Family Life History and Late Mid‐Life Mortality in Norway

Using data on all Norwegians born 1935–68, we analyze the associations between mortality and a combined indicator of fertility and marital or partnership status and history. The focus is on ages 40–73 and the years 1980–2008 (30 million person‐years of observations and 117,000 deaths). Among men in first marriages, the childless have 36 percent higher mortality than those with two or more children. The corresponding figure for women is 61 percent. The never‐married have higher mortality and are differentiated even more by parenthood status. Thus, childless never‐married men and women have mortality three times as high as those who are married and have two or more children. The apparent advantage associated with having at least two children is smallest among men who divorced before their oldest child's tenth birthday. Having step‐children has no association with mortality for those without natural children but is associated with higher mortality among the parous.     

Mortality,past and future

The study of mortality in previous centuries and of the trends in recent decades helps to elucidate some present-day medical problems and to contribute to their solution. The author considers, from a historical and socio-economic point of view, the factors which, during the last 200 years, have influenced the trends of mortality. This analysis indicates the lines along which present research, aimed at reducing mortality and extending expectation of life, should be directed.

Infancy (0–1 year): In backward countries, the whole of infancy is a period of high mortality. In progressive countries, on the other hand, the main reproductive wastage is in the ‘perinatal’ period, that is to say, covering stillbirths and deaths during the first week of life. For example, even in New Zealand, the death risk per day is more than eighty times as high during the first week of life than in the following 358 days.

Historical studies and social class comparisons suggest that further reduction of perinatal mortality is likely to depend on socio-economic, housing and cultural factors rather than on improvements in obstetric skill. Evidence cited by the author indicates that a crucial factor may be to provide expectant mothers with adequate rest during the weeks immediately prior to delivery. In general, research into mortality in infancy is too much bounded by a purely medical point of view whereas a socio-medical approach is needed.

Childhood (1–14 years): There has been an immense reduction in childhood mortality during the last 200 years. Less than 200 years ago the mortality among children aged 1–4 and 5–9 years was thirty-three times, and among those aged 10–14 years twelve times, that of the present day. Future reduction of mortality among children will be primarily a function of social factors and trends.

Adolescence and maturity (15–49 years): One of the outstanding trends of the last 200 years has been a relative increase in tuberculosis mortality among those aged 15–49 years, whereas among children tuberculosis has become relatively less important

as a cause of death. Recently, however, there has been a decline in the relative importance of tuberculosis as a cause of death among the adolescent and mature and, among New York males, it now takes second place to the cardiovascular

diseases. The total mortality of people in this age group has fallen, since the sixteenth century, by 77% for men and 81% for women. No spectacular discoveries are needed to reduce the mortality of this group by a further third; in doing this, control of environment will be the important factor.

Later maturity and old age (50 years and over): In the four centuries since the Renaissance the mortality of people over 50 years of age has been reduced by half. Among the factors contributing to this reduction is a fall in mortality due to tuberculosis. But even cancer, which is popularly supposed to have increased, used to be more common in the eighteenth century than it is now and to appear at an earlier. age. Moreover, there has been a change in the organs most commonly affected. The distribution of the greater proportion of cancer in a given population is a function of living conditions in the broadest sense of the term. Studies of groups exposed to carcinorelevant factors suggest that a high incidence of cancer in one organ is associated with a low incidence in other organs. But on many other causes of death at the older ages far more research is required, especially on the cardio-vascular-renal complex, and on the degenerative joint and bone diseases.     

Adult Mortality Five Years after a Natural Disaster

Exposure to extreme events has been hypothesized to affect subsequent mortality because of mortality selection and scarring effects of the event itself. We examine survival at and in the five years after the 2004 Indian Ocean earthquake and tsunami for a population‐representative sample of residents of Aceh, Indonesia who were differentially exposed to the disaster. For this population, the dynamics of selection and scarring are a complex function of the degree of tsunami impact in the community, the nature of individual exposures, age at exposure, and gender. Among individuals from tsunami‐affected communities we find evidence for positive mortality selection among older individuals, with stronger effects for males than for females, and that this selection dominates any scarring impact of stressful exposures that elevate mortality. Among individuals from other communities, where mortality selection does not play a role, there is evidence of scarring with property loss associated with elevated mortality risks in the five years after the disaster among adults age 50 or older at the time of the disaster.     

Multinational Corporations,Democracy and Child Mortality: A Quantitative,Cross-National Analysis of Developing Countries

This study presents quantitative, sociological models designed to account for cross-national variation in child mortality. We consider variables linked to five different theoretical perspectives that include the economic modernization, social modernization, political modernization, ecological-evolutionary, and dependency perspectives. The study is based on a cross-lagged effects regression analysis of a sample of 59 developing countries. Our preliminary analysis based on additive models replicates prior studies to the extent that we find that indicators linked to economic and social modernization have beneficial effects on child mortality. We also find support for hypotheses derived from the dependency perspective suggesting that multinational corporate penetration fosters higher levels of child mortality. Subsequent analysis incorporating interaction effects suggest that the level of political democracy conditions the effects of dependency relationships based upon multinational corporations. Transnational economic linkages associated with multinational corporations adversely affect child mortality more strongly at lower levels of democracy than at higher levels of democracy–that is intranational, political factors interact with the international, economic forces to affect child mortality. We conclude with some brief policy recommendations and suggestions for the direction of future research.     

A Realist View of Aging,Mortality, and Future Longevity

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

Education and the Gender Gaps in Health and Mortality

The positive associations between education and health and survival are well established, but whether the strength of these associations depends on gender is not. Is the beneficial influence of education on survival and on self-rated health conditioned by gender in the same way, in opposite ways, or not at all? Because women are otherwise disadvantaged in socioeconomic resources that are inputs to health, their health and survival may depend more on education than will men??s. To test this hypothesis, we use data from the National Health Interview Survey-Linked Mortality Files (NHIS-LMF). We find that education??s beneficial influence on feeling healthy and on survival are conditional on gender, but in opposite ways. Education has a larger effect on women??s self-rated health than on men??s, but a larger effect on men??s mortality. To further examine the mortality results, we examine specific causes of death. We find that the conditional effect is largest for deaths from lung cancer, respiratory disease, stroke, homicide, suicide, and accidents. Because women report worse health but men??s mortality is higher, education closes the gender gap in both health and mortality.     

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

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

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.     

Mortality Deceleration and Mortality Selection: Three Unexpected Implications of a Simple Model

Unobserved heterogeneity in mortality risk is pervasive and consequential. Mortality deceleration—the slowing of mortality’s rise with age—has been considered an important window into heterogeneity that otherwise might be impossible to explore. In this article, I argue that deceleration patterns may reveal surprisingly little about the heterogeneity that putatively produces them. I show that even in a very simple model—one that is composed of just two subpopulations with Gompertz mortality—(1) aggregate mortality can decelerate even while a majority of the cohort is frail; (2) multiple decelerations are possible; and (3) mortality selection can produce acceleration as well as deceleration. Simulations show that these patterns are plausible in model cohorts that in the aggregate resemble cohorts in the Human Mortality Database. I argue that these results challenge some conventional heuristics for understanding the relationship between selection and deceleration; undermine certain inferences from deceleration timing to patterns of social inequality; and imply that standard parametric models, assumed to plateau at most once, may sometimes badly misestimate deceleration timing—even by decades.     

Health,wartime stress,and unit cohesion: Evidence from Union Army veterans

We find that Union Army veterans of the American Civil War who faced greater wartime stress (as measured by higher battlefield mortality rates) experienced higher mortality rates at older ages, but that men who were from more cohesive companies were statistically significantly less likely to be affected by wartime stress. Our results hold for overall mortality, mortality from ischemic heart disease and stroke, and new diagnoses of arteriosclerosis. Our findings represent one of the first long-run health follow-ups of the interaction between stress and social networks in a human population in which both stress and social networks are arguably exogenous.     

Child Mortality and Environment in Developing Countries

This paper studies child mortality and fertility in 61 developing countries including the Central Asian Republics (CARs). To control for simultaneity, an estimated value of fertility was used in the mortality equation and a final specification included only exogenous socio-economic, health and environmental variables. We confirm the importance of female literacy in explaining both fertility and mortality, and also find a measure of consumption for the poorest share of the population to be significant, while controlling for nutrition, health expenditure, and income distribution. Incidence of tuberculosis and female agricultural population proxy for environmental impacts, but in spite of these controls, approximately 41% additional mortality was estimated due to living in the CARs. The results fill gaps in the literature: we use a wider range of socio-economic and environmental health variables than previously in an encompassing analysis of mortality and fertility, and find evidence of excessive mortality in the CARs most likely linked to environmental degradation in the region.

Maternal Education, Birth Weight, and Infant Mortality in the United States

This research determines whether the observed decline in infant mortality with socioeconomic level, operationalized as maternal education (dichotomized as college or more, versus high school or less), is due to its “indirect” effect (operating through birth weight) and/or to its “direct” effect (independent of birth weight). The data used are the 2001 U.S. national African American, Mexican American, and European American birth cohorts by sex. The analysis explores the birth outcomes of infants undergoing normal and compromised fetal development separately by using covariate density defined mixture of logistic regressions (CDDmlr). Among normal births, mean birth weight increases significantly (by 27–108 g) with higher maternal education. Mortality declines significantly (by a factor of 0.40–0.96) through the direct effect of education. The indirect effect of education among normal births is small but significant in three cohorts. Furthermore, the indirect effect of maternal education tends to increase mortality despite improved birth weight. Among compromised births, education has small and inconsistent effects on birth weight and infant mortality. Overall, our results are consistent with the view that the decrease in infant death by socioeconomic level is not mediated by improved birth weight. Interventions targeting birth weight may not result in lower infant mortality.     

Estimating Smoking-Attributable Mortality in the United States

Tobacco use is the largest single cause of premature death in the developed world. Two methods of estimating the number of deaths attributable to smoking use mortality from lung cancer as an indicator of the damage from smoking. We re-estimate the coefficients of one of these, the Preston/Glei/Wilmoth model, using recent data from U.S. states. We calculate smoking-attributable fractions for the 50 states and the United States as a whole in 2004, and estimate the contribution of smoking to the high adult mortality of the southern states. We estimate that 21% of deaths among men and 17% among women were attributable to smoking in 2004. Across states, attributable fractions range from 11% to 30% among men and from 7% to 23% among women. Smoking-related mortality also explains as much as 60% of the mortality disadvantage of southern states compared with other regions. At the national level, our estimates are in close agreement with those of the Centers for Disease Control and Prevention and Preston/Glei/Wilmoth, particularly for men, although we find greater variability by state than does CDC. We suggest that our coefficients are suitable for calculating smoking-attributable mortality in contexts with relatively mature epidemics of cigarette smoking.     

Mortality following conjugal bereavement,Belgium 1991-96: The unexpected effect of education

This paper examines excess mortality following spousal bereavement by time since bereavement, sex, age, and education. The main hypothesis challenged is that higher education buffers the harmful effects of spousal loss. Using a log-rate model, death-rate ratios (widowed/married) are estimated for 49,849 and 126,746 Belgian widowers and widows and an equal number of non-bereaved controls matched to the bereaved on their socio-demographic characteristics. The hypothesis that the more educated suffer less excess mortality is not supported. Although higher educational levels are associated with lower mortality in general, they do not alleviate the effects of bereavement. On the contrary, in the period immediately following spousal loss, the more highly educated seem to have more, rather than less, excess mortality. Three possible arguments are suggested to account for this: education-related differences in the partner-relationship, structural differences in the availability of appropriate social support, and cultural differences in potential support networks.     

Mortality in Ghana: Evidence from the cape coast project data

Abstract This paper deals with the estimation of mortality for a rural community of about 20,000 persons in the rain-forest area of south-west Ghana. Specifically, infant, child and adult mortality estimates have been obtained by the application of a wide range of direct and indirect methods of measuring mortality from the different statistics collected by a longitudinal mortality and fertility project conducted during 1974-7. It was noted that infant and childhood mortality rates obtained from death registrations were consistent with those rates yielded by pregnancy histories and child survival statistics. However, the adult mortality estimates derived from orphanhood statistics tended to be lower than those suggested by death registrations. The analysis revealed an infant mortality rate of 100 for boys and 84 for girls, equal childhood mortality rates for boys and girls (85-6), a lower expectation of life at birth for men (45.8 years) than for women (52.8), and a much more severe incidence of mortality among men aged over 40 than for women at the corresponding ages.     

Mortality in Ghana: Evidence from the cape coast project data

This paper deals with the estimation of mortality for a rural community of about 20,000 persons in the rain-forest area of south-west Ghana. Specifically, infant, child and adult mortality estimates have been obtained by the application of a wide range of direct and indirect methods of measuring mortality from the different statistics collected by a longitudinal mortality and fertility project conducted during 1974–7. It was noted that infant and childhood mortality rates obtained from death registrations were consistent with those rates yielded by pregnancy histories and child survival statistics. However, the adult mortality estimates derived from orphanhood statistics tended to be lower than those suggested by death registrations. The analysis revealed an infant mortality rate of 100 for boys and 84 for girls, equal childhood mortality rates for boys and girls (85–6), a lower expectation of life at birth for men (45.8 years) than for women (52.8), and a much more severe incidence of mortality among men aged over 40 than for women at the corresponding ages.     

How Change in Age-specific Mortality Affects Life Expectancy

At current mortality rates, life expectancy is most responsive to change in mortality rates at older ages. Mathematical formulae that describe the linkage between change in age-specific mortality rates and change in life expectancy reveal why. These formulae also shed light on how past progress against mortality has been translated into increases in life expectancy – and on the impact that future progress may have. Furthermore, the mathematics can be adapted to study the effect of mortality change in heterogeneous populations in which those who did at some age would, if saved, enjoy a different life expectancy than those who live.     

Fathers’ Imprisonment and Mothers’ Multiple-Partner Fertility

We consider the intersection between two striking U.S. trends: dramatic increases in the imprisonment of fathers and increases in the proportion of mothers who have children with more than one partner (multiple-partner fertility, or MPF). Using matched longitudinal administrative data that provide unusually comprehensive and accurate information about the occurrence and timing of imprisonment, fertility, and MPF for the population of the state of Wisconsin, we consider the relationship between paternal imprisonment and MPF among unwed mothers. Employing discrete-time event history analysis with multinomial logistic regression, we model the occurrence and timing of the mother’s second birth, distinguishing between a birth with the same father and a birth with a different father, and distinguishing between current imprisonment and a history of imprisonment. We find that current imprisonment is associated with an increased likelihood of MPF and a decreased likelihood of fertility with the same father (compared with no additional birth) and that a history of imprisonment is associated with increased MPF in some models but not in our preferred model. To control for unobserved heterogeneity among mothers and assess the evidence of a causal effect of fathers’ imprisonment, we also employ the case-time-control method, a fixed-effects method for the analysis of nonrepeated events. Results suggest that fathers’ current imprisonment may increase mothers’ MPF. Policy implications are discussed.     

The Significance of Education for Mortality Compression in the United States

Recent studies of old-age mortality trends assess whether longevity improvements over time are linked to increasing compression of mortality at advanced ages. The historical backdrop of these studies is the long-term improvement in a population's socioeconomic resources that fueled longevity gains. We extend this line of inquiry by examining whether socioeconomic differences in longevity within a population are accompanied by old-age mortality compression. Specifically, we document educational differences in longevity and mortality compression for older men and women in the United States. Drawing on the fundamental cause of disease framework, we hypothesize that both longevity and compression increase with higher levels of education and that women with the highest levels of education will exhibit the greatest degree of longevity and compression. Results based on the Health and Retirement Study and the National Health Interview Survey Linked Mortality File confirm a strong educational gradient in both longevity and mortality compression. We also find that mortality is more compressed within educational groups among women than men. The results suggest that educational attainment in the United States maximizes life chances by delaying the biological aging process.     

Modeling and Forecasting Mortality With Economic Growth: A Multipopulation Approach

Research on mortality modeling of multiple populations focuses mainly on extrapolating past mortality trends and summarizing these trends by one or more common latent factors. This article proposes a multipopulation stochastic mortality model that uses the explanatory power of economic growth. In particular, we extend the Li and Lee model (Li and Lee 2005) by including economic growth, represented by the real gross domestic product (GDP) per capita, to capture the common mortality trend for a group of populations with similar socioeconomic conditions. We find that our proposed model provides a better in-sample fit and an out-of-sample forecast performance. Moreover, it generates lower (higher) forecasted period life expectancy for countries with high (low) GDP per capita than the Li and Lee model.