Long-run trends of human aging and longevity

Over the last 200 years, humans experienced a huge increase of life expectancy. These advances were largely driven by extrinsic improvements of their environment (for example, the available diet, disease prevalence, vaccination, and the state of hygiene and sanitation). In this paper, we ask whether future improvements of life expectancy will be bounded from above by human life span. Life span, in contrast to life expectancy, is conceptualized as a biological measure of longevity driven by the intrinsic rate of bodily deterioration. In order to pursue our question, we first present a modern theory of aging developed by bio-gerontologists and show that immutable life span would put an upper limit on life expectancy. We then show for a sample of developed countries that human life span thus defined was indeed constant until the mid-twentieth century but increased since then in sync with life expectancy. In other words, we find evidence for manufactured life span.     

The length of working life

The rapid growth of the aged population in recent years has underscored the economic problems of dependency in old age and has focused attention on the length of working life as compared to the total life span. In addition to interest in the average work-life span, students of labour-force dynamics have found a need for related measures of withdrawals from the labour force at different ages. In this paper, the author adopts the technique of the life table to a measurement of the work-life span by the construction of a table of working life.

Significant contrast is shown between total life expectancy and working life expectancy. In the United States, the average male worker at 20, for example, could expect to live for an additional 46.8 years and to remain in the labour force for an additional 41.1 years. He would therefore have to provide for almost 6 years of retirement. Significant differences are also indicated in comparisons by colour and residence. Further areas of study in applying the concept of working life are suggested.     

Life Quality measures of smoking

The cost of smoking has three principal dimensions: money, reduced life expectancy, and diminished health. Each component can be quantified; all have an influence on the quality and duration of life. The combined influence can be evaluated using an aggregated social indicator, such as the Life Quality Index. It can be expressed in various ways, e.g. as an equivalent move to a nation or to a time with a lower level of the LQI, as an equivalent economic loss, or as an equivalent loss of life expectancy. To illustrate, the analysis is applied to Danish data on smoking; the cost for a typical pack-a-day habit is equivalent to a 57% reduction in personal income, 8.6 years loss of life expectancy, or a 4% drop in the Life Quality Index. These measures underscore the seriousness of smoking as a health hazard.     

[Age-specific mortality and life expectancy].]

The author attempts to assess the degree of influence of infant mortality on average life expectancy and to develop a method to directly revise average life expectancy given a change in mortality.     

中国老年人口健康预期寿命差异的分解研究

健康预期寿命是反映人群健康长寿的重要指标,健康预期寿命差异反映了一个国家或地区的健康不平等状况。利用多状态生命表分析了中国老年人口健康预期寿命在过去十余年间的趋势与变动,并通过夏普利值分解法测算了人口社会学等11类因素对老年人口健康预期寿命差异的具体贡献值。得到以下四项重要研究结论:第一,从2005年到2018年,中国老年人口健康预期寿命差异的程度略有增加,女性、农村群体相比对应群体差距始终较高;泰尔指数分解发现,组内不平等(而非组间不平等)是造成上述差异的主要原因;老年人口健康预期寿命的性别差异呈现出高龄老人缩小而低龄老人扩大的趋势。第二,婚姻状况是健康预期寿命变动最重要的影响因素,但影响程度呈现逐年下降趋势,反之,受教育程度的影响在逐年上升;进一步将11类影响因素归类后发现:"个体特征"是最重要的影响因素,"经济因素"和"行为因素"的重要性次之,"环境因素"的影响最小。第三,上述影响因素对中国老年人口健康预期寿命的影响总体呈上升趋势,分城乡、分性别后依然呈现出相同的特征。最后,各因素在不同城乡、性别、婚姻状态的群体中的影响存在异质性。     

Can higher life expectancy induce more schooling and earlier retirement?

In this paper, we show that it may be optimal for individuals to educate more and retire earlier when life expectancy increases. This result reconciles the findings of Hazan (Econometrica 77:1829–1863, 2009) with theory. Further, the paper contributes to a better understanding of the conflicting empirical findings on the causal effect on income per capita from increased life expectancy.     

1994～2004年中国老年人的生活自理预期寿命及其变化

本文应用2004年和1994年国家统计局全国人口变动抽样调查中有关老年人生活自理能力的数据,采用Sullivan法对老年人的生活自理预期寿命进行了分析,并且比较了1994年到2004年生活自理预期寿命的变化。研究发现,2004年中国男性老年人平均有1.5年生活不能自理,女性老年人平均为2.5年。随着年龄的增长,中国老年人的生活自理预期寿命占余寿的比重也在逐渐下降。女性老年人的预期寿命比男性高,生活自理预期寿命在60~80岁也高于男性,但是85岁及以上女性的生活自理预期寿命低于男性,而且女性老年人生活自理预期寿命占余寿的比重在整个老年阶段均低于男性老年人。从10年间的变化看,中国老年人的预期寿命和生活自理预期寿命都有所增长,但是生活自理预期寿命在余寿中的比重反而下降了,而且随年龄的增长,下降得也越来越快,男性和女性均呈现同样的态势。就平均水平而言,健康状况改善的程度低于寿命的延长,高龄女性老年人在这个方面尤其处于劣势。     

我国人口预期寿命的结构及影响因素研究—基于省级面板数据的分析

基于省级面板数据,本文对预期寿命结构及其影响因素问题进行研究。首先,文章分析了我国整体预期寿命及两性预期寿命的地理分布特性,随时间的变化特点,以及与经济发展水平的关系。然后,建立预期寿命的固定效应模型,分析不同影响因素与预期寿命的关系。研究发现经济发展水平、教育和卫生资源对男性和女性预期寿命会产生不同的影响,其中经济发展水平会显著影响女性预期寿命,而教育对男性预期寿命的影响更显著。由此,经济发展水平的提高会导致两性预期寿命差距的增加,而教育水平的提高和卫生资源投入的增加则可能会降低两性预期寿命的差距。     

人口死亡水平的国际比较

利用各国的人口资料,使用婴儿死亡率和平均预期寿命这两个关于人口死亡的重要指标,比较中国和世界 人口的死亡水平和变动趋势。根据各国的人均收入,揭示人均收入和平均寿命的统计关系。     

Life Expectancy as an Objective Factor of a Subjective Well-Being

The paper has two parts. In the first part we offer a definition of well-being which makes life expectancy an explicit variable. We recognize the importance of happiness as a significant aspect of any definition of well-being, but we side-step the issue of what determines its level or how to measure it, and concentrate instead on the consequences of our new variable, life expectancy. We argue that life is valued for its quality, and, if positive, its extension is an improvement of well-being. From this we show how, given certain assumptions, disparate problems that have moral and/or social significance can be approached from the perspective of improving well-being. We close the first part by showing that our definition has enough flexibility to be used for that class of decisions which require tradeoffs between quality of life (happiness) and life expectancy. As a corollary we show that attitudes toward risk depend on expectations, and on some occasions, age itself. In the second part we argue, first, that real economic factors, not reducible to mere psychological ones, may still offer an adequate explanation for the fact that absolute income and happiness do not always correlate well. However, we take no position on the many controversies, such as whether it is relative or absolute increases in wealth that bears most directly on changes in happiness. We confirm through statistical analysis (simple regressions) the well established influence that absolute income has on life expectancy, and, hence, by inference and definition, we argue that this must also be the case with well-being. Secondly, we find through statistical analysis that healthcare has as much impact on life expectancy as does absolute income, leading us to theoretically examine the appropriate income cost for access to healthcare if life expectancy is to improve. And thirdly, by assuming a homogeneous function of life expectancy, we theoretically show how a market oriented healthcare system can exacerbate inequities in life expectancy, and so on well-being. Lastly, we consider some policy implications of those inequities.     

The implications of increased survivorship for mortality variation in aging populations

The remarkable growth in life expectancy during the twentieth century inspired predictions of a future in which all people, not just a fortunate few, will live long lives ending at or near the maximum human life span. We show that increased longevity has been accompanied by less variation in ages at death, but survivors to the oldest ages have grown increasingly heterogeneous in their mortality risks. These trends are consistent across countries, and apply even to populations with record-low variability in the length of life. We argue that as a result of continuing improvements in survival, delayed mortality selection has shifted health disparities from early to later life, where they manifest in the growing inequalities in late-life mortality.     

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 contribution of a history of heavy smoking to Scotland's mortality disadvantage

Scotland has a lower life expectancy than any country in Western Europe or North America, and this disadvantage is concentrated above age 50. According to the Human Mortality Database, life expectancy at age 50 has been lower in Scotland than in any other developed country since 1980. Relative to 15 developed countries that we have chosen for comparison, Scotland's life expectancy in 2009 at age 50 was lower by an average of 2.5?years for women and 1.6?years for men. We estimate that Scottish women lost 3.6?years of life expectancy at age 50 as a result of smoking, compared to 1.4?years for the comparison countries. The equivalent figures among men are 3.1 and 2.1?years. These differences are large enough for the history of heavy smoking in Scotland to account both for most of the shortfall in life expectancy for both sexes and for the country's unusually narrow sex differences in life expectancy.     

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.     

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.     

中国各地区人口预期寿命及地理分布分析

平均预期寿命是世界公认的衡量人类进步的标准。本文以生命表为基础,主要依据我国第六次人口普查资料,计算各省市区的预期寿命并进行相关分析,计算结果表明,2010年中国人口平均预期寿命为78.17岁,男75.86岁,女80.68岁,已进入发达国家行列。预期寿命与婴儿死亡率呈负相关r＝-0.789,与人均国民总收入呈正相关r＝0.604。预期寿命女性比男性长4～7岁,符合一般规律。影响男性寿命低于女性的原因很多,本文重点讨论了遗传因素和生活方式的影响,并对预期寿命的地理分布进行分析。     

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.     

Long‐Term Trends in Life Expectancy and Active Life Expectancy in the United States

Changes in life expectancy and in active life expectancy may have effects on the fiscal integrity of both the Social Security and Medicare programs. Analysis of the fiscal stability of these programs shows that the most serious problem may be the growth of Medicare expenditures projected to surpass, in about 2024, Social Security costs. This is aggravated by the associated rapid growth of the Medicaid program. To understand how the growth of Medicare, Medicaid, and Social Security might be correlated we present estimates of changes in life expectancy and active life expectancy from 1935 to 1999 and then project those values to 2080. How the correlation of life expectancy and active life expectancy changes over time, and by age, may provide insights into how increased health care expenditures, if effective in changing health in the elderly, could modify the age structure of the labor force and the availability of human capital.     

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.     

The Contribution of Drug Overdose to Educational Gradients in Life Expectancy in the United States, 1992–2011

Since the mid-1990s, the United States has witnessed a dramatic rise in drug overdose mortality. Educational gradients in life expectancy widened over the same period, and drug overdose likely plays a role in this widening, particularly for non-Hispanic whites. The contemporary drug epidemic is distinctive in terms of its scope, the nature of the substances involved, and its geographic patterning, which influence how it impacts different education groups. I use vital statistics and National Health Interview Survey data to examine the contribution of drug overdose to educational gradients in life expectancy from 1992–2011. I find that over this period, years of life lost due to drug overdose increased for all education groups and for both males and females. The contribution of drug overdose to educational gradients in life expectancy has increased over time and is greater for non-Hispanic whites than for the population as a whole. Drug overdose accounts for a sizable proportion of the increases in educational gradients in life expectancy, particularly at the prime adult ages (ages 30–60), where it accounts for 25 % to 100 % of the widening in educational gradients between 1992 and 2011. Drug overdose mortality has increased more rapidly for females than for males, leading to a gender convergence. These findings shed light on the processes driving recent changes in educational gradients in life expectancy and suggest that effective measures to address the drug overdose epidemic should take into account its differential burden across education groups.