Mortality Inequality in England over the Past 20 Years*

In this paper, we study the evolution of age‐group‐ and gender‐specific mortality and mortality inequality in England between 2003 and 2016, by comparing small geographic areas ranked by deprivation and grouped into bins of similar population size. We show that across all age groups, but especially in the older age groups (65+), there has been a clear and significant reduction in rates of mortality since 2003. In spite of these improvements, we continue to see significant inequalities in mortality across most age groups in 2016 and evidence of rising inequalities among women in the 65+ and men in the 80+ age groups. Furthermore, we see a striking stalling of the downwards trend in mortality and mortality inequality observed between 2003 and 2010 during the years of economic austerity in the aftermath of the 2008 financial crisis in England between 2010 and 2016. Analysis of specific causes of death among adults aged 20–79 allows us to examine the drivers and dynamics of these trends in more depth, as well as to consider scope for, and types of, interventions that would be appropriate at different ages.     

Gender and Age Differences in Socio‐economic Inequalities in Total and Avoidable Mortality in Portugal: A Trend Analysis*

The purpose of this paper is to analyse how socio‐economic inequalities in mortality (total and avoidable) evolved in Portugal from the 1990s onwards by looking at differences by gender, age group, poverty and cause of death. Results show that mortality in younger age groups is decreasing faster in the most deprived municipalities. Yet, avoidable deaths do not follow this pattern, particularly with respect to treatable mortality amenable to the health care services. Although total and avoidable mortality are decreasing across all age groups and both genders, decreases in treatable deaths during and after the 2011–14 economic crisis slowed down among the young, with a sharpening of socio‐economic inequalities in avoidable mortality among adults and the elderly. This provides evidence that, in some respects, focusing programmes on those living in poor circumstances has been successful over time. However, the impact of the Great Recession on health care services might have contributed to a significant increase in some treatable causes of death associated with these services.     

Geographic Inequality in Income and Mortality in Germany*

We use data from the German Federal Statistical Office on population counts, births, deaths and income to study the development of socio‐economic inequality in mortality rates from 1990 to 2015 for different age groups and both genders. Ranking the 401 German districts by average disposable income per capita, we observe large inequalities in district‐level mortality rates in 1990, which had almost disappeared, or at least been flattened considerably, by 2015 particularly for infants, children and the very old. The most important driver of this reduction in inequality is German reunification in 1990. As indicated by more detailed analyses comparing districts in the former East and the former West, even five years after reunification there was a large gap in disposable income, with all Eastern districts considerably poorer than the poorest district in the West. At the same time, mortality rates were higher for all age groups and both genders in the East. Income has caught up, to the extent that there are equally poor districts in the East and West in most recent years (although the West is still much richer on average). Mortality rates in the East have improved considerably and are even below mortality rates for similarly poor districts in the West in the most recent data.     

Mortality Inequality in Finland*

We study inequality in mortality in Finland using registry data that cover the whole population for years 1990–2018. We create municipality‐level indices of regional deprivation (poverty rate), and show how age‐specific mortality rates have evolved across regions and over time. The inequality in mortality has been remarkably low over the time period for most age groups. However, among young and prime‐age males, the mortality rates have been persistently higher in the poorer areas. For these age groups, the leading causes of death are deaths of despair (alcohol and suicides) and accidents. For the cohorts that were young during the deep recession of the early 1990s, we also document higher inequality in middle‐age mortality than for cohorts entering the labour market in recovery periods.     

Inequality in Mortality in Spain*

We analyse the evolution of mortality rates in Spain by age and gender between 1990 and 2018. We compare municipalities, ranked by socio‐economic status (SES) and grouped into bins of similar population size, to study changes not only in levels but also in inequality in mortality across the SES spectrum. We document large decreases in mortality rates throughout the period for all age groups, including children, even after 2000, and continuing after the Great Recession. These declines are stronger for boys and men, who had higher mortality rates to begin with. We find that inequality in mortality across municipalities was low among the young by 2018, while it was higher among adult men and older women. Inequality in fact increased over the period for older men. We explore the role of different causes of death and find that this increase in inequality is driven by stronger improvements in cancer‐related mortality among men living in richer areas. These improvements are not found among women, given their increases in mortality due to lung cancer.     

Inequality in Mortality: Updated Estimates for the United States,Canada and France*

This study provides comparisons of inequalities in mortality between the United States, Canada and France using the most recent available data. The period between 2010 and 2018 saw increases in mortality and in inequality in mortality for most age and gender groups in the United States. The main exceptions were children under 5 and adults over 65. In contrast, Canada saw a further flattening of mortality gradients in most groups, as well as further declines in overall mortality. The sole exception was Canadian women over 80 years old, who saw small increases in mortality rates. France saw continuing improvements in mortality rates in all groups. Both Canada and France have distributions of mortality that are much more equal than those in the United States, demonstrating the importance of public policy in the achievement of equality in health.     

Mortality Inequality in the Czech Republic*

We examine the evolution of mortality and mortality inequality among the 77 districts of the Czech Republic ranked by a new poverty index, from 1994 to 2016. The country experienced dramatic improvements in mortality for all age categories and both genders, but with very little variation in inequality. Inequality in mortality has remained substantially stable, increasing only for females aged 20–64.     

Mind the Gap: A Study of Cause-Specific Mortality by Socioeconomic Circumstances

Socioeconomic groups may be exposed to varying levels of mortality; this is certainly the case in the United Kingdom, where the gaps in life expectancy, differentiated by socioeconomic circumstances, are widening. The reasons for such diverging trends are yet unclear, but a study of cause-specific mortality may provide rich insight into this phenomenon. Therefore, we investigate the relationship between socioeconomic circumstances and cause-specific mortality using a unique dataset obtained from the U.K. Office for National Statistics. We apply a multinomial logistic framework; the reason is twofold. First, covariates such as socioeconomic circumstances are readily incorporated, and, second, the framework is able to handle the intrinsic dependence amongst the competing causes. As a consequence of the dataset and modeling framework, we are able to investigate the impact of improvements in cause-specific mortality by socioeconomic circumstances. We assess the impact using (residual) life expectancy, a measure of aggregate mortality. Of main interest are the gaps in life expectancy among socioeconomic groups, the trends in these gaps over time, and the ability to identify the causes most influential in reducing these gaps. This analysis is performed through the investigation of different scenarios: first, by eliminating one cause of death at a time; second, by meeting a target set by the World Health Organization (WHO), called WHO 25 × 25; and third, by developing an optimal strategy to increase life expectancy and reduce inequalities.     

Beyond the Gompertz law: exploring the late-life mortality deceleration phenomenon

Using a new distribution capable of exhibiting all the possible modes of accelerating and decelerating mortality, we conduct a systematic investigation of late-life mortality in humans. We check the insensitivity of the distribution to age cutoffs in the data relative to the logistic mortality model and propose a method to forecast evolution in the characteristic deceleration ages of the distribution. A number of data sets have been explored, with a particular emphasis on those originating from Scandinavia. Although those from Australia, Canada, and the USA are compatible with Gompertzian mortality, those from the other countries examined are not. We find in particular that the onset of mortality deceleration is being progressively delayed in Western societies but that there is evidence of mortality plateauing at earlier ages.     

Modeling of group-specific mortality in China using a modified Lee–Carter model

The paper assesses sex-age-specific mortality rates of the four groups of people in China, the country, cities, towns, and counties, based on the mortality data from the China Population Statistics Yearbooks (1988–2009) using a newly proposed modified Lee–Carter model. The results show that in general, the expected age-specific mortality rates decrease over the years, and the decreasing speed increased in the past decade. During 2000–2008, the expected mortality rates decreased over the years for females of all ages and groups and males in cities, remained with no changes for males ages 13–36 in the country and towns, but increased for males ages 13–43 in counties. Predictions for 2009 are made based on the 2000–2008 data, and comparisons to the observed rates from an annual survey show that they match each other well except for males ages 13–43 in counties, whose mortality rates reached record highs around 2005, and bounced back to the level of 2000 in 2008 and was reduced a little further in 2009, benefiting from the promulgations and enforcements of some safety regulations by the government on construction and mining sites where most labors are from counties. The predicted age-specific mortality rates from the model are compared to the assumed rates in the China Life Insurance Mortality Table (2000–2003) promulgated by the China Insurance Regulatory Commission, and they show a great deal of similarity in terms of changing trends over the ages.     

Extreme Value Analysis of Mortality at the Oldest Ages: A Case Study Based on Individual Ages at Death

In this article, the force of mortality at the oldest ages is studied using the statistical tools from extreme value theory. A unique data basis recording all individual ages at death above 95 for extinct cohorts born in Belgium between 1886 and 1904 is used to illustrate the relevance of the proposed approach. No leveling off in the force of mortality at the oldest ages is found, and the analysis supports the existence of an upper limit to human lifetime for these cohorts. Therefore, assuming that the force of mortality becomes ultimately constant, that is, that the remaining lifetime tends to the Negative Exponential distribution as the attained age grows is a conservative strategy for managing life annuities.     

Mortality Measurement at Advanced Ages: A Study of the Social Security Administration Death Master File

Accurate estimates of mortality at advanced ages are essential to improving forecasts of mortality and the population size of the oldest old age group. However, estimation of hazard rates at extremely old ages poses serious challenges to researchers: (1) The observed mortality deceleration may be at least partially an artifact of mixing different birth cohorts with different mortality (heterogeneity effect); (2) standard assumptions of hazard rate estimates may be invalid when risk of death is extremely high at old ages and (3) ages of very old people may be exaggerated. One way of obtaining estimates of mortality at extreme ages is to pool together international records of persons surviving to extreme ages with subsequent efforts of strict age validation. This approach helps researchers to resolve the third of the above-mentioned problems but does not resolve the first two problems because of inevitable data heterogeneity when data for people belonging to different birth cohorts and countries are pooled together. In this paper we propose an alternative approach, which gives an opportunity to resolve the first two problems by compiling data for more homogeneous single-year birth cohorts with hazard rates measured at narrow (monthly) age intervals. Possible ways of resolving the third problem of hazard rate estimation are elaborated. This approach is based on data from the Social Security Administration Death Master File (DMF). Some birth cohorts covered by DMF could be studied by the method of extinct generations. Availability of month of birth and month of death information provides a unique opportunity to obtain hazard rate estimates for every month of age. Study of several single-year extinct birth cohorts shows that mortality trajectory at advanced ages follows the Gompertz law up to the ages 102-105 years without a noticeable deceleration. Earlier reports of mortality deceleration (deviation of mortality from the Gompertz law) at ages below 100 appear to be artifacts of mixing together several birth cohorts with different mortality levels and using cross-sectional instead of cohort data. Age exaggeration and crude assumptions applied to mortality estimates at advanced ages may also contribute to mortality underestimation at very advanced ages.     

Mortality Measurement at Advanced Ages

Abstract

Accurate estimates of mortality at advanced ages are essential to improving forecasts of mortality and the population size of the oldest old age group. However, estimation of hazard rates at extremely old ages poses serious challenges to researchers: (1) The observed mortality deceleration may be at least partially an artifact of mixing different birth cohorts with different mortality (heterogeneity effect); (2) standard assumptions of hazard rate estimates may be invalid when risk of death is extremely high at old ages and (3) ages of very old people may be exaggerated. One way of obtaining estimates of mortality at extreme ages is to pool together international records of persons surviving to extreme ages with subsequent efforts of strict age validation. This approach helps researchers to resolve the third of the above-mentioned problems but does not resolve the first two problems because of inevitable data heterogeneity when data for people belonging to different birth cohorts and countries are pooled together. In this paper we propose an alternative approach, which gives an opportunity to resolve the first two problems by compiling data for more homogeneous single-year birth cohorts with hazard rates measured at narrow (monthly) age intervals. Possible ways of resolving the third problem of hazard rate estimation are elaborated. This approach is based on data from the Social Security Administration Death Master File (DMF). Some birth cohorts covered by DMF could be studied by the method of extinct generations. Availability of month of birth and month of death information provides a unique opportunity to obtain hazard rate estimates for every month of age. Study of several single-year extinct birth cohorts shows that mortality trajectory at advanced ages follows the Gompertz law up to the ages 102–105 years without a noticeable deceleration. Earlier reports of mortality deceleration (deviation of mortality from the Gompertz law) at ages below 100 appear to be artifacts of mixing together several birth cohorts with different mortality levels and using cross-sectional instead of cohort data. Age exaggeration and crude assumptions applied to mortality estimates at advanced ages may also contribute to mortality underestimation at very advanced ages.     

An Extreme Value Analysis Of Advanced Age Mortality Data

Abstract

Extreme value theory describes the behavior of random variables at extremely high or low levels. The application of extreme value theory to statistics allows us to fit models to data from the upper tail of a distribution. This paper presents a statistical analysis of advanced age mortality data, using extreme value models to quantify the upper tail of the distribution of human life spans.

Our analysis focuses on mortality data from two sources. Statistics Canada publishes the annual number of deaths in Canada, broken down by angender and age. We use the deaths data from 1949 to 1997 in our analysis. The Japanese Ministry of Health, Labor, and Welfare also publishes detailed annual mortality data, including the 10 oldest reported ages at death in each year. We analyze the Japanese data over the period from 1980 to 2000.

Using the r-largest and peaks-over-threshold approaches to extreme value modeling, we fit generalized extreme value and generalized Pareto distributions to the life span data. Changes in distribution by birth cohort or over time are modeled through the use of covariates. We then evaluate the appropriateness of the fitted models and discuss reasons for their shortcomings. Finally, we use our findings to address the existence of a finite upper bound on the life span distribution and the behavior of the force of mortality at advanced ages.     

COVID-19 and Ethnic Inequalities in England and Wales*

The economic and public health crisis created by the COVID-19 pandemic has exposed existing inequalities between ethnic groups in England and Wales, as well as creating new ones. We draw on current mortality and case data, alongside pre-crisis labour force data, to investigate the relative vulnerability of different ethnic groups to adverse health and economic impacts. After accounting for differences in population structure and regional concentration, we show that most minority groups suffered excess mortality compared with the white British majority group. Differences in underlying health conditions such as diabetes may play a role; so too may occupational exposure to the virus, given the very different labour market profiles of ethnic groups. Distinctive patterns of occupational concentration also highlight the vulnerability of some groups to the economic consequences of social distancing measures, with Bangladeshi and Pakistani men particularly likely to be employed in occupations directly affected by the UK's ‘lockdown’. We show that differences in household structures and inequalities in access to savings mean that a number of minority groups are also less able to weather short-term shocks to their income. Documenting these immediate consequences of the crisis reveals the potential for inequalities to become entrenched in the longer term.     

A logistic two-population mortality projection model for modelling mortality at advanced ages for both sexes

In the current literature, numerous mortality projection models have been proposed and tested, but in general they have been designed for and applied to mainly ages below 90. As medical advances are being shifted to older ages over time and there is a rapid growth in the number of centenarians, there is a need to expand the modelling to older ages. We propose a logistic two-population mortality projection model for the death rates at ages 80 to 100+ for both sexes. We apply this model and its extensions to high quality old-age mortality data of Belgium, Sweden, Switzerland, and the UK and produce decent model performance in both mortality fitting and forecasting. The model structure also provides a reasonable way to close off the life table, which is supported by both theoretical arguments and empirical evidence.     

Human Survival at Older Ages and the Implications for Longevity Bond Pricing

Abstract

Governments are concerned about the future of pension plans, for which increasing longevity is judged to be an important risk to their future viability. We focus on human survival at age 65, the starting age point for many pension products. Using a simple model, we link basic measures of life expectancy to the shape of the human survival function and consider its various forms. The model is then used as the basis for investigating actual survival in England and Wales. We find that life expectancy is increasing at a faster rate than at any time in history, with no evidence of this trend slowing or any upper age limit. With interest growing in the use of longevity bonds as a way to transfer longevity risks from pension providers to the capital markets, we seek to understand how longevity drift affects pension liabilities based on mortality rates at the point of annuitization, versus what actually happens as a cohort ages. The main findings are that longevity bonds are an effective hedge against longevity risk; however, it is not only the oldest old that are driving risk, but also more 65-year-olds reaching less extreme ages such as 80. In addition, we find that the possibility of future inflation and interest rates could be as an important a risk to annuities as longevity itself.     

Brazil's rise: Inequality, culture and globalization

This paper argues that the manifold patterns of globalization in relation to inequality can give rise to both the emergence of economic powers (again) rooted in widespread or deep social inequalities and to transversal forces—that cut across social domains (such as the economy, politics or cultural life), national borders, and social groups or classes—seeking to reinforce or to overturn those inequalities. These rising global players both represent particular historical courses toward modernity and capitalism and express in their contradictory outlook the very trends informing hegemonic globalization. These societies are fundamentally split in terms of a global/local economic and socio-cultural dynamics, which at once positions them in favor of integration and resists several of its instantiations. This further sets off a political dispute over the meaning and impact of globalization, which raises an awareness of cultural particularity and also prompts moves toward global articulations as a means to tackle inequality. The Brazilian case is offered as an example of this process: inequality lies at the root of its capitalist modernization, strongly connected to the legacy of slavery, and the recent juncture of globalization has both deepened inequality and opened a chance of fighting it.     

北京市城镇居民收入差距实证分析

随着社会主义市场经济体制改革的进行，收入分配问题变得异常重要。本通过对改革开放以来北京市城镇居民收入差距的构成和变动的分析，发现虽然收入差距扩大了，收入在不同化程度、年龄的居民中的分配更加合理，但仍存在行业垄断等剧收入差距扩大的因素。政府应规范市场、促进劳动力的自由流动，以使劳动可以公平地获得收入。     

Mortality regimes and longevity risk in a life annuity portfolio

This paper explores the presence of changes of trends or jumps in French mortality from 1947 to 2007, and assesses their implications on the longevity risk management of a life annuity portfolio. We accomplish this by extending the Poisson log-bilinear regression developed by Brouhns et al. (2002) with a regime-switching model. Estimation results show that French mortality is characterized by two distinct regimes. One refers to a strong uncertainty state, which corresponds to the longevity conditions observed during the decade following World War II. The second regime is related to the low volatility of longevity improvements observed during the last 30 years. We use these results to analyze the impact of mortality regimes on the longevity risk management of a life annuity portfolio. Simulation results suggest that the changes of trends in the mortality process have some implications for longevity risk management.