Age patterns of adult mortality in relation to causes of death and increasing longevity

This study focuses on the contribution of leading causes of death to the general phenomenon of mortality compression in Canada, a topic that has received very limited attention thus far. We analyse the evolution through time of the adult modal age at death (M) and the standard deviation above the mode (SD(M+)) for each leading cause of death in Canada (1974-2008), thanks to detailed data by cause, sex, single year of age and calendar year obtained through a special governmental initiative aiming for greater data access. Changes in the adult age-at-death distribution, such as described by M and SD(M+), are evaluated using a novel nonparametric smoothing approach known as the P-splines method, that we specifically adapt to the context of cause of death analysis. Preliminary results show that between 1974 and 2008, M has increased while SD(M+) has decreased for cancer and heart diseases, Canada’s top two leading causes of death.

Life expectancy is increasing in most high-income countries. The development is not uniform, though. Whereas some countries experienced steady progress during recent decades, others have periods of stagnation and, eventually, phases of catching up.

The aim of our paper is to investigate whether comparable developments
in life expectancy are based on the same underlying mortality dynamics. We use surfaces of rates of mortality improvement as our tool of analysis. Based on two-dimensional plots of smoothed death rates, our ``maps'' depict the rate of mortality change over time. We argue that this approach provides an excellent exploratory tool to visually analyze mortality dynamics, in particular to detect age-, period-, and cohort-effects. Preliminary results demonstrate for international comparisons that periods of stagnation followed by rapid increases can be caused by cohort factors (e.g. Denmark) as well as by period factors (e.g. East Germany).

An analysis by major causes of death for the United States shows that
antagonistic cohort effects were instrumental for the slow life
expectancy increase during the 1980s and the 1990s: If negative cohort
effects of respiratory diseases and cancer had been absent, life
expectancy would have increased much faster due to improvements in
survival for heart diseases.

Adult lifespan variation has been stagnant since the 1960s in most countries, despite increases in longevity. We investigated the role that smoking has played in this stagnation using Finnish register data by occupational class (1971-2007). We expected stronger mortality compression in the absence of smoking and expected smoking-attributable mortality to explain divergences in compression by occupational group. Instead we only found a modest impact on lifespan variation from smoking, despite it having a large impact on longevity. Among men, diverging trends in lifespan variation by occupational class would have widened even further in the absence of smoking, while among women trends in lifespan variation were mostly unaffected by smoking. The maturation of the smoking epidemic is not expected to bring about strong reductions in the uncertainty in the timing of death, nor is it expected to reduce inequalities in this dimension by occupational class in Finland.

The Brazilian Northeast is historically considered one of the least developed regions of Lain America. It features deficient vital statistics, which hinders the ability of management and development of public health policies. Aiming at identifying explanatory factors of life conditions and vulnerability of the major causes of mortality of elderly women by cardiovascular diseases (CVDs) in the northeastern of Brazil in 2010, an ecological study was carried out in 188 northeastern micro regions. The population data was taken from Census 2010 and mortality data from the Brazilian Ministry of Health. Two models were compared and the outcome variable mortality rate due to CVD was directly observed in model-1 and estimated by four major underlying causes in model-2. The Structural Equations Modeling (SEM) used showed better adjustments to final model-1, with significance in the measurement model for the indicators – years of study, percentage of elderly women living in homes with bathroom and water supply, probability of living to 60 years old – and fit indicators of the structural model. The SEM proved to be highly sensitive.

The increase in mortality rates with advancing age is thought to reflect functional decline and processes associated with physiological aging. When viewed on a logarithmic scale, mortality rates tend to increase at a constant rate in the adult age range. This “slope”, the Rate of Mortality Increase with age is commonly used as a measure of actuarial aging in biodemographic research. The goal of this paper is to examine the black-white difference in this slope – a lower rate of mortality increase among blacks. The analysis uses a unique application of classical decomposition methods to partition the black-white RMI disparity into two components, each reflecting a dimension of cause-specific mortality disparities between blacks and whites. The first component reflects the extent to which the rate of increase among blacks is lower for individual causes of death. The second reflects the extent to which the cause of death distribution among blacks is tilted towards causes of death that increase relatively slowly with age. These results are also related to the well-known black white mortality crossover – the tendency for mortality among whites to exceed that of blacks at the oldest ages.

Harmful Widowhood Practice (HWP) is an obnoxious inhuman treatment following the death of their husbands. They are the Umuadas - the daughters married outside their community, family members and community because of the prevalent cultural norms. The HWP is a common traditional practice in most African societies. In Nigeria, it is predominantly practiced in Igboland. The traditional HWPs are wife and assets inheritance including sexual cleansings. The study therefore examined the HWPs in Igboland, Nigeria
The study adopted qualitative method of data collection. Validated and structured interview guide was used for data collection. The 241 widows identified in 5 communities of OMC were randomly selected and interview for the study. Data collected were analysed using thematic approach
Findings of the investigation reveal harmful widow practices persisted in 5 communities of OMC and possibly apply to all parts of Nigeria due to Igbo world perception about deaths, its causes, marriage and umuadas ruthless behaviour in implementing widowhood practices. Efforts of change agents e.g. churches, NGOs & governments to curb the harmful cultural practices proved abortive due to inadequate legislation
HWP is common in Nigeria therefore for the achievement of MDGs in Africa government should provide legislation for the protection of widows

According to SRS, since 1980s, mortality rates have been declining continuously among the Indian adult and older ages. Alongside, the morbidity rates increased remarkably during the last two decade. In the current state of mortality transition, country is witnessing the unique phenomena of low mortality and high morbidity during the last two decade. Kumar (1993) addressed low mortality and high morbidity in Kerala, which seems to be true for India and bigger states in present demographic scenario. During 1995/96-2004, the prevalence rate of chronic NCDs increased four-folds than other categories of diseases. Consequently, chronic NCDs were responsible for major share of deaths than any other major categories of causes of death (Visaria 2004). As a result, the mortality transition progresses with greater pace during the last two decade. Modal age at death (M) increased linearly by 5 years for both females and males (r2=0.9515 for females and r2=0.9020 for males). Significant increase in modal age at death ascertained the dominance of old age mortality over the adult age mortality. Among the demographically advanced states, Kerala is foremost where old age mortality has been in dominance since 1970s compared to less advanced state say Uttar Pradesh, where the old age mortality has been in dominance since 1990s.

The level of maternal mortality is an indicator of disparity in access to appropriate health care and nutrition services particularly during pregnancy and childbirth. India has made an appreciable progress in improving the overall health status but it is far from satisfaction. The pace of decline of maternal mortality on has been quite low. The maternal mortality is not only a health issue but also a matter of social injustice and discrimination. The National Family Health Survey 1992-93 was provide the national level estimate of maternal mortality but due to the scanty sample size state level estimates could not be produced therefore several indirect methods have been proposed for estimation of maternal mortality.
The fertility beyond age 35 years (i.e. excess fertility) is risky for both women and child and it leads to miscarriage, maternal & child mortality thus in this study an attempt has been made to relate excess fertility to the maternal death using simple regression technique. The proposed predictor variable explains 85 percent to the maternal mortality. Estimates obtained through proposed procedure are quite close to the observed value of maternal mortality. Also maternal mortality is estimated for the different categories of the population.

This paper compares regional cause-specific mortality profiles in the course of time from the last census in Soviet Union (1989) to nowadays (2010) taking for the reference point the year of the last and a single so far census in Ukraine, 2001. In the early 2000s, the geography of mortality varies from one cause to the other. Standardized death rates for the biggest killer, circulatory system diseases were higher in eastern and northern parts of the country, which is sometimes associated with Chernobyl disaster. Mortality from external causes was as well high on the east, center and north. South is distinctive by infectious mortality and digestive system problems. The results show that this interregional variation has increased between 1989 and 2001 in respect to most causes of death except cancers and respiratory system diseases. Since 2001, reversely, differences are reducing.
Considering regional cause-of death patterns highlights the fact that some regions of Ukraine are more advanced than others on the path of health transition, which is characterized by the prevailed type of nosological structure as well as spread of lifestyles, self-preserving behaviour and modern attitude toward health in a wide sense.

Demographers are still trying to find a way of modelling the relationship between mortality and age. So far the Gompertz-Makeham function was for a long time universally used for extrapolating mortality curves. But at present it is important to develop new models. This is mainly the fact that there is an improvement in mortality. More and more people live to old age. The second reason is better availability of statistical data. As a result of improving mortality of the oldest persons and better statistical data many new models have emerged. Currently, come to the fore logistic models. In this paper we will present selected logistic models and we will apply them to the data on mortality of the Czech population. The results will be compared with the methodology of the Czech Statistical Office and life expectancy obtained from the mortality tables without extrapolation.