In Western countries of the Northern hemisphere, mortality is typically larger in winter than in summer which is attributed to the detrimental effects of cold to health. This book investigates whether sociodemographic and socioeconomic factors play a role as important for seasonal mortality as they do for mortality in general
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To investigate how economic conditions and crises affect mortality and its predictability in industrialized countries, we review the related literature, and we forecast mortality developments in Spain, Hungary, and Russia—three countries which have recently undergone major transformation processes following the introduction of radical economic and political reforms. The results of our retrospective mortality forecasts from 1991 to 2009 suggest that our model can capture major changes in long-term mortality trends, and that the forecast errors it generates are usually smaller than those of other well-accepted models, like the Lee-Carter model and its coherent variant. This is because our approach is capable of modeling (1) dynamic shifts in survival improvements from younger to older ages over time, as well as (2) substantial changes in long-term trends by optionally complementing the extrapolated mortality trends in a country of interest with those of selected reference countries. However, the forecasting performance of our model is limited (like that of every model): e.g., if mortality becomes extremely volatile—as was the case in Russia after the dissolution of the Soviet Union—generating a precise forecast will depend more on luck than on methodology and expert judgment. In general, we conclude that, on their own, recent economic changes appear to have minor effects on life expectancy in industrialized countries, but that the effects of these changes are greater if they occur in conjunction with other major social and political changes.
The aim of this study is to answer the question of whether improvements in the health of the elderly in European countries could compensate for population ageing on the supply side of the labour market. We propose a state-of-health-specific (additive) decomposition of the old-age dependency ratio into an old-age healthy dependency ratio and an old-age unhealthy dependency ratio in order to participate in a discussion of the significance of changes in population health to compensate for the ageing of the labour force. Applying the proposed indicators to the Eurostat's population projection for the years 2010–2050, and assuming there will be equal improvements in life expectancy and healthy life expectancy at birth, we discuss various scenarios concerning future of the European labour force. While improvements in population health are anticipated during the years 2010–2050, the growth in the number of elderly people in Europe may be expected to lead to a rise in both healthy and unhealthy dependency ratios. The healthy dependency ratio is, however, projected to make up the greater part of the old-age dependency ratio. In the European countries in 2006, the value of the old-age dependency ratio was 25. But in the year 2050, with a positive migration balance over the years 2010–2050, there would be 18 elderly people in poor health plus 34 in good health per 100 people in the current working age range of 15–64. In the scenarios developed in this study, we demonstrate that improvements in health and progress in preventing disability will not, by themselves, compensate for the ageing of the workforce. However, coupled with a positive migration balance, at the level and with the age structure assumed in the Eurostat's population projections, these developments could ease the effect of population ageing on the supply side of the European labour market.
Life expectancy at birth in the United States during the twentieth century was lower than in many other highly developed countries. We investigate how this mortality disadvantage in the last 100 years translates into the number of hypothetical lives lost and their sex and age structure. We estimate the hypothetical US population if it had experienced in each decade since 1900 the mortality level of the country with the then highest life expectancy and compare the results to the actual figures in 2000. By 2000, the number of additional people who could have been alive had the mortality levels in the United States been as low as those in countries with the highest life expectancy was 66 million. This number is distributed equally between males and females. Suboptimal mortality at reproductive ages is crucial for the cumulative effect of potential lives lost, resulting from premature deaths of women who could still become first‐time mothers or bear additional children. Out of the 66 million additional persons who could have been alive in 2000, 45 million are attributable to those indirect deaths. Although the differences in the composition of the population by sex and age under the two mortality regimes are minor, the majority of people who might have been alive—54 million—were of working age or younger.
This doctoral thesis examines the trends and patterns of premature mortality in the German Baltic Sea region in past and present. Based on demographic methods, it shows that the crucial determinants have changed over the course of the epidemiologic transition. Nutrition and sanitation were decisive factors in the 19th century, which led to significant variations in infant mortality by social class. Today, the access to adequate health care and risk-relevant behavior play a more important role in the region, with men in the eastern part showing the highest rates of avoidable mortality.
Mortality analysis by causes of death is one of the key areas of demographic research. However, the relevance and usefulness of such analysis strongly depend on the validity, reliability, and usability of the collected data. This thesis extends the traditional approach to studying the issue of cause-of-death data quality by examining the consistency of the data collected by a given country. Two dimensions are addressed: spatial consistency, or the consistency of the data across the country's subnational entities; and temporal consistency, or the consistency of cause-of-death data over time.
Using individual-and population level data, this doctoral thesis provides an analysis of the trends in mortality, disability, and long-term care needs in Germany, focusing on the role of individual's socioeconomic status. The results indicate an expansion in care needs for all socioeconomic groups, but once older people become in need of care, other factors than socioeconomic status start operating. The results show that regional mortality differences are strongly linked to the higher share of men with disabilities in the East rather than to mortality differences among men with disabilities.
Mortality data for 30 mostly developed countries available in the Kannisto–Thatcher Database on Old‐Age Mortality (KTDB) are drawn on to assess the pace of decline in death rates at ages 80 years and above. As of 2004 this database recorded 37 million persons at these ages, including 130,000 centenarians (more than double the number in 1990). For men, the probability of surviving from age 80 to age 90 has risen from 12 percent in 1950 to 26 percent in 2002; for women, the increase has been from 16 percent to 38 percent. In the lowest‐mortality country, Japan, life expectancy at age 80 in 2006 is estimated to be 6.5 years for men and 11.3 years for women. For selected countries, average annual percent declines in age‐specific death rates over the preceding ten years are calculated for single‐year age groups 80 to 99 and the years 1970 to 2004. The results are presented in Lexis maps showing the patterns of change in old‐age mortality by cohort and period, and separately for men and women. The trends are not favorable in all countries: for example, old‐age mortality in the United States has stagnated since 1980. But countries with exceptionally low mortality, like Japan and France, do not show a deceleration in death rate declines. It is argued that life expectancy at advanced ages may continue to increase at the same pace as in the past.
This doctoral thesis examines the trends and patterns of premature mortality in the German Baltic Sea region in past and present. Based on demographic methods, it shows that the crucial determinants have changed over the course of the epidemiologic transition. Nutrition and sanitation were decisive factors in the 19th century, which led to significant variations in infant mortality by social class. Today, the access to adequate health care and risk-relevant behavior play a more important role in the region, with men in the eastern part showing the highest rates of avoidable mortality.
Three key observations – the remarkable continuity of mortality improvement, the changing age pattern of mortality improvement, and the location of longevity extension potentials at the highest ages – are the basis for the individual articles of this thesis. The articles explore challenges that are caused by the interplay of the above mentioned developments. The proposed approaches, as well as the insights offered on the boundaries of age-specific mortality, shed light on some of the challenges both demographers and the general public face currently, and will face in the future.
Three key observations – the remarkable continuity of mortality improvement, the changing age pattern of mortality improvement, and the location of longevity extension potentials at the highest ages – are the basis for the individual articles of this thesis. The articles explore challenges that are caused by the interplay of the above mentioned developments. The proposed approaches, as well as the insights offered on the boundaries of age-specific mortality, shed light on some of the challenges both demographers and the general public face currently, and will face in the future.
Les pratiques de certification et de codage des causes initiales de décès ne sont pas toutes les mêmes, ce qui peut nuire à la pertinence et la fiabilité des statistiques de mortalité par cause. La cohérence de ces données au sein d'un même pays peut être considérée comme un critère de qualité. Cet article évalue la cohérence à l'échelle infranationale des statistiques sur les causes de décès en Russie, en Allemagne, aux États-Unis et en France. On estime la part respective des principaux groupes de causes dans les structures de mortalité régionales, et on les compare aux moyennes interrégionales. Ces écarts à la moyenne sont présentés sur des matrices de cartes thermiques qui permettent d'identifier les combinaisons cause-région les plus éloignées des moyennes, les causes présentant une forte variabilité infranationale, ainsi que les régions dont la structure de mortalité est particulière. C'est en France que les données sur les causes de décès sont les plus cohérentes d'une région à l'autre, et en Russie que la part des valeurs aberrantes est la plus élevée. On constate également des différences selon la difficulté à diagnostiquer les causes de décès : la variabilité interrégionale diminue avec le degré de spécificité des symptômes permettant le diagnostic. Plus le diagnostic est difficile, plus les écarts interrégionaux sont importants.