Demography and Life Expectancy J. Hughes 2007

1 Definitions Gerontology: the study of the aging process (biological, sociological, and historical). Geriatrics: the branch of medicine that deals with health care for the elderly. Demography: the statistical study of human populations.

2 Fertility: Definitions Crude birth rate : the annual number of live births per thousand people General fertility rate : the annual number of live births per 1000 women of childbearing age (often taken to be from 15 to 49 years old, but sometimes from 15 to 44). Age-specific fertility rate : the annual number of live births per 1000 women in particular age groups (usually age 15-19, etc.) Total fertility rate : the number of live births per woman completing her reproductive life if her childbearing at each age reflected current age-specific fertility rates

3 2.1 Fertility in every developed country has fallen beneath the 2.1 “replacement rate.”

4 Total Fertility Rates – Europe and North America ____________________ Source:United Nations

5 Birth Rates by Region in 2002

6 Contraception and Fertility

7 Total Fertility Rates – Asian Countries ____________________ Source:United Nations In chart minimum value in y axis is 0 and crosses at 0. 5 In PowerPoint a white fill box has been used to blank out the 0

8 European Fertility Rates ____________________ Source:GAD

Total Fertility Rates – Iran, Turkey, Brazil, ____________________ Source:United Nations In chart minimum value in y axis is 0 and crosses at 0. 5 In PowerPoint a white fill box has been used to blank out the and 2020 are text boxes in PowerPoint with a white fill

10 Mortality: Definitions Crude death rate : the annual number of deaths per 1000 people Infant mortality rate : the annual number of deaths of children less than 1 year old per thousand live births

11 Death rates in US (CDC 2007)

12 Causes of Death in US (CDC 2007)

13 Mortality rate increases with age

14 Log mortality is linear Mortality increases exponentially!

15 Definition: Life expectancy Life expectancy: the number of years which an individual at a given age can expect to live at present mortality rates For example: Mean lifespan of US females: 79 years. Expected ls of US females 20 yrs old: 83 yrs. Expected ls of US females 85 yrs old: 91 yrs Expected ls of US females 90 yrs old: 94 yrs. Life expectancy at birth = mean lifespan At older ages life expectancy > mean lifespan Mean Longevity: average longevity of a population. Sum of ages at death / # of individuals. Maximum longevity: age at death of the longest-lived number of a population.

16 Life expectancyInfant mortality rate at birth (years)(per 1000 live births) Prehistoric Sweden, 1750s37210 India, 1880s25230 U. S., France, Japan, Life expectancy and infant mortality throughout human history

17 Historical Life Expectancy

18 Survival curves since Stone Age

19 Infant Mortality by Region in 2002

20 Human lifespan demographics.

21 Human lifespan demographics.

22 Human lifespan Mean Longevity in the US: –Males, 75 yrs. –Females, 80 yrs. Maximum longevity (verified): –Jeanne Clament who died in 1997 at age 122

23 Life spans in the developed countries have risen dramatically.

24 Life expectancy by age groups and gender (2007 CDC report)

25 Demographic Transition Increasing Longevity Declining Fertility Baby Boom Cohort Stabilization

26 ____________________ Source:GAD for UK; United Nations for World Note:These are “Period” Life expectations, which actually underestimate the expected life span of a baby born in the year specified, but which are easier to calculate than the correct “cohort” figures and therefore frequently used in international comparisons. See footnote x in lecture text for explanation Life Expectancy at Birth (1) – Male – World & UK

27 ____________________ Source:Eurostat demographic year book; GAD for UK Note:On “Period” basis Life Expectancy at 60 (1) – Male – UK & France

28 Squaring the survival curve

29 Age Percent Surviving Source: Arias E. United States Life Tables, National Vital Statistics Reports; vol. 53, no. 6. Hyattsville, MD: National Center for Health Statistics, Survival Curves for U.S. Population, 1900 to 2002

30 Life expectancy at birth Source: France: Vallin And Meslé 2001; Russia: Meslé et al. 1998; Ukraine: Meslé amd Vallin, in press; other coutnries: various statistical and demographic yearbooks. This chart is in Demographic Research – Special Collection 2: Article 2, Convergences and divergences in mortality. A new approach to health transition, by Jacques Vallin and France Meslé, April 16, Trend in life expectancy (both sexes) since 1965 in industrialised countries

31 Developed CountriesDeveloping Countries Japan 15China30 Italy11Turkey24 France10India22 United Kingdom7Egypt19 USA7 Kenya18 Sweden 6.1 Brazil15 Argentina9 Increase in Average Life Expectancy in Years in Some Countries, , Total (MF)

32 Male Life Expectancy at 65 Developed Countries MALE LIFE EXPECTANCY AT 65 COUNTRY Increase Netherlands Denmark Norway Sweden Belgium Canada US Italy New Zealand Austria UK France Finland Switzerland Australia Japan Average Data is from the Human Mortality Database. University of California, Berkeley (USA), and Max Planck Institute for Demographic Research (Germany). Available at (data downloaded on February 2007).

33 Female Life Expectancy at 65 Developed Countries Data is from the Human Mortality Database. University of California, Berkeley (USA), and Max Planck Institute for Demographic Research (Germany). Available at (data downloaded on February 2007).

34 Probability of 50 year old living to 90, 1900 to 2002, by Gender Percent Men Women 30 Source: Computed from U.S. life tables in: Arias E. United States life tables, National vital statistics reports; vol. 53, no. 6. Hyattsville, MD: National Center for health Statistics, 2004.

35 Life expectancy at birth by sex, France by Gender

36 Probable causes for longevity in favor of women: Genetic (XX vs. XY) or Environmental (geography, country, income) Other causes: Lesser life stress in females Less smoking Protective action of estrogens? Lesser accumulation of mDNA deletions/mutations with better protection against oxidative damage Others? Implication for prevention and treatment

37 Proportion of population aged 0-14 versus 65+ (In Italy)

Age Group A B A B From Pop Pyramids to Pop Columns

39 Italy’s Population Structure Age Band ____________________ Source:U.N. Medium variant for 2050 projection Millions

40 Dependency Ratio Dynamics

41 Dependency Ratio Forecasts Ratio of Year Olds to UK Italy USA China Korea World ____________________ Source:UN Medium Variant

42 Demographic Change in UK and China – UN Medium Variant % Population by Age Band UK China Years ____________________ Source: OECD Historical Statistics: OECD Economic Outlook

43 Dependency Ratio Dynamics under Different Demographic Challenges Increase in longevity - no change in fertility Support ratio effect can be fully offset by proportional rise in retirement age Decline in fertility in addition to increase in longevity Proportional rise in retirement age insufficient to offset dependency ratio effect

44 Dependency Ratio Dynamics

45 Key Choices Accept the deterioration of dependency ratios  Poorer pensioners  Higher taxes  Higher savings Offset the deterioration of dependency ratios  Immigration  Higher birth rate  Later retirement ages  Healthy longevity (Longevity Dividend)

46 Rising Longevity, Fixed Retirement Age and Stable Support Ratios Initial Structure Plus Rising Longevity Plus Immigration to Keep Support Ratio Constant Retirement Age

47 Dependency Ratio Dynamics

48 Population Density – US and Europe ____________________ Source:United Nations, Statistical Abstract of the US s per Sq.km: 2000

49 Europe and Its Neighbours – Population ____________________ Source:UN Medium Variant * Note:UN definition plus Pakistan, Afghanistan and Iran European Union Western Asia* Africa Eastern Europe Russia, Ukraine & Belarus Millions

50 Demographics and Geopolitical Weight

51 Immigration: Pros and Cons Arguments for : Arguments against: Argument of inevitability : - Support ratio improvement - Big population gives geopolitical weight. - Cultural diversity and economic vitality - Population density: environmental & economic consequences - Integration challenge - Only a temporary solution if all the world is successful: shifting the burden of adjustment to a stable population onto our grandchildren but at a higher population density - It is going to happen anyway, so let’s ensure the integration is successful