correct mistakes. The announcement of the results to the public after the entire census was completed provided an opportunity for the public to confirm the data and correct mistakes. This process of confirmation is an essential quality control step.     

Estimation of demographic measures for India, 1881-1961, based on census age distributions

Abstract India is one of the very few developing countries which have a relatively long history of population censuses. The first census was taken in 1872, the second in 1881 and since then there has been a census every ten years, the latest in 1971. Yet the registration of births and deaths in India, even at the present time, is too inadequate to be of much help in estimating fertility and mortality conditions in the country. From time to time Indian census actuaries have indirectly constructed life tables by comparing one census age distribution with the preceding one. Official life tables are available for all the decades from 1872-1881 to 1951-1961, except for 1911-1921 and 1931-1941. Kingsley Davis(1) filled in the gap by constructing life tables for the latter two decades. He also estimated the birth and death rates ofIndia for the decades from 1881-1891 to 1931-1941. Estimates of these rates for the following two decades, 1941-1951 and 1951-1961, were made by Indian census actuaries. The birth rates of Davis and the Indian actuaries were obtained basically by the reverse survival method from the age distribution and the computed life table of the population. Coale and Hoover(2), however, estimated the birth and death rates and the life table of the Indian population in 1951 by applying stable population theory. The most recent estimates of the birth rate and death rate for 1963-1964 are based on the results of the National Sample Survey. All these estimates are presented in summary form in Table 1.     

[The situation of China's urban and rural population].]

The accuracy of measurements of the ratio of urban to rural population in China is critically assessed, using data from the 1953, 1964, and 1982 censuses. As explanations for the inaccuracies, the author points to political conditions and to the use of different measurements at different points in time.     

The female population of Chile, 1855-1964: a microcomputer balance sheet method

This article summarizes the essential features of the inverse projection method and applies it to data on the female population of Chile for the period 1855-1964. Changes in age distribution, vital rates, life expectancy, fertility, and gross and net reproduction rates over time are described.     

Revised regional model life tables at very low levels of mortality

This paper presents and discusses new model life tables at very low mortality, which make use of age-specific death rates from the 1960s, 1970s, and 1980s. These life tables fit recorded death rates in very low mortality populations better than do the existing ones at expectations of life of 77.5 and 80 years. The old tables incorporate too-high mortality at the higher ages and in infancy and they incorporate regional differences that no longer exist. The new tables "close out" the mortality schedules above age 80 more realistically. The convergence of age patterns of mortality at very high life expectancies in populations that used to conform to different families is in itself of demographic interest. Some convergence may perhaps be expected. Sullivan (1973) found that, in Taiwan, the comparison of mortality at ages 1-5 to mortality at 5-35 in the late 1950s showed higher mortality at the younger ages relative to the ensuing 30-year age interval than was found in any of the models, including the South model, which has the highest relative mortality from ages 1-5 among the 4 regional patterns. Then, in the late 1960s, the relation of mortality at 1-5 to mortality at 5-35 in Taiwan fell to a position intermediate between the West and South tables. Sullivan found in data on mortality by cause of death a large reduction in mortality from diarrhea and enteritis, no doubt as a result of environmental sanitation. Mortality from these causes is concentrated among young children, and reduction in deaths from these causes would naturally diminish the excess mortality in this age interval. The East pattern, characterized by very high mortality in infancy (but not from 1-5), may be the result of the prevalence of early weaning or avoidance of breast feeding altogether in the populations characterized by this pattern. As health conditions have improved, evidenced by the overall design of mortality, these special factors are diminished or erased. Model life tables at these very low mortality levels have different uses from most applications of model life tables at higher mortality. The use of model tables to estimate accurate schedules of mortality when the basic data are incomplete or inaccurate is less relevant in this range of mortality levels.     

Change of marital fertility in China from 1964 to 1981]

In 1982 the Chinese National Family Planning Commission conducted a nationwide (excepting Taiwan and Tibet) .001 random sampling of the total population to gather data on the fertility and age structures of married women. In comparing general marital fertility and standardized fertility, findings show that from 1964 to 1970 both rates averaged 225.1/1000. When family planning work began on a wide scale in 1971, the rates steadily declined, reaching 116.7/1000 in 1980. However, in 1967-68 the standard fertility rate rose by 21.34% due to the chaos of the Cultural Revolution, and in 1980-81 the rate increased by 13.2%, indicating that problems still remain in family planning. The total marital fertility rate dropped 2.84/1000 from 1964 to 1981. The rate of decline in rural areas was greater than in the cities, but the cities had a larger percentage decline than the countryside. In the 5-year periods of 1965, 1970, 1975, and 1980, marital fertility rates tended to decline in 1970 and 1975 among women aged 30-40 years because during those periods greater control was placed on women having multiple children. For 1980 and 1975, combined total rates for 15-19 year olds dropped 17.1%, but the combined total rates of 30-49 year olds dropped by 61.2%, indicating that in recent years the drop in marital fertility is mostly among those over 30 years of age.     

Active life expectancy estimates for the U.S. elderly population: A multidimensional continuous-mixture model of functional change applied to completed Cohorts, 1982–1996

An increment-decrement stochastic-process life table model that continuously mixes measures of functional change is developed to represent age transitions among highly refined disability states interacting simultaneously with mortality. The model is applied to data from the National Long Term Care Surveys of elderly persons in the years 1982 to 1996 to produce active life expectancy estimates based on completed-cohort life tables. At ages 65 and 85, comparisons with extant period estimates for 1990 show that our active life expectancy estimates are larger for both males and females than are extant period estimates based on coarse disability states.     

Population development and changes of China's minority nationalities]

The People's Republic of China (PRC) is a nation composed of many ethnic groups. After the Communist victory of 1947, the government announced that there were 55 minority nationalities. The 1982 census provides demographic statistics concerning the position of those minorities within the population of the PRC. Since 1964, minority population has increased more rapidly than the population of the Han majority. Between 1953 and 1982, China's population increased 73.2%. The Han population increased 71.2%, the minorities, 90.4%. According to the 1982 census, the total fertility rate of the village-dwelling minorities in 1981 was 5.1%, while the fertility rate of the majority was 2.7%. The mortality rate of the various minorities decreased to the level of that of the Han. Consequently, the percentage of minorities in the total population also increased, from 5.8% of the total population in 1964 to 6.7% in 1982. The reasons for this increase include the following: the change in population reproduction brought about by democratic and socialist reform; the identification of minorities; improvement in health and medical facilities; the reinstatement of and change in racial minority policy promulgated in 1978; and intermarriage between minorities and Han Chinese. Although the minorities account for only 6.7% of China's total population, their distribution constitutes 62.5% of the nation's total area. In the past, the minorities have scattered to the various parts of the country and mingled with other ethnic groups. The high density of minorities is concentrated in the plains where the climate is mild and agricultural produce, such as wheat, rice, and corn, are cultivated. The lowest density areas with respect to the minorities are the inland highlands, deserts, and cold pastoral areas. The age structure of the minorities is young; the marriageable population is numerous; and the fertility rate is high. The educational standard of the minorities has been greatly enhanced, but is still lower than that of the Han Chinese.     

Differences in life expectancy by education and occupation in Italy, 1980-94: indirect estimates from maternal and paternal orphanhood

In the present study, we use the modified orphanhood method to analyse mortality differences by socio-economic status in Italy. This technique permits the indirect estimation of adult mortality from survey-based information on parents' survival in developed populations and helps to overcome several limitations of conventional studies on mortality differences by social class. We estimate a time series of life tables by education and occupation and analyse the differences in life expectancy by socio-economic status along with their changes between 1980-84, 1985-89, and 1990-94. Whereas mortality differences between the highest social class and the other socio-economic status groups increased among men, they decreased among women. We speculate about the reasons for these sex-specific trends and evaluate the application of indirect estimation techniques to the populations of developed countries.     

A flexible two-dimensional mortality model for use in indirect estimation

Mortality estimates for many populations are derived using model life tables, which describe typical age patterns of human mortality. We propose a new system of model life tables as a means of improving the quality and transparency of such estimates. A flexible two-dimensional model was fitted to a collection of life tables from the Human Mortality Database. The model can be used to estimate full life tables given one or two pieces of information: child mortality only, or child and adult mortality. Using life tables from a variety of sources, we have compared the performance of new and old methods. The new model outperforms the Coale-Demeny and UN model life tables. Estimation errors are similar to those produced by the modified Brass logit procedure. The proposed model is better suited to the practical needs of mortality estimation, since both input parameters are continuous yet the second one is optional.     

Mortality and fertility in Arctic Communities Greenland - A case study

Summary The purpose of this paper is to estimate the present level of mortality and fertility as well as its history amongst the indigenous population of Greenland during the period 1834-1953 on the basis of a series of censuses taken during that time. Mortality and fertility parameters have been estimated by techniques particularly suited for the analysis of incomplete demographic data - e.g. stable population analysis. During the period studied Greenland was a Danish colony. It did not become constitutionally part of Denmark until 1953. The paper shows that even though the importance of Danish - and other European - influence should not be underestimated, the socio-economic structure of Greenland was relatively stable until 1953. The results show an extremely high mortality and a correspondingly high fertility. There is also evidence that mortality fluctuated considerably during the period. This might also be true of fertility, but it is impossible to establish this by means of the techniques used. These results are supported by an analysis of registrations of births and deaths for part of the period. The paper concludes with an evaluation of the validity of the techniques of estimation, having regard to the nature of the Greenland censuses. It is pointed out that the empirical material from which model stable populations must have been constructed varies somewhat from that applicable to an Arctic population.     

A reducible four-parameter system of model life tables

Abstract In this paper a four-parameter extension of Brass's relational system of model life tables is suggested that (1) matches a wide range of empirical age patterns of mortality, (2) is easy to apply, especially to partial life tables, and (3) contains demographically meaningful parameters. A test of the model on a set of 62 empirical life tables indicates that four parameters are necessary and sufficient for fitting a wide range of mortality patterns. A further test on an historical series of Swedish life tables reveals a consistent pattern of mortality change. Examination of the parameters for a set of geographicallyrelated life tables suggests a way to define families of life tables. Identification of such temporal and spatial relationships allows the model to be reduced to a form with twoor three-parameters for application to incomplete or inaccurate data.     

Comparison of Four Methods for Estimating Complete Life Tables from Abridged Life Tables Using Mortality Data Supplied to EUROCARE-3

ABSTRACT

To estimate mortality due to cancer, it is necessary to have mortality data by year of age in the population of cancer patients. When such data are not available, estimating one-year (complete) life tables from five-year (abridged) life tables is necessary. Four such methods—Elandt–Johnson, Kostaki, Brass logit, and Akima spline methods—are compared with respect to 782 empirical complete life tables pertaining to 19 European regions or countries, from 1954 to 2000. Abridged life tables are first derived from the empirical ones, then used to produce one-year-life tables by each of the four methods. These reconstituted complete life tables are then compared with the empirical complete life tables. Among the four methods, the Elandt–Johnson demographic method produces the best reconstitutions at adult ages, specifically those ages at which observed cancer survival needs to be corrected.     

Model life tables: An empirical test of their applicability to less developed countries

Model life tables are commonly used for estimating various parameters of mortality of populations in developing countries with limited data. The application of the models is based on the assumption that the agemortality pattern of the population under consideration resembles one of the life tables in the models. The analysis in this paper tests the validity of this assumption for developing countries with data usable for the purpose. The major conclusion is that infant mortality in the populations analyzed is higher than predicted by the models corresponding to the levels of adult mortality of these populations. The observed discrepancy is ascribed to the selectivity involved in the construction of model life tables, which are primarily derived from the historical experience of Western countries. Populations in the currently developing countries apparently differ in the process of mortality change from those used in the models. Though the analysis is limited to a few countries and may not necessarily be true for all the less developed countries, it suggests the need for caution in the use of conventional model life tables.     

A reconsideration of negro-white mortality differentials in the united states

This paper summarizes the results of an investigation of the validity of Negro-white mortality differentials as reflected in the series of official United States life tables since the turn of the century. Pertinent excerpts from these often-quoted tables are reproduced in Appendix Table A-1 for convenient reference. The paper divides into two main parts.First, mortality levels and differentials beyond early childhood are derived, without use of the existing vital records, by interpreting the series of ten-year cumulative survival rates implicit in the census records for native whites and for Negroes. The results are in general agreement with the official figures, particularly for males.Second, mortality levels and differentials in early childhood are estimated by extrapolating the official 1)5 values via model life tables; that is, by the analytical procedure that would be followed in the absence of direct information on early childhood mortality. Unless it is assumed that age patterns of death for United States Negroes were extremely deviant from those found in populations with reliable census and vital statistics, one must conclude that the official figures grossly underestimate early childhood mortality for Negroes, at least for the period, 1910-40. It follows that, during those decades, Negro-white mortality differentials in terms of expectation of life at birth were also substantially higher than is suggested by the official estimates.     

On model life tables]

A comparative study and detailed analysis of various standard model life tables are presented. After examining the development of various methods by which demographic factors and weighting techniques are applied, the reasons for the existence of vast discrepancies among the model life tables for various world regions are discussed. It is argued that the 1955 UN model life tables and others developed in Europe and in the United States theoretically apply to Western populations, thus the so-called Chilean, Far East, Southern Asia, and Latin American models, all of which are extensions of Western models, are not totally applicable. Nonetheless, it is concluded that the UN's model population tables 90, 95, and 100 (published in 1955) closely approximate China's 1982 census statistics for life expectancy.     

Estimating the regional migration patterns of the foreign-born population in the United States: 1950-1990

"In this paper, we apply model schedules to graduate data on the internal and external regional [U.S.] migration patterns of the foreign-born population for the 1950-1990 period.... To find estimates of the unrecorded migration flows in-between for four census-defined periods in our study (that is, for 1950-1955, 1960-1965, 1970-1975, and 1980-1985) we interpolate between the data of adjacent census time periods. Finally, we combine the estimated migration data with the corresponding mortality data to calculate and analyze the multiregional life tables and projections associated with each five-year time interval." (EXCERPT)     

[Mortality distribution factors and life tables].]

This is an introduction to life table methodology. Particular attention is given to problems concerning the calculation of the distribution of deaths by age and their impact on estimates of life expectancy. Problems are illustrated using data from the abbreviated life tables of China for 1982.