共查询到20条相似文献，搜索用时 15 毫秒
1.
Marlies Br Bram Wouterse Carlos Riumallo Herl Tom Van Ourti Eddy Van Doorslaer 《Fiscal Studies》2021,42(1):79-101
We analyse the trends in inequality in mortality across poverty groups at different ages over the period 1996–2016 in the Netherlands. In addition, we examine whether these trends are related to unequal changes in avoidable mortality, separated by preventable and treatable causes of death. We find that while inequalities in mortality have decreased at ages up to 65, inequalities increased for the oldest age groups. The decline in inequality at the younger ages can, to a large extent, be explained by a strong decrease of mortality from preventable and cardiovascular causes among the poor. The link between inequality and avoidable mortality at the oldest ages is less straightforward. The increasing inequality at old age might be the result of the inequalities shifting from the young to the older age groups, or of the rich benefiting more from the recent health (care) improvements than the poor. 相似文献
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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. 相似文献
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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. 相似文献
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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. 相似文献
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While Norway has experienced income growth accompanied by a large decline in mortality during the past several decades, little is known about the distribution of these improvements in longevity across the income distribution. Using municipality‐level income and mortality data, we show that the stark income gradient in infant mortality across municipalities in the 1950s mostly closed in the late 1960s. However, the income gradient in mortality for older age categories across municipalities persisted until 2010 and only flattened thereafter. Further, the infant mortality gap between rich and poor Norwegian families based on individual‐level data persisted several decades longer than the gap between rich and poor municipalities and only finally closed in the early 21st century. 相似文献
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Peter Redler Amelie Wuppermann Joachim Winter Hannes Schwandt Janet Currie 《Fiscal Studies》2021,42(1):147-170
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. 相似文献
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Michael Baker Janet Currie Boriana Miloucheva Hannes Schwandt Josselin Thuilliez 《Fiscal Studies》2021,42(1):25-46
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. 相似文献
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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. 相似文献
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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. 相似文献
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Christopher Pollitt 《公共资金与管理》2013,33(1):7-8
English sub-national governance is fragmented, embracing regions, city regions and local government. This complex pattern of sub-national provision has grown ever more varied, subject to ad hoc initiatives, with no overall rationale. There has been little political incentive to address the nature of English sub-national governance. This paper examines component elements of English governance and draws conclusions about prospects for change. 相似文献
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Frank van Berkum Katrien Antonio Michel Vellekoop 《Scandinavian actuarial journal》2016,2016(7):581-603
Most mortality models proposed in recent literature rely on the standard ARIMA framework (in particular: a random walk with drift) to project mortality rates. As a result the projections are highly sensitive to the calibration period. We therefore analyse the impact of allowing for multiple structural changes on a large collection of mortality models. We find that this may lead to more robust projections for the period effect but that there is only a limited effect on the ranking of the models based on backtesting criteria, since there is often not yet sufficient statistical evidence for structural changes. However, there are cases for which we do find improvements in estimates and we therefore conclude that one should not exclude on beforehand that structural changes may have occurred. 相似文献
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A new market for so-called mortality derivatives is now appearing with survivor swaps (also called mortality swaps), longevity bonds and other specialized solutions. The development of these new financial instruments is triggered by the increased focus on the systematic mortality risk inherent in life insurance contracts, and their main focus is thus to allow the life insurance companies to hedge their systematic mortality risk. At the same time, this new class of financial contract is interesting from an investor's point of view, since it increases the possibility for an investor to diversify the investment portfolio. The systematic mortality risk stems from the uncertainty related to the future development of the mortality intensities. Mathematically, this uncertainty is described by modeling the underlying mortality intensities via stochastic processes. We consider two different portfolios of insured lives, where the underlying mortality intensities are correlated, and study the combined financial and mortality risk inherent in a portfolio of general life insurance contracts. In order to hedge this risk, we allow for investments in survivor swaps and derive risk-minimizing strategies in markets where such contracts are available. The strategies are evaluated numerically. 相似文献
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Policy-makers are increasingly advocating market-based reforms to increase choices for service users and therefore to drive improvement through competition. This article assesses this approach in a hospital trust where there is plenty of scope for patients to choose providers and so for reforms based on a market logic to work. The market had very little impact on the hospital's activities, but demands from the Department of Health and the strategic health authority for the hospital to become more market-oriented were creating the potential for significant dysfunctional consequences. 相似文献
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住房公积金制度对住房财富积累具有较强的中介效应,其再分配机制对住房财富水平有显著影响。为此,结合中国家庭金融调查数据,引入结构方程模型和不平等回归分解法,对其影响路径进行系统性研究发现：我国住房公积金制度对高收入和高社会地位群体的住房财富积累具有稳定的正向再分配效应,对住房财富不平等的贡献较高。按照公积金的代际支付转移及分配差异的负反馈循环机制,这种不平等远未达到其最大影响。未来通过政策调整和结构优化,在公积金制度公平性和财富分配方面还蕴含着巨大的改善空间。 相似文献
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《公共资金与管理》2012,32(1):72-80
ABSTRACTOutsourcing is difficult to define and trickier to measure. Despite transparency and procurement requirements, there are no comprehensive datasets detailing the extent to which English councils have contracted-out service provision. This lack of information, coupled with austerity pressures, has probably increased the number of ‘known unknowns’ and ‘unknown unknowns’ about the efficacy of this service delivery model. Such developments have significant implications for accountability, risk management and policy-making. 相似文献
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Christian S. Pedersen Stephen E. Satchell 《The GENEVA Papers on Risk and Insurance - Theory》1998,23(2):89-117
Recalling the class of risk measures introduced by Stone [1973], the authors survey measures from different academic disciplines—including psychology, operations research, management science, economics, and finance—that have been introduced since 1973. We introduce a general class of risk measures that extends Stone's class to include these new measures. Finally, we give four axioms that describe necessary attributes of a good financial risk measure and show which of the measures surveyed satisfy these. We demonstrate that all measures that satisfy our axioms, as well as those that do not but are commonly used in finance, belong to our new generalized class. 相似文献
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Mark Bebbington Rebecca Green Chin-Diew Lai Ričardas Zitikis 《Scandinavian actuarial journal》2014,2014(3):189-207
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. 相似文献
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Mika Mäkinen 《Scandinavian actuarial journal》2013,2013(2-3):174-183
This article presents the reference mortality model K2004 approved by the Actuarial Society of Finland and the technique that was implemented in developing it. Initially, I will present the historical development of individual mortality rates in Finland. Then, the requirements posed for a modern mortality modelling will be presented. Reference mortality model K2004 is based on total population mortality rates, which were adjusted to correspond with that portion of the population that has a life insurance policy. First, the model presents a margin of the observed life insurance mortality rate in the total population with a Lee-Carter method together with a forecast, where the downward trend in mortality rates is expected to continue at the rate illustrated since the 1960s. Then, the mortality rate has been adjusted into life insurance mortality per age so that it corresponds to the differences observed between total population and the portion of population that has a life insurance during 1991–2001. Finally, a cohort and gender-specific functional margin will be presented to obtained data. 相似文献