1. Demography and Life Expectancy J. Hughes 2007

2. 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.

3. 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, 20-24 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

4. 3 2.1 Fertility in every developed country has fallen beneath the 2.1 “replacement rate.”

5. 4 Total Fertility Rates – Europe and North America 1950-2000 ____________________ Source:United Nations

6. 5 Birth Rates by Region in 2002

7. 6 Contraception and Fertility

8. 7 Total Fertility Rates – Asian Countries 1950-2000 ____________________ 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

9. 8 European Fertility Rates - 2001 ____________________ Source:GAD

10. 9 -55-65-75-85-05-95-15-25 Total Fertility Rates – Iran, Turkey, Brazil, 1950-2020 ____________________ Source:United Nations 20201950 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 1950 and 2020 are text boxes in PowerPoint with a white fill

11. 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

12. 11 Death rates in US (CDC 2007)

13. 12 Causes of Death in US (CDC 2007)

14. 13 Mortality rate increases with age

15. 14 Log mortality is linear Mortality increases exponentially!

16. 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.

17. 16 Life expectancyInfant mortality rate at birth (years)(per 1000 live births) Prehistoric20-35200-300 Sweden, 1750s37210 India, 1880s25230 U. S., 190048133 France, 19506652 Japan, 1996804 Life expectancy and infant mortality throughout human history

18. 17 Historical Life Expectancy

19. 18 Survival curves since Stone Age

20. 19 Infant Mortality by Region in 2002

21. 20 Human lifespan demographics.

22. 21 Human lifespan demographics.

23. 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

24. 23 Life spans in the developed countries have risen dramatically.

25. 24 Life expectancy by age groups and gender (2007 CDC report)

26. 25 Demographic Transition Increasing Longevity Declining Fertility Baby Boom Cohort Stabilization

27. 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

28. 27 ____________________ Source:Eurostat demographic year book; GAD for UK Note:On “Period” basis Life Expectancy at 60 (1) – Male – UK & France

29. 28 Squaring the survival curve

30. 29 Age 0 20 40 60 80 100 0102030405060708090100 1900 Percent Surviving 1950 2002 Source: Arias E. United States Life Tables, 2002. National Vital Statistics Reports; vol. 53, no. 6. Hyattsville, MD: National Center for Health Statistics, 2004. Survival Curves for U.S. Population, 1900 to 2002

31. 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, 2004 82 78 74 68 76 80 72 66 70 64 19651970197519801985199019952000 Trend in life expectancy (both sexes) since 1965 in industrialised countries

32. 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, 1950-1995, Total (MF)

33. 32 Male Life Expectancy at 65 Developed Countries MALE LIFE EXPECTANCY AT 65 COUNTRY19622002Increase Netherlands 13.9315.64 1.71 Denmark 13.5115.37 1.86 Norway 14.1816.21 2.03 Sweden 13.716.88 3.18 Belgium 12.4615.86 3.4 Canada 13.6417.17 3.53 US 12.9216.56 3.64 Italy 12.916.92 4.02 New Zealand 12.7116.89 4.18 Austria 11.9916.25 4.26 UK 11.8516.26 4.41 France 12.5417.06 4.52 Finland 11.1615.77 4.61 Switzerland 12.7717.49 4.72 Australia 12.4417.58 5.14 Japan 11.5517.98 6.43 Average 12.7716.62 3.85 Data is from the Human Mortality Database. University of California, Berkeley (USA), and Max Planck Institute for Demographic Research (Germany). Available at www.mortality.org (data downloaded on February 2007). www.mortality.org

34. 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 www.mortality.org (data downloaded on February 2007).www.mortality.org

35. 34 Probability of 50 year old living to 90, 1900 to 2002, by Gender 2.7 5.0 15.2 3.8 9.6 26.6 0 5 10 15 20 25 190019502002 Percent Men Women 30 Source: Computed from U.S. life tables in: Arias E. United States life tables, 2002. National vital statistics reports; vol. 53, no. 6. Hyattsville, MD: National Center for health Statistics, 2004.

36. 35 Life expectancy at birth by sex, France 1806-1997 by Gender

37. 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

38. 37 Proportion of population aged 0-14 versus 65+ (In Italy)

39. 38 0 - 4 5 - 9 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85 - 89 90 - 94 95 - 99 100 + Age Group A B A B From Pop Pyramids to Pop Columns

40. 39 Italy’s Population Structure 1970-2050 Age Band 80-100 60-80 40-60 20-40 0-20 197020002050 ____________________ Source:U.N. Medium variant for 2050 projection Millions

41. 40 Dependency Ratio Dynamics

42. 41 Dependency Ratio Forecasts 2000-2050 Ratio of 20-64 Year Olds to 65+ 20002050 UK3.72.1 Italy3.41.4 USA4.82.8 China8.82.4 Korea9.01.7 World7.83.6 ____________________ Source:UN Medium Variant

43. 42 Demographic Change in UK and China – UN Medium Variant % Population by Age Band 20502000 UK China 60+15-590-15 Years ____________________ Source: OECD Historical Statistics: OECD Economic Outlook

44. 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

45. 44 Dependency Ratio Dynamics

46. 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)

47. 46 Rising Longevity, Fixed Retirement Age and Stable Support Ratios Initial Structure Plus Rising Longevity Plus Immigration to Keep Support Ratio Constant Retirement Age

48. 47 Dependency Ratio Dynamics

49. 48 Population Density – US and Europe ____________________ Source:United Nations, Statistical Abstract of the US 2002 000s per Sq.km: 2000

50. 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

51. 50 Demographics and Geopolitical Weight

52. 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