Scarring and Mortality Selection Among Civil War POWs: A Long-Term Mortality, Morbidity, and Socioeconomic Follow-Up

Debilitating events could leave either more frail or more robust survivors, depending on the extent of scarring and mortality selection. The majority of empirical analyses find more frail survivors. I find heterogeneous effects. Among severely stressed former Union Army prisoners of war (POWs), the effect that dominates 35?years after the end of the Civil War depends on age at imprisonment. Among survivors to 1900, those younger than 30 at imprisonment faced higher old-age mortality and morbidity and worse socioeconomic outcomes than non-POW and other POW controls, whereas those older than 30 at imprisonment faced a lower older-age death risk than the controls.     

Economic Conditions in Early Life and Circulatory Disease Mortality

I test the Developmental Origins of Health and Disease hypothesis using a cohort perspective on mortality. I combine data from the National Health Interview Survey Linked Mortality Files, 1986–2006, and U.S. economic data between 1902 and 1956 (403,746 respondents and 39,439 deaths), to estimate how exposures to adverse economic conditions in utero and during the first three years of life affect circulatory disease mortality risk in adulthood. I also examine cohort‐based variation in these associations. Findings suggest that in utero exposures to poor economic conditions increased risk of death from circulatory diseases. Results are consistent with theory and evidence suggesting that developmental processes early in life are strongly associated with circulatory disease susceptibility in older adulthood. However, findings indicate that the mortality effects of these early‐life exposures have likely weakened across birth cohorts.     

Adult height and childhood disease

Taller populations are typically richer populations, and taller individuals live longer and earn more. In consequence, adult height has recently become a focus in understanding the relationship between health and wealth. We investigate the childhood determinants of population adult height, focusing on the respective roles of income and of disease. Across a range of European countries and the United States, we find a strong inverse relationship between postneonatal (ages 1 month to 1 year) mortality, interpreted as a measure of the disease and nutritional burden in childhood, and the mean height of those children as adults. Consistent with these findings, we develop a model of selection and stunting in which the early-life burden of undernutrition and disease not only is responsible for mortality in childhood but also leaves a residue of long-term health risks for survivors, risks that express themselves in adult height and in late-life disease. The model predicts that at sufficiently high mortality levels, selection can dominate scarring, leaving a taller population of survivors. We find evidence of this effect in the poorest and highest-mortality countries of the world, supplementing recent findings on the effects of the Great Chinese Famine.     

Women, aging, and schizophrenia

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the lifespan. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women then men, and women are over-represented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed to the problems of older women with schizophrenia.     

The relative effects of shocks in early- and later-life conditions on mortality

The relative importance of cohorts' early-life conditions, compared to later period conditions, on adult and old-age mortality is not known. This article studies how cohort-level mortality depends on shocks in cohorts' early- and later-life (period) conditions. I use cohorts' own mortality as a proxy for the early-life conditions, and define shocks as deviations from trend. Using historical data for five European Countries i find that shocks in early-life conditions are only weakly associated with cohorts' later mortality. This may be because individual-level health is robust to early-life conditions, or because at the cohort level scarring, selection, and immunity cancel each other. Shocks in period conditions, measured as deviations from trend in period child mortality, are strongly and positively correlated with mortality at all older ages. The results suggest that at the cohort level changing period conditions drive mortality variation and change.     

Effects of parasitoid community structure upon the population dynamics of the honeysuckle leafminer,Chromatomyia suikazurae (Diptera: Agromyzidae)

Population dynamics of a leafminer,Chromatomyia suikazurae (Agromyzidae, Diptera) and its parasitoid community were studied for ten years at seven natural populations along an altitudinal gradient in Japan. This species which mines leaves of a forest shrub,Lonicera gracilipes (Caprifoliaceae), was attacked by 25 hymenopterous parasitoid species. Annually, the parasitoid community structure varied less within a population than among populations. The seven parasitoid communities were clustered into three groups corresponding to the altitudinal gradient: (a) lowland communities dominated by late-attacking, generalist pupal idiobiont eulophids and with highest species diversity, (b) hillside communities dominated by an early-attacking, specialist larval-pupal koinobiont braconid and (c) highland communities dominated by an early-attacking, generalist larval idiobiont eulophid. Annual changes of the host larval densities among the local populations were largely synchronous rather than cyclic. Among these populations, host density levels and mortality patterns greatly varied. By analyzing these inter-populational differences of host mortality patterns, the following conclusions were drawn: (1) The host mortality patterns were determined by the host utilization patterns of the locally dominant species. (2) The host pupal mortality but not larval mortality was related to species diversity but not to species richness itself of each parasitoid community. (3) Density dependence was detected only in pupal mortality at a lowland population dominated by late-attacking pupal parasitoids. These results suggest that interspecific interactions of parasitoids add additive effects to host population dynamics dissimilarly among local populations with different parasitoid communities.     

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.     

On the Survival of Centenarians and the Span of Life

It has been argued in the literature that the observed mortality crossover among older black Americans relative to the white population is a result of ‘differential early mortality which selects the least robust persons from the disadvantaged population at relatively earlier ages so that, at advanced ages, the disadvantaged population has proportionately more robust persons’ (Kenneth G. Manton). The authors examine the plausibility of the observed black mortality crossover and the heterogeneity argument supporting its existence. In addition to citing evidence from the literature, they use life tables from various countries known to have good mortality data to explore the relation between mortality in childhood and at younger adult ages and mortality in old age for cohorts and periods. Analysis suggests that the association between childhood and old-age mortality for cohorts is positive, implying that observed mortality crossovers are produced by deficient data rather than population heterogeneity.     

Women,Aging, and Schizophrenia

SUMMARY

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the life span. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women than men, and women are overrepresented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed for the problems of older women with schizophrenia.     

Risk Exposure in Early Life and Mortality at Older Ages: Evidence from Union Army Veterans

This study examines the relation between risk exposures in early life and hazard of mortality among 11,978 Union Army veterans aged 50 and over in 1900. Veterans' risk exposures prior to enlistment—as approximated by birth season, country of birth, residential region, city size, and height at enlistment—significantly influenced their chance of survival after 1900. These effects are robust irrespective of whether socioeconomic well‐being in 1900 has been taken into account; however, they are sensitive to the particular age periods selected for survival analysis. Whereas some of the effects such as being born in Ireland and coming from large cities became apparent in the first decade after 1900 and then dissipated over time, the effects of birth season, being born in Germany, residential region in the United States, and height at enlistment were more salient in the post‐1910 periods. Height at enlistment shows a positive association with risk of mortality in the post‐1910 periods. Compared to corresponding findings from more recent cohorts, the exceptional robustness of the effects of risk exposures prior to enlistment on old‐age mortality among the veterans highlights the harshness of living conditions early in their lives.     

Trends in age at marriage in postwar Ireland

Age at marriage in the Republic of Ireland has declined substantially from the very high level that prevailed in 1946. Between 1946 and 1969 the median age of grooms fell from 32 to 26 and of brides from 27 to 24. To some extent this is a reflection of the declining importance of the rural population but to a much greater extent it is due to the falling age at marriage among all sections of the population. Simultaneous with the decline in age at marriage, the frequency distributions of brides' and grooms' ages have become both more skewed and more peaked. Thus earlier marriage has also meant greater uniformity in age at marriage, but the phenomenon of first marriage at a fairly advanced age persists. There has been a marked trend towards greater equality between husbands' and wives' ages over the postwar period: the proportion of marriages in which there was less than five years' gap between the ages of the bride and groom rose from 49 percent in 1946 to 71 percent in 1969. The percentage of marriages in which the groom was ten or more years older than the bride has fallen from 22 to seven percent. The evidence suggests that the “marriage market” became less favourable to males (especially older males) over the period and that part of the narrowing in the gap in relative age of brides and grooms has been due to the greater willingness of younger males to marry. It also seems that changes in the age structure of the unmarried population has had an impact on the age distribution of grooms.     

Changing vital rates and age distributions

Abstract In a time of rapid change in birth and death rates demographers need to know the consequences of such changes for age distribution. Does the fall in death rates tend to make the age distribution older? It certainly enables individuals to grow older, but for population aggregates the effect depends on the ages at which mortality improves. Coale, Stolnitz, Schwarz, Lorimer, the United Nations and other writers have investigated trends in age-specific birth and death rates. In particular they have demonstrated that the falling mortality which is now nearly universal does not generally make the population older and sometimes makes it younger. The present article contributes a technique for further examination of this phenomenon.     

Life Span Extension in Humans Is Self‐Reinforcing: A General Theory of Longevity

This article proposes that longevity is not merely the result of an absence of mortality but a self‐reinforcing and positively selected life‐history trait in social species. It argues that a small increase in longevity is amplified as (1) reductions in mortality at young ages increase natural selection for mechanisms of maintenance and repair at all older ages as well as increasing the potential for intergenerational transfers; (2) intergenera‐tional transfers of resources from old to young increase fitness (e.g., through improved health, skill, and competitive ability) of the young and thus favor the presence of older individuals in a population; and (3) the division of labor increases both efficiency and innovation at all levels, resulting in increased resources that can be reinvested. This theory is framed around the longevity‐oriented question posed two decades ago by the ger‐ontologist George Sacher, “Why do we live as long as we do?,” rather than the more prevalent question today, “Why do we grow old?” The article describes the foundational principles and the main phases of a model for the evolution of longevity mediated through social organization, and applies the concept specifically to human populations.     

Diverging Trends in Female Old‐Age Mortality: The United States and the Netherlands versus France and Japan

In the most advanced countries, child mortality and adult mortality under age 65 years have fallen so low that further improvement in life expectancy relies almost completely on the decline of mortality at older ages. This phenomenon is particularly pronounced among women, who are far ahead of men in survival rates. Thus, to project the future of life expectancy, this study focuses on trends in female life expectancy at ages 65 and older. Four countries are selected for this analysis: the United States, Netherlands, France, and Japan. It is particularly interesting to understand why American and Dutch trends in female old‐age mortality have been diverging from those in France and Japan for two decades. It is shown here that most of the divergence derives from the fact that decline in cardiovascular mortality is more and more offset by increases in other causes of death in the United States and the Netherlands, while the other two countries are more successful in reducing mortality from all causes at increasingly older ages. This latter phenomenon could represent a new stage of the health transition.     

The Intergenerational Effect of Cambodia's Genocide on Children's Education and Health

We investigate the intergenerational impact of conflict on the educational and health outcomes of children born years after the conflict ended by exploiting geographical variation in the intensity of the genocide that occurred during the Khmer Rouge (KR) regime in Cambodia. We find that children of individuals who were of prime marriage age during the genocide and experienced greater intensity of genocide have worse educational and health outcomes. In particular, for each standard deviation increase in the intensity of the genocide, average children's normal grade progression rate decreases by 0.03 standard deviations and average children's height‐for‐ age Z‐score decreases by 0.06 standard deviations. We examine several channels through which genocide could affect children born to survivors after the conflict and find suggestive evidence that the marriage market acts as a channel that transmits the adverse impact of conflict across generations. Our findings are robust to alternative measures of mortality rates and post‐KR internal migration.     

The impact of migration on the nonmetropolitan population age structure, 1960–1990

In this paper we examine the short-run impact of migration on the age composition of nonmetropolitan areas. Changes in age structure can have important consequences at the local level, and the influence of migration is particularly notable because it is highly age-graded, with different migration patterns found in various types of nonmetropolitan communities. Here we compare the impact of migration on age structures in metropolitan and nonmetropolitan areas across the last three decades. Within nonmetropolitan areas we also compare counties with colleges, commuting counties, agricultural counties and retirement counties. We conclude that several factors influence the impact of migration on age structure. Impacts will be greater in smaller than in larger population groups, and in areas that specialize in economic functions that impinge on a particular age group. But in general, migration adds young people to metropolitan areas and older people to nonmetropolitan areas. Differential impacts may be lessened in periods, such as 1970–80, when substantial population redistribution was underway. Nevertheless, prior and present fertility and mortality trends, and the cumulative history of migration well exceed the impact of migration on age in any ten-year interval.Abbreviations Metro Metropolitan - Nonmetro Nonmetropolitan An earlier version of this paper was presented at the annual meeting of the Western Regional Science Association, Wailea, Hawaii, 22 February 1993.     

The Effect of Veteran Status on Mortality among Older Americans and its Pathways

This research examines excess mortality among American veterans age 70 years or older during a two-to-three year interval from 1993/94 to the end of 1995. Using a structural hazard rate model, we analyzed data on a sample of respondents age 70 or over from the Survey of Asset and Health Dynamics among the Oldest Old (AHEAD). We found that at age 70, older veterans have a slightly higher death rate than their nonveteran counterparts, implying a mortality crossover right before this age. Such excess mortality among veterans increases considerably with age, when other factors are held equal. The direct and indirect effects of veteran status on mortality by means of physical and mental health mostly perform in opposite directions, and such effects vary greatly in magnitude and direction as a function of age. The intervening effects of physical and mental health status decrease substantially with increasing age. Many of the mechanisms inherent in the excess mortality among older veterans are not captured by variations in their health status, especially among the oldest-old. A more extensive study on this topic is urgently needed.     

The Impact of Parental Death on Child Well-being: Evidence From the Indian Ocean Tsunami

Identifying the impact of parental death on the well-being of children is complicated because parental death is likely to be correlated with other, unobserved factors that affect child well-being. Population-representative longitudinal data collected in Aceh, Indonesia, before and after the December 2004 Indian Ocean tsunami are used to identify the impact of parental deaths on the well-being of children aged 9–17 at the time of the tsunami. Exploiting the unanticipated nature of parental death resulting from the tsunami in combination with measuring well-being of the same children before and after the tsunami, models that include child fixed effects are estimated to isolate the causal effect of parental death. Comparisons are drawn between children who lost one or both parents and children whose parents survived. Shorter-term impacts on school attendance and time allocation one year after the tsunami are examined, as well as longer-term impacts on education trajectories and marriage. Shorter- and longer-term impacts are not the same. Five years after the tsunami, there are substantial deleterious impacts of the tsunami on older boys and girls, whereas the effects on younger children are more muted.     

The Old Old — or the New Old?

This paper gives an account of the demographic trends that are bringing about changes in the population aged 80 years and older in Australia. The old old population of the future will differ in size and structure from earlier cohorts reaching advanced age: an examination is made of the contribution of the effects of past birth rates; recent changes in mortality at older ages; the impact of immigration especially on the cultural diversity of the old old; and changes in sex ratios and marriage patterns that result in changes in social circumstances. The indications are that a much more dynamic view of the old old is required. The present report is the first in a three-part study which mill cover social and health trends and discuss the implications of the newly emergent old old population for social policy.     

Changing mortality and morbidity rates and the health status and life expectancy of the older population

This paper demonstrates the consequences of changes in mortality and health transition rates for changes in both health status life expectancy and the prevalence of health problems in the older population. A five-state multistate life table for the mid-1980s provides the baseline for estimating the effect of differing mortality and morbidity schedules. Results show that improving mortality alone implies increases in both the years and the proportion of dependent life; improving morbidity alone reduces both the years and the proportion of dependent life. Improving mortality alone leads to a higher prevalence of dependent individuals in the life table population; improving morbidity alone leads to a lower percentage of individuals with problems in functioning.