Aging and Life Satisfaction

This paper was intended to examine how major life events – suchas retirement, deterioration of health, and loss of spouse –experienced in the aging process may affect the elderly's lifesatisfaction. An explanation was also proposed to the change inthe effects of age groups on life satisfaction because of thecontrol of the aging effect. A simple form of a longitudinalsurvey conducted in Taiwan in 1989 and 1993 was used for theempirical test. It was found that life satisfaction among theelderly decreased as age increased beyond 65 years of age. Itwas also found that social demographic variables, an incomedecrease, living arrangement, and level of activity participationhave a profound impact on life satisfaction of Taiwan's elderly. When the correlates were controlled, the coefficients for agegroups greater than 70 turned positive. This change could beexplained by two types of cohort experience: (1) from rough toprosperous life experience and (2) cohort norm on lifeexpectancy.     

Unmet Needs for Assistance with ADLs and IADLs: A Measure of Healthy Life Expectancy

Measures of healthy life expectancy have beendeveloped over the last thirty years to evaluate thequality of life of an increasing life expectancy.These measures are usually accounting for prevalencerates of either disability or physical dependence inperforming everyday activities. Although they allowfor a better assessment of quality of life, they arenot reflecting the fact that a disabled person mightbe receiving adequate or inadequate assistance forthese activities. In a context of population aging,where our health care system will have to deal moreand more with chronic disease instead of acutedisease, it is imperative to develop a measure thatwill account for the adequacy of the assistanceprovided to the disabled elderly population. Usingdata from the 1986 Health and Activity LimitationSurvey, we are introducing a measure of healthy lifeexpectancy which will fill this gap. We present theconstruction of this measure of population health anddiscuss its usefulness in assessing policies at amacro level.     

Inequality in life expectancy, functional status, and active life expectancy across selected black and white populations in the United States

We calculated population-level estimates of mortality, functional health, and active life expectancy for black and white adults living in a diverse set of 23 local areas in 1990, and nationwide. At age 16, life expectancy and active life expectancy vary across the local populations by as much as 28 and 25 years respectively. The relationship between population infirmity and longevity also varies. Rural residents outlive urban residents, but their additional years are primarily inactive. Among urban residents, those in more affluent areas outlive those in high-poverty areas. For both whites and blacks, these gains represent increases in active years. For whites alone they also reflect reductions in years spent in poor health.     

Population statistics] as of July 1, 1998

This article presents estimates of relevant population numbers and vital rates in Thailand as of July 1, 1998. Utilizing the standard demographic techniques of analysis, the estimates provided are assured to be the most accurate demographic estimates possible. Total population was estimated at 61,143,000. Estimates by sex, locales, region, and by age group are included. In addition, the crude birth rate per 1000 population was estimated at 18.7; the crude death rate per 1000 population was 6.5. For the natural growth rate the estimate was at 1.2%, and the infant mortality rate was 25.0 per 1000 live births. In terms of life expectancy at birth, the estimate for males was 69.9 years, while for females it was 74.9 years. Additional years in life expectancy at age 60 were 20.3 years for males and 23.9 years for females. The total fertility rate per woman is 1.98, and contraceptive prevalence is 72.2%. The demographic data will be disseminated to Thai and international population researchers and planners.     

Differences in Life Expectancy and Disability Free Life Expectancy in Italy. A Challenge to Health Systems

Background Measures of health expectancy such as Disability Free Life Expectancy are used to evaluate and compare regional/national health statuses. These indicators are useful for understanding changes in the health status and defining health policies and decisions on the provision of services because provide useful information on possible areas needing interventions and burden of care to health systems. Methods Two databases have been used for the analysis: the Italian Health Interview Survey and the European Community Household Panel. The data were analyzed by gender and geographic area. DFLE was calculated by the Sullivan method. Results In 2005 in Italy women have a longer life expectancy than men: 84 and 78 years, respectively. But if we consider life without disability in Italy the male disadvantage reduces: men live 85% of their years without disability, women only 75%. Geographic differences do exist because Disability Free Life Expectancy is longer in Northern and in Central regions; shorter in the South. At a European level similar data can be found: on average women live longer but they have a longer time of life with disability. Conclusion In Italy women live longer but have a worse quality of health than men; in the South there is a worse quality of health. Similar findings can be identified at a European level. The Italian situation with the highest percentage of DFLE at 65 out of the total LE at 65 and one of the longest LE witnesses ageing is not necessarily associated to a worsening of health.     

Global Patterns of Healthy Life Expectancy for Older Women

SUMMARY

This paper focuses on patterns of healthy life expectancy for older women around the globe in the year 2000, and on the determinants of differences in disease and injury for older ages. Our study uses data from the World Health Organization for women and men in 191 countries. These data include a summary measure of population health, healthy life expectancy (HALE), which measures the number of years of life expected to be lived in good health, and a complementary measure of the loss of health (disability-adjusted life years or DALYs) due to a comprehensive set of disease and injury causes. We examine two topics in detail: (1) cross-national patterns of female-male differences in healthy life expectancy at age 60; and (2) identification of the major injury and disability causes of disability in women at older ages. Globally, the male-female gap is lower for HALE than for total life expectancy. The sex gap is highest for Russia (10.0 years) and lowest in North Africa and the Middle East, where males and females have similar levels of healthy life expectancy, and in some cases, females have lower levels of healthy life expectancy. We discuss the implications of the findings for international health policy.     

The Legacy of the Great Recession in Italy: A Wider Geographical,Gender, and Generational Gap in Working Life Expectancy

Under the pressure of population aging the Italian pension system has undergone reforms to increase labor force participation and retirement age, and, thus, the length of working life. However, how the duration of working life has developed in recent years is not well understood. This paper is the first to analyze trends in working life expectancy in Italy. We use data from a nationally representative longitudinal sample of 880,000 individuals from 2003 to 2013 and estimate working life expectancy by gender, occupational category, and region of residence using a Markov chain approach. We document large and increasing heterogeneity in the length of working life. From 2003–2004 to 2012–2013, working life expectancy for men declined from 35.2 to 27.2 years and for women from 34.7 to 23.7 years, increasing the gender gap to 3.5 years. Both young and old were hit, as roughly half of the decline was attributable to ages below 40, half above 40. Working life expectancy declined for all occupational groups, but those in manual occupations lost most, 8.5 years (men) and 10.5 years (women). The North–South economic gradient widened such that men living in the North were expected to work 8 years longer than women living in the South. The fraction of working life of total life expectancy at age 15 declined to record lows at 40% for men and 34% for women in 2012–2013. Policies aiming at increasing total population working life expectancy need to take into consideration the socio-demographic disparities highlighted by our results.

     

亲属、法律、家庭养老

中国家庭养老的传统在今天仍被社会、家庭和个人所重视和依赖。这种传统的部分基础是亲属制度。在这种制度下家中的每个人有其约定俗成的权利和义务 ,在赡养老年人的问题上也如此。亲属数量和类别的多少不仅可以增加老年人晚年接受各方面照料的力量 ,也会潜移默化地促使人们认同、接受和依靠家庭养老这种方式。国家法律也对家庭养老传统的延续起到了监督和推动的作用     

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.     

Gender Differences in Disability-Free Life Expectancy for Selected Risk Factors and Chronic Conditions in Canada

SUMMARY

This article shows how mortality and morbidity patterns differ for women and men 45 years of age and older. The impact on disability-free life expectancy was calculated for selected risk factors and chronic conditions: low income, low education, abnormal body mass index, lack of physical activity, smoking, cancer, diabetes, and arthritis. For each factor, the expected number of years free of disability was calculated for men and women using multi-state life tables. In terms of disability-free life expectancy, the greatest impacts on affected women were for diabetes (14.1 years), arthritis (8.8 years), and physical inactivity (6.0 years), while for affected men, the greatest impacts were for diabetes (10.5 years), smoking (6.9 years), arthritis (6.5 years), and cancer (6.4 years). The implications of these results are discussed from the perspective of developing programs designed to improve population health status.     

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.     

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。     

Three measures of longevity: Time trends and record values

This article examines the trend over time in the measures of “typical” longevity experienced by members of a population: life expectancy at birth, and the median and modal ages at death. The article also analyzes trends in record values observed for all three measures. The record life expectancy at birth increased from a level of 44 years in Sweden in 1840 to 82 years in Japan in 2005. The record median age at death shows increasing patterns similar to those observed in life expectancy at birth. However, the record modal age at death changes very little until the second half of the twentieth century: it moved from a plateau level, around age 80, to having a similar pace of increase as that observed for the mean and the median in most recent years. These findings explain the previously observed uninterrupted increase in the record life expectancy. The cause of this increase has changed over time from a dominance of child mortality reductions to a dominance of adult mortality reductions, which became evident by studying trends in the record modal age at death.     

Social inequalities in disability-free life expectancy in the french male population, 1980–1991

We calculate aggregate indicators of population health for occupational groups to gauge changes in health disparities during the 1980-1991 period. The study is based on the experiences of French adult men in three major occupational classes: managers, manual workers, and an intermediary occupational group. Life table models show that managers have longer life expectancy and disability-free life expectancy (DFLE) than manual workers, and a shorter life expectancy with disability. The concurrent increases in life expectancy and DFLE during the period maintained the occupational disparities in health; the years lived with disability, however, declined for all groups, as for the entire French population.     

Global patterns of healthy life expectancy for older women

This paper focuses on patterns of healthy life expectancy for older women around the globe in the year 2000, and on the determinants of differences in disease and injury for older ages. Our study uses data from the World Health Organization for women and men in 191 countries. These data include a summary measure of population health, healthy life expectancy (HALE), which measures the number of years of life expected to be lived in good health, and a complementary measure of the loss of health (disability-adjusted life years or DALYs) due to a comprehensive set of disease and injury causes. We examine two topics in detail: (1) cross-national patterns of female-male differences in healthy life expectancy at age 60; and (2) identification of the major injury and disability causes of disability in women at older ages. Globally, the male-female gap is lower for HALE than for total life expectancy. The sex gap is highest for Russia (10.0 years) and lowest in North Africa and the Middle East, where males and females have similar levels of healthy life expectancy, and in some cases, females have lower levels of healthy life expectancy. We discuss the implications of the findings for international health policy.     

Changing Life Expectancy and Health Expectancy Among Russian Adults: Results from the Past 20 Years

The decade following the collapse of the Soviet Union was characterized by wide fluctuations in Russian mortality rates, but since the early 2000s, life expectancy has improved progressively. Recent upturns in longevity have promoted policy debates over extending the retirement age in the country. However, whether observed gains in life expectancy are accompanied by improving health remains to be addressed. Using data from the 1994–2014 Russian Longitudinal Monitoring Survey of the Higher School of Economics, this study investigates trends over 20 years in healthy life expectancy (HLE) and illness-free life expectancy (IFLE) for men and women at adult ages. Analyses using the Sullivan method show that men and women at adult ages have experienced large increases in health expectancies during the post-Soviet period. Increases in HLE exceeded increases in total life expectancy for both genders. Further, health expectancies have evolved over time through cycles of increases and decreases, just like life expectancy. These results suggest increases in good-quality years among men and women at working ages, offering support for changing the official retirement age. The extent of the change in the retirement age, however, needs to be carefully considered, given that, despite recent improvements, the health expectancy of the Russian population still remains low.     

The problem of the aged population in China]

The situation regarding the population of China over age 60 is reviewed. From 1953 to 1980 the aged population doubled in size, with the population in urban areas growing at a faster rate than in rural areas. The author notes that declining birth and mortality rates and longer life expectancy will cause the absolute number of the aged to increase. For China, each percentage point increase in the aged means an increase of 10 million aged people. As the ratio of the aged to the rest of the society becomes increasingly larger, China will become an aged society. Tables on age distribution and life expectancy are included.     

Health Profiles and Profile-Specific Health Expectancies of Older Women and Men: The Netherlands

SUMMARY

This study focuses on gender differences in health profiles, and examines which health profiles drive gender differences in remaining life expectancy in women and men aged 65 and over in The Netherlands. Data from the first two cycles of the Longitudinal Aging Study Amsterdam (n = 2,141 and 1,659, respectively) were used to calculate health profiles for individuals of 65–85 years. For both women and men, six profiles were found: I. cancer; II. “other” chronic diseases; III. cognitive impairment; IV. frailty or multimorbidity; V. cardiovascular diseases; and VI. good health. The further characterization of these types showed some gender differences. Remaining life expectancy for women was greater than for men in each health profile. A decomposition into health expectancies showed that both women and men could expect to live about 5 years in good health from age 66. The greatest gender differences in years spent with health problems were found for profile IV and for profile III. Their greater number of years spent in these health states have direct consequences for the type and cost of care women need.     

The Segmented Trend Line of Highest Life Expectancies

The well‐known Oeppen–Vaupel straight line of maximum female life expectancies showed that the highest life expectancy observed in a given year increased linearly from 1840 to 2000. Their analysis fueled major controversy, especially when used to extrapolate future improvements in life expectancy at the same pace. We improve on the empirical analysis by enriching the dataset, expanding the period to 1750–2005, and considering both maximum life expectancy at birth and lowest age‐specific survival rates. It clearly appears that the original Oeppen–Vaupel straight line must be divided into several segments characterized by different slopes and that each segment corresponds to a major advance in the health transition. There is room to push life expectancy higher, but unless some new breakthrough increases the human life span, progress will very likely decelerate as mortality reduction affects individuals at older and older ages. The main key to the future lies not in knowing whether the observed straight line can be extrapolated but in anticipating the next major health improvement that will lead to an additional increase in life expectancy.     

我国年龄组平均预期寿命变动的实证研究

平均预期寿命是国内外评价一个国家或地区人口健康状况的重要指标。国家统计局只公布0岁组平均预期寿命,而要进一步研究,则需要分年龄组资料。利用1995年、2005年全国1%人口抽样数据编制分性别、分城乡的完全生命表,在此基础上定量分析得出:我国各年龄组平均预期寿命,女性>男性,城镇>乡村;暂时平均预期寿命的相对增长速度,1995~2005年快于1981~1995年,女性快于男性;老年组死亡率的降低对0岁组平均预期寿命的贡献率最大。