Suchergebnisse

This study examines the potential role that information about trends in causes of death could have in improving projections of mortality in low‐mortality countries. The article first summarizes overall trends in mortality by cause since the middle of the twentieth century. Special attention is given to the crucial impact of the smoking epidemic on mortality and on cause‐of‐death patterns. The article then discusses the implications for projections and reaches two conclusions. First, mortality projections can be improved by taking into account the distorting effects of smoking. Mortality attributable to smoking has risen in the past but has now leveled off or declined, thus boosting improvements in life expectancy. Second, making cause‐specific projections is not likely to be helpful. Trends in specific medical causes of death have exhibited discontinuities in the past, and future trends are therefore difficult to predict.

Abstract
Insurance companies, employer pension plans, and the U.S. government all provide annuities and therefore assume aggregate mortality risk. Using the widely-cited Lee-Carter mortality model, we quantify aggregate mortality risk as the risk that the average annuitant lives longer than is predicted by the model, and we determine that annuities expose providers to substantial risk. We also find that other recent actuarial forecasts lie at the edge or outside of Lee-Carter's 95% confidence interval, suggesting even more uncertainty about future mortality.We then evaluate the implications of aggregate mortality risk for insurance companies; this analysis can be extended to private pension providers and Social Security. Given the forecasts of the Lee-Carter model, we calculate that a markup of 3.9% on an annuity premium (or shareholders' capital equal to 3.9% of the expected present value of annuity payments) would be required to reduce the probability of insolvency resulting from aggregate mortality shocks to 5%, and a markup of 5.7% would reduce the probability of insolvency to 1%. Based on the same model, we find that a projection scale commonly referred to by the insurance industry underestimates aggregate mortality improvements and would leave annuities underpriced.Annuity providers could manage aggregate mortality risk more efficiently by transferring it to financial markets through mortality-contingent bonds. We calculate the returns that one recently proposed mortality bond would have paid had it been available over a long period. Using both the Capital and the Consumption Capital Asset Pricing Models, we determine the risk premium that investors would have required to hold the bond. At plausible coefficients of risk aversion, annuity providers should be able to hedge aggregate mortality risk via such bonds at very low cost.

This study examined the extent of birth displacement and its effect on the under-five mortality estimates in Kenya. Using data from 2003 and 2008/09 Kenya Demographic and Health Surveys, we evaluate the variability of birth displacement by region and place of residence based on the survival status of the child. We compute birth ratios for children born in the 5th calendar year preceding each survey and note the possible effect on under-five mortality estimates. Results show that under-five mortality estimates in 2008/09 survey are smaller than that of a similar period in 2003 survey by 17 percent. Overall, birth ratios for the 5th calendar year were below 100 percent suggesting presence of birth displacement. However, there was no variance in the displacement between surviving and dead children, hence modest impact on the under-five mortality rate. Evidence suggests that the remarkable decline in the under-five mortality rate recorded in 2008/09 is a function of both overestimation of mortality rate in 2003 survey and underestimation in 2008/09 survey. We recommend that data from more than one source be used to interpret under-five mortality decline and further research should be conducted linking the observed mortality decline to the delivery of known effective interventions.

This article analyses the mortality caused by road accidents in Moldova depending on the degree of involvement of pedestrians, cyclists, motorcyclists, drivers and passengers of transport units, depending on age and sex. Results suggest that traffic-related mortality in Moldova has shown an increased incidence among the young and working-age population, where a significant difference between males and females is observed. Among the youth, traffic-related deaths register between 10-27% of the overall mortality in both sexes. The risk exposure of dying in a traffic accident decreases with age and is less significant in the retired ages. During the years 1998-2015, avoidance of trafficrelated deaths would have assured an increase in life expectancy between 0.40-0.56 years in males, and 0.09-0.23 years in females. The continuous increase in the number of transport units on public roads, as well as in the number of hours spent in traffic, influences the degree of exposure to the risk of death or injury as a result of road traffic accidents. Trauma resulting from road accidents increases the incidence of premature mortality and disability among the population, which is reflected by the decrease of healthy life expectancy. It is ascertained that the road accident mortality requires a detailed and comprehensive analysis given the multitude of factors influencing deaths and injuries related to a traffic accident among the population. Thus, in order to improve road safety and reduce mortality incidence among traffic participants, a range of actions has to be implemented by the liable actors, including through the international experience.

This work presents a new mathematical expression for middle and old age mortality as an alternative to the classic Gompertz-Makeham model. Whereas old age mortality is driven by biological aging, middle mortality is mainly caused by behavior. To test the model, sex differences in life expectancy and mortality in Europe from the mid-nineteenth century until recent periods are investigated. The here presented mortality model shows that the female advantage in life expectancy and its dynamics are mainly caused by male risky life style.

This paper examines whether infant and child mortality risks among successive siblings are closely correlated, and if so, whether the survival status of the preceding child is an important factor affecting infant and child mortality in Kenya. The data were drawn from the 1988/89 Kenya Demographic and Health Survey. Logistic regression was used as the major method of data analysis. The results show that both infant and child mortality rates are significantly higher among subsequent children whose preceding siblings had died in infancy than for those whose preceding sibling had survived through infancy. The effect of the survival status of the preceding child on infant mortality was statistically strong, even after a large number of control variables were taken into account. However, its effect on child mortality appears to be spurious since it was rendered statistically insignificant when just a few control variables were introduced into the analysis. The results provide empirical evidence that infant and child mortality risks among successive siblings are closely correlated in Kenyan families, and that the effect of the survival status of the preceding child is important in determining infant mortality but not child mortality.

Regional mortality differences are one dimension of health inequalities, but its trends and determinants in Germany are widely unknown. This book examines and illustrates patterns of regional mortality in Germany-with focus on small-area differentials-and their changes over time. It identifies explanatory factors at individual and regional level. Mortality differences between eastern and western Germany exist, but small-area mortality differentials are often greater. Though the main spatial mortality patterns remain, this study provides evidence that some distinct changes in the small-area mortality patterns in Germany-especially among women-occurred within a short period of time. Mortality inequalities at younger ages and in behavior-related causes as well as differences in socioeconomic conditions contribute strongly to regional mortality differences in Germany. The book shows that the complex interplay between individual- and regional-level mortality risk factors requires a multidimensional approach to reduce regional mortality inequalities.