Latin American convergence and divergence towards the mortality profiles of developed countries

It is uncertain whether Latin America and Caribbean (LAC) countries are approaching a single mortality regime. Over the last three decades, LAC has experienced major public health interventions and the highest number of homicides in the world. However, these interventions and homicide rates are not evenly shared across countries. This study documents trends in life expectancy and lifespan variability for 20 LAC countries, 2000–14. By extending a previous method, we decompose differences in lifespan variability between LAC and a developed world benchmark into cause-specific effects. For both sexes, dispersion of amenable diseases through the age span makes the largest contribution to the gap between LAC and the benchmark. Additionally, for males, the concentration of homicides, accidents, and suicides in mid-life further impedes mortality convergence. Great disparity exists in the region: while some countries are rapidly approaching the developed regime, others remain far behind and suffer a clear disadvantage in population health.     

西部山区农民易地扶贫搬迁意愿的影响因素

从现在到2020年是打赢脱贫攻坚战的关键时期,从农民自身角度研究搬迁意愿,对加快实施易地扶贫移民搬迁具有重要意义。研究依据西方微观人口迁移理论：地方效用理论、计划行为理论和效价[CD*2]期望理论,整合构建了中国国情下由政府引导的易地扶贫搬迁意愿的理论分析框架。以陕南移民搬迁为例,在验证性因子分析的基础上,运用有序Logit模型和最优尺度模型对理论假设进行检验。结果显示：①心理因素、政策和预期因素、环境因素对搬迁意愿具有显著影响 ②控制变量中家庭人口数、非农劳动力比例、家庭成员求学婚姻等控制变量与搬迁意愿显著相关;③没有搬迁的主要的顾虑是搬迁后找不到工作、城镇生活成本高、搬迁成本高、搬迁后的适应等问题。研究建议政府部门在搬迁补助、就业安置、搬迁后适应等方面加大支持力度,增强搬迁的信心。     

Older Adults’ Expectations about Mortality,Driving Life and Years Left without Driving

ABSTRACT

People are living and driving longer than ever before, with little preparation for transitioning to being non-drivers. We investigated driving expectations among drivers age 65 and older, including sociodemographic and driving context predictors. Cross-sectional data from 349 older drivers were explored to determine variation in how many years they expected to continue driving. General linear models examined predictors of both expectations. In this predominantly Black/African American sample, 76% of older drivers (mean age = 73 ± 5.7 years) expected a non-driving future, forecasting living an average of 5.75 ± 7.29 years after driving cessation. Regression models on years left of driving life and years left to live post-driving cessation predicted nearly half of the variance in older drivers’ expectations with five significant predictors: income, current age, age expected to live to, self-limiting driving to nearby places and difficulty, visualizing being a non-driver. Many older drivers expect to stop driving before end of life.     

Measuring longevity achievements under welfare interdependencies: a case for joint life expectancy indicators

Whereas period life expectancy constitutes an intuitive indicator of the survival conditions prevailing at a particular period, this paper argues that, given the existence of welfare interdependencies, that widespread indicator is nonetheless an incomplete measure of the longevity achievements relevant for human well-being. The central importance of coexistence for human-beings implies that usual life expectancy measures should be complemented by joint life expectancy indicators, which measure the average coexistence time under particular survival conditions. After a study of the theoretical foundations of ‘single’ and ‘joint’ life expectancy indicators, it is shown that joint life expectancy measures tend to enrich significantly the comparison of longevity achievements across countries and periods. Moreover, the introduction of joint life expectancy indicators—as a complement to conventional life expectancy measures—into multi-variable indexes such as the United Nations’ HDI is also shown to affect international rankings of standards of living to a non negligible extent.

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.     

Long and happy living: Trends and patterns of happy life expectancy in the U.S., 1970–2000

This study assesses the trends and differentials in length of quality life in the U.S. population as measured by happy life expectancy in 1970, 1980, 1990, and 2000. The analysis combines age-specific prevalence rates of subjective well-being from a large nationally representative survey and life table estimates of mortality in decennial Census years. Employing the period prevalence-rate life table method—Sullivan method, the analysis finds evidence for improvement in quality of life in the U.S. Happy life expectancy largely increased in both absolute terms (number of years) and relative terms (proportion of life) over time at all adult ages examined. And increases in total life expectancy were mainly contributed by increases in expectancy in happy years rather than unhappy years. Happy life expectancy is longer than active life expectancy. And there has been greater compression of unhappiness than compression of morbidity. There are substantial differentials in happy life expectancy by sex and race because of differential prevalence rates of happiness. Women and whites had longer years of total and happy life expectancies at most ages and dates, while men and blacks had greater proportions of happy life expectancies across the three decades. Although race differentials generally decreased at older ages and with time, relative disadvantages of blacks persisted.     

Structural Pluralism and Life Expectancy in Less-Developed Countries: The Role of Women's Status

This study replicates a previous finding forthe U.S. counties that showed a strongassociation, net of controls between``structural pluralism' and lower mortality. ``Structural pluralism' refers to a community'scapacity for political competition, and is acore element of ``democracy.' Pluralism hasthis effect because it facilitates theacquisition of appropriate medical facilitiesand because it tends to optimize the biologicalfunctioning of the residents. Working from amajor component of pluralism, minorityparticipation, this hypothesis is tested byshowing that women's status in less developedcountries improves life expectancy net ofcontrols. A path analysis demonstrates thatthe structural dimensions work through healthorganization as an intervening variable, andthe future testing of biological optimizationis outlined. Location in Africa south of theSahara is a partially unexplained controlvariable that has a powerful negative impact. Interpreting women's status as a component ofpluralism explains why it predicts increasedlife expectancy for all citizens, not justwomen. It is a global dimension that affectsall the members of a community.     

Eliciting Subjective Survival Curves: Lessons from Partial Identification

When analyzing data on subjective expectations of continuous outcomes, researchers have access to a limited number of reported probabilities for each respondent from which to construct complete distribution functions. Moreover, reported probabilities may be rounded and thus not equal to true beliefs. Using survival expectations elicited from a representative sample from the Netherlands, we investigate what can be learned if we take these two sources of missing information into account and expectations are therefore only partially identified. We find novel evidence for rounding by checking whether reported expectations are consistent with a hazard of death that increases weakly with age. Only 39% of reported beliefs are consistent with this under the assumption that all probabilities are reported precisely, while 92% are if we allow for rounding. Using the available information to construct bounds on subjective life expectancy, we show that the data alone are not sufficiently informative to allow for useful inference in partially identified linear models, even in the absence of rounding. We propose to improve precision by interpolation between rounded probabilities. Interpolation in combination with a limited amount of rounding does yield informative intervals.     

Global Patterns of Healthy Life Expectancy for Older Women

SUMMARY

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

The choice among past trends as a basis for the prediction of future trends in old-age mortality

We explored the extent to which projections of future old-age mortality trends differ when different projection bases are used. For seven European countries, four alternative sets of annual rates of mortality change were estimated with age–period log-linear regression models, and subsequently applied to age-specific all-cause mortality rates (80+) in 1999 to predict mortality levels up to 2050. On average, up to 2050, e80 is predicted to increase further by 2.33 years among men and 4.03 years among women. Choosing a historical period of 25 instead of 50 years results in higher predicted gains in e80 for men but lower gains for women. Choosing non-smoking-related mortality instead of all-cause mortality leads to higher gains for women and mixed results for men. In all alternatives there is a strong divergence of predicted mortality levels between the countries. Future projections should be preceded by a thorough study of past trends and their determinants.