2. 1 The Mortality of China’s Oldest Old: Comparisons from the Healthy Longevity Survey (HLS) and the 2000 Census Daniel Goodkind International Programs Center This report is released to inform interested parties of ongoing research and to encourage discussion. The views expressed are those of the author and not necessarily those of the U.S. Census Bureau. The use of data not generated by the U.S. Census Bureau precludes performing the same statistical reviews on those data which the U.S. Census Bureau does on its own data. Helping You Make Informed Decisions 1

3. 2 Goal: Compare mortality rates derived from the HLS and the 2000 Census 1.1. Which source would we expect to have more complete reporting of deaths? 2.2. How similar are these rates? 2.3. What are the reasons for any differences? 2

4. 3 U.S. Census Bureau estimates and projections of country populations online at: w w w. c e n s u s. g o v Look under “I” for “International DataBase”(IDB) For China, we use : 1990 Census as Base Year. Mortality, fertility, net migration, etc. from census & other sources. Adjustments to above based on comparisons with 2000 census. Always looking to confirm above “absolutes”. 3

5. 4 Completeness of Death Reporting: Advantages of HLS over 2000 Census Census mortality may be undercounted : *Census not focused on health/mortality *Questions ask of deaths to all household members over the past year - not focused on individuals - ambiguity about belonging to this HH? =>Respondents may forget/not report deaths 4

6. 5 Completeness of Death Reporting: Advantages of HLS over 2000 Census Example of census mortality underreporting: *Hill and Banister (2004) – deaths of all adults in 2000 Census underreported by: 11% for males 18% for females 5

7. 6 Completeness of Death Reporting: Advantages of HLS over 2000 Census Advantages of the HLS: *Focuses on specific elder *Focuses on health and longevity of that elder *Longitudinal design, waves 2.3 years apart =>Deaths could not be “forgotten” by follow- up respondents in the HLS 6

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11. 10 Risk Sets Used to Compare Mortality (Central Death Rates) in 2000 Census & HLS |---------x-------  || 2000 Census 11//’99 11/’00 2 nd wave …. |--------x--------  ||… HLS Risk Set Avrg.7/’99 Avrg. 7/’00 Desired 1 st wave … ||  --------x--------|  --------x--------|… HLS Risk Set Avrg. 5/’98 Avrg.5/’00 Used 10

12. 11 Initial Sample Size and Sequential Loss in Our Analysis due to: Sample Size RemainingLoss 9093 Initial Round of Respondents 8199 894 Loss to Follow Up 8182 17 Death Year not Stated 6674 1508 Deaths During 1 st Year 5010 633 Censored Cases Removed 4377 1664 Deaths During 2 nd Year 11

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15. 14 HLS death rates 20-25 percent lower compared to census. Why? * About half of enumerated areas not randomly chosen * 80- and 90-enarians were matched to 100-enarians. Selected for better health? * Note – 20-25% shortfall in HLS s based on unadjusted census mortality * Comparison – China’s census rural/urban difference in adult nMx only 15% 14

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20. 19 Why higher mortality in 2 nd year after initial interview? *Mortality truly rose over time? *Drop-out Bias: Drop-outs were unhealthy and died early? *Respondents “forgot” about deaths occurring further back in time?

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22. 21 Another Hypothesis Involving Recall - Telescoping – Misrecall bias causing respondents to shift forward the date of events “It seemed like only yesterday that..” 21

23. 22 Implications of Telescoping *At least 10 percent of deaths in 1 st year after initial interview were misreported in 2 nd year *Evidence of telescoping in the 3 rd wave? (2002) *Could telescoping also bias census results upward? 22

24. 23 Summary We expected mortality rates from HLS to be higher than from 2000 Census We found the opposite Reasons – *Selection issues in HLS *Possible telescoping in 2000 Census 23

25. 24 Do these findings affect all conclusions from HLS? Probably not - Conclusions drawn about relative differences in the HLS (e.g. sex, education, ADLs and mortality. etc.) may well be valid. Yet absolute levels of mortality among China elders still somewhat uncertain. 24

26. 25 Thank You! 25