Estimating the completeness of reporting of adult deaths in populations that are approximately stable

An elaboration of Preston's (Preston and Hill, 1980) procedure for determining the completeness with which deaths are recorded in approximately stable populations is presented. Both the procedures of Preston and that of Brass are conventionally limited to mortality beyond early childhood, to mortality above age 5 or age 10. The method considered here is based on characteristics of stable populations, i.e., populations that have been subject for a long time to little variation in age-specific mortality schedules or in overall levels of fertility. The essential features of a stable population are maintained even if fertility has changed. This is the case as long as no strong trend in fertility existed more than 15 or 20 years before the date at which the population is observed. Recent changes in fertility may affect the structure of the population at adult ages, but the effect on estimates of completeness of death records can generally be kept within tolerably narrow limits. Prior to showing how explicit estimates of the relative completeness of recording of numbers of deaths and persons can be derived from counts of deaths and persons by age, it is noted that a life table for a stable population can be constructed directly from the recorded distribution of deaths by age, or from the recorded distribution of persons. The procedures described are applied to several different populations in order to illustrate the computational steps necessary to estimate the completeness of death records at ages above childhood in populations that are approximately stable.     

Uncrossing the U.S. Black-White Mortality Crossover: The Role of Cohort Forces in Life Course Mortality Risk

In this article, I examine the black-white crossover in U.S. adult all-cause mortality, emphasizing how cohort effects condition age-specific estimates of mortality risk. I employ hierarchical age-period-cohort methods on the National Health Interview Survey-Linked Mortality Files between 1986 and 2006 to show that the black-white mortality crossover can be uncrossed by factoring out period and cohort effects of mortality risk. That is, when controlling for variations in cohort and period patterns of U.S. adult mortality, the estimated age effects of non-Hispanic black and non-Hispanic white U.S. adult mortality risk do not cross at any age. This is the case for both men and women. Further, results show that nearly all the recent temporal change in U.S. adult mortality risk was cohort driven. The findings support the contention that the non-Hispanic black and non-Hispanic white U.S. adult populations experienced disparate cohort patterns of mortality risk and that these different experiences are driving the convergence and crossover of mortality risk at older ages.     

Religious attendance and mortality: Implications for the black-white mortality crossover

This study investigates the relationships among religious attendance, mortality, and the black-white mortality crossover. We build on prior research by examining the link between attendance and mortality while testing whether religious involvement captures an important source of population heterogeneity that contributes to a crossover Using data from the Established Populations for Epidemiologic Studies of the Elderly, we find a strong negative association between attendance and mortality. Our results also show evidence of a racial crossover in mortality rates for both men and women. When religious attendance is modeled in terms of differential frailty, clear gender differences emerge. For women, the effect of attendance is race- and age-dependent, modifying the age at crossover by 10 years. For men, however; the effect of attendance is not related to race and does not alter the crossover pattern. When other health risks are modeled in terms of differential frailty, wefind neither race nor age-related effects. Overall, the results highlight the importance of considering religious attendance when examining racial and gender differences in age-specific mortality rates.     

A description of the extreme aged population based on improved medicare enrollment data

The mortality and size of the extreme aged population can be studied most accurately with Medicare enrollment data from the Social Security Administration's Master Beneficiary Record after certain types of questionable records are eliminated. With the improved data base we find that mortality rates at the very old ages are higher than published rates, we are more confident of the reality of the race crossover, and we can estimate the number of centenarians more accurately. Furthermore, a large matched-records study shows close agreement on age at death between the Master Beneficiary Record and the death certificate.     

The influence of cause-specific mortality conditions on the age pattern of mortality with special reference to Taiwan

Abstract This paper discusses the relationship between the level of mortality at ages one to four, on one hand, and five to 34 on the other. This relationship has been observed to vary considerably among mortality schedules at different levels of mortality and even among schedules at the same general level of mortality. This variation is shown among the modem life table systems of the Regional Model Life Tables and the United Nations Model Life Tables. Controlling for the leyel ofmortality from age five to age 34, the West Tables and the United Nations Tables embody approximately the same 'average' relationship between early childhood and adult mortality. Relatively to this average relationship, the South and East Tables consistently display higher childhood mortality rates for a given level of adult mortality. Indeed, the childhood rates of the South Table are twice those of the West Tables over a range of life expectancy at birth from 40 to 70 years. The relationship between childhood and adult mortality from 1957 to 1968, a period of rapid mortality decline, was investigated in Taiwan. In 1957, the Taiwanese data reflected the severe childhood mortality of the South Model Tables. However, by 1968, due to an especially large decline in childhood mortality, this relationship was more moderate and resembled the mortality pattern of the West or East Model Tables. An analysis of the decline in cause-specific mortality during the period revealed that a dramatic decline in childhood mortality from gastro-enteritis was primarily responsible for the shift in the relationship between childhood and adult mortality in Taiwan. It is asserted that, while any of several diseases which result in fatalities primarily among children of pre-school ages, could cause relatively severe childhood mortality, gastro-enteritis is likely to be a primary contributor to such an age pattern. This assertion is based on the fact that, especially in the developing areas of the world, malnutrition and gastro-enteritis are usually precipitating and complicating factors of other childhood diseases. A limited test of this hypothesis was provided by considering the causal components of childhood mortality rates in two populations known, for certain periods, to have exhibited relatively severe childhood mortality conditions; Spain and Portugal. For the years in which those populations were characterized by the South mortality pattern, gastro-enteritis was a principal cause of mortality in childhood. Moreover, with the decline in mortality from gastro-enteritis, the mortality pattern in Spain and Portugal no longer exhibited childhood mortality rates which were severe relative to those of adult life. The implications of these findings for the analysis of mortality conditions in many areas of the developing world, where the gastro-enteritis malnutrition syndrome annually claims a heavy toll of life in early childhood, are not clear. In those areas, the effect of this syndrome on the age pattern of mortality could be offset by special conditions inflating adult mortality rates. Nevertheless, in circumstances where there is evidence indicating substantial childhood mortality from this syndrome and no evidence indicating compensating severe adult mortality, there is reason to suspect that the existing mortality pattern reflects the relatively severe childhood mortality conditions of the South Model Tables. Additionally, where mortality from the gastro-enteritis malnutrition syndrome has been severe in past years, but has been reduced to low levels in recent years, it is probable that the relationship between childhood and adult mortality will shift in favour of the former - quite possibly, in the manner of Taiwan, from a South to an East or West age pattern.     

Estimating African-American mortality from inaccurate data

This paper evaluates the quality of vital statistics and census data for estimating African-American mortality over a period of six decades. The authors employ intercensal cohort comparisons and extinct generation estimates to demonstrate that conventionally constructed African-American death rates may be seriously flawed as early as age 50. Using the crude death rate at ages 50+ for 1978-1982 in conjunction with estimated growth rates and two model life table systems, the authors estimate black age-specific death rates in 1978–1982. These results suggest that if a racial crossover in death rates occurs, the age pattern of mortality among African-Americans must be far outside the range observed in populations with more accurate data.     

Demography of the marriage market in the United States

In this paper, a new index designed to measure the relative availability of unmarried men and women is introduced. Termed the "Availability Ratio," the measure is defined as the number of suitable persons divided by the average competition. Suitability, in turn, is defined in terms of race, age and education. After various experimental tests, particular age and eeducational constraints were empirically derived from marriage data. Persons of opposite sex sharing living quarters are tested as unavailable. Estimates are also made of those presumed to be unsuitable on the basis of the % of persons aged 45-74 who have never married. Adjustments for the census undercount are given. 1980 and 1970 estimates are presented for the US population. Subsequent analyses will focus on metropolitan areas, which are more likely to function as actual marriage markets in contrast to the nation as a whole. The substantive evidence indicates that women under 25 are in a good position to find a mate, but that after this age, their prospects deteriorate rapidly. The outlook is especially poor for the more educated women at older ages, especially black women. At ages 40-49, for example, there are fewer than 3 suitable men available for every 10 college-educated women. The results suggest that the combination of preferences of women for older men (or men's tastes for younger women), combined with higher survival rates for women at older ages, results in a very unbalanced market situationn for all but the youngest cohorts of men and women.     

How Has the Lower Boundary of Human Mortality Evolved,and Has It Already Stopped Decreasing?

In contrast to the upper boundary of mortality, the lower boundary has so far largely been neglected. Based on the three key features—location, sex-specific difference, and level—I analyze past and present trends in the lower boundary of human mortality. The analysis is based on cohort mortality data for 38 countries, covering all the cohorts born between 1900 and 1993. Minimum mortality is analyzed using observed as well as smoothed estimates. The results show that the ages at which minimum mortality is reached have shifted to lower ages. Although the differences have become almost negligible over time, males are showing higher levels of minimum mortality than females. The level of minimum mortality was halved more than five times over the analyzed time horizon. The results also suggest that even after more than 150 years of mortality improvements, minimum mortality has not yet reached a lowest limit and is likely to decrease further in the near future. Trends in the three key features also raise questions about the importance of evolutionary, social, and biological determinants for the recent and future development of minimum mortality.     

The effect of number of siblings on adult mortality: Evidence from Swedish registers for cohorts born between 1938 and 1972

Demographic research has paid much attention to the impact of childhood conditions on adult mortality. We focus on one of the key aspects of early life conditions, sibling group size, and examine the causal effect of growing up in a large family on mortality. While previous studies have focused on low- or middle-income countries, we examine whether growing up in a large family is a disadvantage in Sweden, a context where most parents have adequate resources, which are complemented by a generous welfare state. We used Swedish register data and frailty models, examining all-cause and cause-specific mortality between the ages of 40 and 74 for the 1938–72 cohorts, and also a quasi-experimental approach that exploited multiple births as a source of exogenous variation in the number of siblings. Overall our results do not indicate that growing up in a large family has a detrimental effect on longevity in Sweden.     

The Contribution of Smoking to Black-White Differences in U.S. Mortality

Smoking has significantly impacted American mortality and remains a major cause of morbidity and mortality. No previous study has systematically examined the contribution of smoking-attributable deaths to mortality trends among blacks or to black-white mortality differences at older ages over time in the United States. In this article, we employ multiple methods and data sources to provide a comprehensive assessment of this contribution. We find that smoking has contributed to the black-white gap in life expectancy at age 50 for males, accounting for 20 % to 48 % of the gap between 1980 and 2005, but not for females. The fraction of deaths attributable to smoking at ages above 50 is greater for black males than for white males; and among men, current smoking status explains about 20 % of the black excess relative risk in all-cause mortality at ages above 50 without adjustment for socioeconomic characteristics. These findings advance our understanding of the contribution of smoking to contemporary mortality trends and differences and reinforce the need for interventions that better address the needs of all groups.     

Parental imprisonment,the prison boom,and the concentration of childhood disadvantage

Although much research has focused on how imprisonment transforms the life course of disadvantaged black men, researchers have paid little attention to how parental imprisonment alters the social experience of childhood. This article estimates the risk of parental imprisonment by age 14 for black and white children born in 1978 and 1990. This article also estimates the risk of parental imprisonment for children whose parents did not finish high school, finished high school only, or attended college. Results show the following: (1) 1 in 40 white children born in 1978 and 1 in 25 white children born in 1990 had a parent imprisoned; (2) 1 in 7 black children born in 1978 and 1 in 4 black children born in 1990 had a parent imprisoned; (3) inequality in the risk of parental imprisonment between white children of college-educated parents and all other children is growing; and (4) by age 14, 50.5% of black children born in 1990 to high school dropouts had a father imprisoned. These estimates, robustness checks, and extensions to longitudinal data indicate that parental imprisonment has emerged as a novel—and distinctively American—childhood risk that is concentrated among black children and children of low-education parents.     

Trends,Age Patterns and Differentials in Childhood Mortality in Haiti (1960–1987)

This paper examines the trends, patterns and differentials in childhood mortality in Haiti between 1960 and 1987 with data from three surveys and one census. Data comparability is maximized by a series of adjustments, and both direct and indirect techniques are applied. The results indicate that a slow decline in childhood mortality has occurred since 1960 for the country as a whole. Neonatal survival has shown impressive gains, especially in rural Haiti. Post-neonatal mortality has not, however, declined at the same rate. Mortality between the ages of one and five years has declined at about the same pace as infant mortality, maintaining consistency with model patterns of mortality change. The overall national decline in child mortality appears to have consisted of two phases. The first occurred in rural Haiti during the late 1960s and early 1970s and was due largely to a fall in neonatal mortality. The second phase of the decline was concentrated in Port-au-Prince, and seems to have affected all ages of childhood.     

The Effect of Age Misreporting in China on the Calculation of Mortality Rates at Very High Ages

When mortality rates by age are calculated from recorded deaths and enumerated populations, rates at higher ages are typically in error because of misstated ages. Mortality rates for China in 1981 have been calculated from the number of deaths in 1981 in each household recorded in the 1982 census, and from the census population back-projected one year. Because age was determined from date of birth, and because persons of the Chinese culture have very precise knowledge of date of birth, the mortality rates even at high ages should be unusually accurate. This expectation is fulfilled for most of China, but severe misreporting of age is found in a province that contains a large minority of a non-Han nationality, which lacks precise knowledge of date of birth. Although the province contains only 1.3% of China's population, male death rates above age 90 for all of China are distorted seriously by the erroneous data from this location.     

Black–White Disparities in Adult Mortality: Implications of Differential Record Linkage for Understanding the Mortality Crossover

Mortality rates among black individuals exceed those of white individuals throughout much of the life course. The black–white disparity in mortality rates is widest in young adulthood, and then rates converge with increasing age until a crossover occurs at about age 85 years, after which black older adults exhibit a lower mortality rate relative to white older adults. Data quality issues in survey-linked mortality studies may hinder accurate estimation of this disparity and may even be responsible for the observed black–white mortality crossover, especially if the linkage of surveys to death records during mortality follow-up is less accurate for black older adults. This study assesses black–white differences in the linkage of the 1986–2009 National Health Interview Survey to the National Death Index through 2011 and the implications of racial/ethnic differences in record linkage for mortality disparity estimates. Match class and match score (i.e., indicators of linkage quality) differ by race/ethnicity, with black adults exhibiting less certain matches than white adults in all age groups. The magnitude of the black–white mortality disparity varies with alternative linkage scenarios, but convergence and crossover continue to be observed in each case. Beyond black–white differences in linkage quality, this study also identifies declines over time in linkage quality and even eligibility for linkage among all adults. Although linkage quality is lower among black adults than white adults, differential record linkage does not account for the black–white mortality crossover.     

The Methuselah Effect: The Pernicious Impact of Unreported Deaths on Old-Age Mortality Estimates

We examine inferences about old-age mortality that arise when researchers use survey data matched to death records. We show that even small rates of failure to match respondents can lead to substantial bias in the measurement of mortality rates at older ages. This type of measurement error is consequential for three strands in the demographic literature: (1) the deceleration in mortality rates at old ages; (2) the black-white mortality crossover; and (3) the relatively low rate of old-age mortality among Hispanics, often called the “Hispanic paradox.” Using the National Longitudinal Survey of Older Men matched to death records in both the U.S. Vital Statistics system and the Social Security Death Index, we demonstrate that even small rates of missing mortality matching plausibly lead to an appearance of mortality deceleration when none exists and can generate a spurious black-white mortality crossover. We confirm these findings using data from the National Health Interview Survey matched to the U.S. Vital Statistics system, a data set known as the “gold standard” (Cowper et al. 2002) for estimating age-specific mortality. Moreover, with these data, we show that the Hispanic paradox is also plausibly explained by a similar undercount.     

Parental age and offspring mortality: Negative effects of reproductive ageing may be counterbalanced by secular increases in longevity

As parental ages at birth continue to rise, concerns about the effects of fertility postponement on offspring are increasing. Due to reproductive ageing, advanced parental ages have been associated with negative health outcomes for offspring, including decreased longevity. The literature, however, has neglected to examine the potential benefits of being born at a later date. Secular declines in mortality mean that later birth cohorts are living longer. We analyse mortality over ages 30–74 among 1.9 million Swedish men and women born 1938–60, and use a sibling comparison design that accounts for all time-invariant factors shared by the siblings. When incorporating cohort improvements in mortality, we find that those born to older mothers do not suffer any significant mortality disadvantage, and that those born to older fathers have lower mortality. These findings are likely to be explained by secular declines in mortality counterbalancing the negative effects of reproductive ageing.     

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

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

Reexamining the Dominance of Birth Cohort Effects on Mortality

The association between birth cohort and subsequent mortality has been of interest especially following publication of studies around 1930 of cohorts born up to the latter part of the nineteenth century, particularly for England and Wales. Updated results are presented for this population, together with those for two other cohorts, twentieth‐century Japanese and British populations born about 1930, which have been identified as having particularly clear‐cut birth cohort patterns, and which are used to underpin incorporation of cohort effects in both British official and actuarial mortality forecasts. Graphical methods used to identify cohort patterns are discussed. A number of limitations and difficulties are identified that mean that the conclusions about the predominance of cohort effects are less robust than often assumed. It is argued that alternative explanations should be considered and that the concentration on birth cohorts with particularly advantaged patterns may distort research priorities.     

The exceptionally high life expectancy of Costa Rican nonagenarians

Robust data from a voter registry show that Costa Rican nonagenarians have an exceptionally high live expectancy. Mortality at age 90 in Costa Rica is at least 14% lower than an average of 13 high-income countries. This advantage increases with age by 1% per year. Males have an additional 12% advantage. Age-90 life expectancy for males is 4.4 years, one-half year more than any other country in the world. These estimates do not use problematic data on reported ages, but ages are computed from birth dates in the Costa Rican birth-registration ledgers. Census data con rm the exceptionally high survival of elderly Costa Ricans, especially males. Comparisons with the United States and Sweden show that the Costa Rican advantage comes mostly from reduced incidence of cardiovascular diseases, coupled with a low prevalence of obesity, as the only available explanatory risk factor. Costa Rican nonagenarians are survivors of cohorts that underwent extremely harsh health conditions when young, and their advantage might be just a heterogeneity in frailty effect that might disappear in more recent cohorts. The availability of reliable estimates for the oldest-old in low- income populations is extremely rare. These results may enlighten the debate over how harsh early-life health conditions affect older-age mortality.     

Comparing Observed and Unobserved Components of Childhood: Evidence From Finnish Register Data on Midlife Mortality From Siblings and Their Parents

In this study, we argue that the long arm of childhood that determines adult mortality should be thought of as comprising an observed part and its unobserved counterpart, reflecting the observed socioeconomic position of individuals and their parents and unobserved factors shared within a family. Our estimates of the observed and unobserved parts of the long arm of childhood are based on family-level variance in a survival analytic regression model, using siblings nested within families as the units of analysis. The study uses a sample of Finnish siblings born between 1936 and 1950 obtained from Finnish census data. Individuals are followed from ages 35 to 72. To explain familial influence on mortality, we use demographic background factors, the socioeconomic position of the parents, and the individuals’ own socioeconomic position at age 35 as predictors of all-cause and cause-specific mortality. The observed part—demographic and socioeconomic factors, including region; number of siblings; native language; parents’ education and occupation; and individuals’ income, occupation, tenancy status, and education—accounts for between 10 % and 25 % of the total familial influence on mortality. The larger part of the influence of the family on mortality is not explained by observed individual and parental socioeconomic position or demographic background and thus remains an unobserved component of the arm of childhood. This component highlights the need to investigate the influence of childhood circumstances on adult mortality in a comprehensive framework, including demographic, social, behavioral, and genetic information from the family of origin.