Data quality and accuracy of United Nations population projections, 1950-95

Between 1951 and 1998, the United Nations (UN) published 16 sets of population projections for the world, its major regions, and countries. This paper reports the accuracy of the projection results. I analyse the quality of the historical data used for the base populations of the projections, and for extrapolating fertility and mortality. I study also the impact this quality has had on the accuracy of the projection results. Results and assumptions for the sets of projections are compared with corresponding estimates from the UN 1998 Revision for total fertility and life expectancy at birth, total population, and the projected age structures. The report covers seven major regions (Africa, Asia, the former USSR, Europe, Northern America, Latin America, and Oceania) and the largest ten countries of the world as of 1998 (China, India, the USA, Indonesia, Brazil, Pakistan, Russia, Japan, Bangladesh, and Nigeria).     

Modeling and Forecasting Health Expectancy: Theoretical Framework and Application

Life expectancy continues to grow in most Western countries; however, a major remaining question is whether longer life expectancy will be associated with more or fewer life years spent with poor health. Therefore, complementing forecasts of life expectancy with forecasts of health expectancies is useful. To forecast health expectancy, an extension of the stochastic extrapolative models developed for forecasting total life expectancy could be applied, but instead of projecting total mortality and using regular life tables, one could project transition probabilities between health states simultaneously and use multistate life table methods. In this article, we present a theoretical framework for a multistate life table model in which the transition probabilities depend on age and calendar time. The goal of our study is to describe a model that projects transition probabilities by the Lee-Carter method, and to illustrate how it can be used to forecast future health expectancy with prediction intervals around the estimates. We applied the method to data on the Dutch population aged 55 and older, and projected transition probabilities until 2030 to obtain forecasts of life expectancy, disability-free life expectancy, and probability of compression of disability.     

Bayesian Probabilistic Projections of Life Expectancy for All Countries

We propose a Bayesian hierarchical model for producing probabilistic forecasts of male period life expectancy at birth for all the countries of the world to 2100. Such forecasts would be an input to the production of probabilistic population projections for all countries, which is currently being considered by the United Nations. To evaluate the method, we conducted an out-of-sample cross-validation experiment, fitting the model to the data from 1950–1995 and using the estimated model to forecast for the subsequent 10 years. The 10-year predictions had a mean absolute error of about 1 year, about 40 % less than the current UN methodology. The probabilistic forecasts were calibrated in the sense that, for example, the 80 % prediction intervals contained the truth about 80 % of the time. We illustrate our method with results from Madagascar (a typical country with steadily improving life expectancy), Latvia (a country that has had a mortality crisis), and Japan (a leading country). We also show aggregated results for South Asia, a region with eight countries. Free, publicly available R software packages called bayesLife and bayesDem are available to implement the method.     

Change in disability-free life expectancy for Americans 70 years old and older*

In this article, we examine changes in life expectancy free of disability using longitudinal data collected from 1984 through 2000 from two cohorts who composed the Longitudinal Studies of Aging I and II. Life expectancies with and without ADL and/or IADL disability are calculated using a Markov-based multistate life table approach. At age 70, disability-free life expectancy increased over a 10-year period by 0.6 of a year in the later cohort, which was the same as the increase in total life expectancy, both increases marginally statistically significant. The average length of expected life with IADL and ADL disability did not change. Changes in disability-free life expectancy resulted from decreases in disability incidence and increases in the incidence of recovery from disability across the two survey cohorts. Age-specific mortality among the ADL disabled declined significantly in the later cohort after age 80. Mortality for the IADL disabled and the nondisabled did not change significantly. Those with ADL disability at age 70 experienced substantial increases in both total life expectancy and disability-free life expectancy. These results indicate the importance of efforts both to prevent and delay disability and to promote recovery from disability for increasing life expectancy without disability. Results also indicate that while reductions in incidence and increases in recovery work to decrease population prevalence of disability, declining mortality among the disabled has been a force toward increasing disability prevalence.     

Future life expectancy in Australia,Europe, Japan and North America

Human life expectancy has risen in most developed countries over the last century, causing the observed demographic shifts. Babel, Bomsdorf and Schmidt (forthcoming) introduce a stochastic mortality model using panel data procedures which distinguishes between a common time effect and a common age effect of mortality evolvement. Using this mortality model, the present paper provides forecasts of future life expectancy for 17 countries divided into 12 regions: Australia, Alps, Bene, Canada, England and Wales, France, Germany, Italy, Japan, Spain, Scandinavia and the United States of America. We consider (traditional) period life expectancies as well as cohort life expectancies, the latter being a more realistic approach but less common. It turns out that a continuing increase of life expectancy is expected in all considered countries. Further, we show that the probabilistic uncertainty of forecast life expectancies is different if either period life expectancies or cohort life expectancies are considered and, moreover, the uncertainty increases substantially if the error of parameter estimation is included.     

Including the Smoking Epidemic in Internationally Coherent Mortality Projections

We present a new mortality projection methodology that distinguishes smoking- and non-smoking-related mortality and takes into account mortality trends of the opposite sex and in other countries. We evaluate to what extent future projections of life expectancy at birth (e ₀) for the Netherlands up to 2040 are affected by the application of these components. All-cause mortality and non-smoking-related mortality for the years 1970–2006 are projected by the Lee-Carter and Li-Lee methodologies. Smoking-related mortality is projected according to assumptions on future smoking-attributable mortality. Projecting all-cause mortality in the Netherlands, using the Lee-Carter model, leads to high gains in e ₀ (4.1 for males; 4.4 for females) and divergence between the sexes. Coherent projections, which include the mortality experience of the other 21 sex- and country-specific populations, result in much higher gains for males (6.4) and females (5.7), and convergence. The separate projection of smoking and non-smoking-related mortality produces a steady increase in e ₀ for males (4.8) and a nonlinear trend for females, with lower gains in e ₀ in the short run, resulting in temporary sex convergence. The latter effect is also found in coherent projections. Our methodology provides more robust projections, especially thanks to the distinction between smoking- and non-smoking-related mortality.     

Potential support ratios: Cohort versus period perspectives

The ‘prospective potential support ratio’ has been proposed by researchers as a measure that accurately quantifies the burden of ageing, by identifying the fraction of a population that has passed a certain measure of longevity, for example, 17?years of life expectancy. Nevertheless, the prospective potential support ratio usually focuses on the current mortality schedule, or period life expectancy. Instead, in this paper we look at the actual mortality experienced by cohorts in a population, using cohort life tables. We analyse differences between the two perspectives using mortality models, historical data, and forecasted data. Cohort life expectancy takes future mortality improvements into account, unlike period life expectancy, leading to a higher prospective potential support ratio. Our results indicate that using cohort instead of period life expectancy returns around 0.5 extra younger people per older person among the analysed countries. We discuss the policy implications implied by our cohort measures.     

The Trend in International Health Inequality

Estimates of average life expectancy for 169 countries are used to compute the trend in between‐country health inequality from 1980 to 2000. Results show that inequality in the distribution of life expectancy across countries declined in the 1980s, but then increased through the 1990s. The recent turnaround in between‐country health inequality is significant because it reverses a long‐term trend of declining inequality across countries that began in the first half of the twentieth century. The primary cause of rising inequality across countries is declining life expectancy in sub‐Saharan Africa, largely owing to HIV/AIDS. Life expectancy in sub‐Saharan Africa holds the key to the future trend in between‐country inequality.     

Estimation of local demographic variation in a flexible framework for population projections

A cohort component projection of local populations based on sex and single year of age offers great value for planning local services, but demands data beyond the detail available. Local fertility, mortality and migration schedules by age and sex must be estimated sensitively to local variation if the results are to be of greater value than simpler methods of projection. Two approaches are compared, using data for the recent past: (a) direct estimation of local area age-specific schedules of fertility, mortality and migration based on data available to the national statistical agency; (b) graduation of national schedules using only local area population estimates by age, total numbers of births, and total numbers of deaths; age-specific migration is indirectly estimated from successive population estimates. These two approaches are compared with a projection using the same rates for each area. The three projections have been implemented for electoral wards in the Fife local government area of Scotland, using the flexible framework provided by POPGROUP software. Persuasive local population projections based on standard data for standard areas are feasible without the regular publication of migration flows.     

Has the HIV Epidemic Peaked?

This study reviews the highly diverse regional and country patterns of HIV epidemics and discusses possible causes of the geographic variation in epidemic sizes. Past trends and projections of the epidemics are presented and the peak years of epidemics are estimated. The potential future impact of new prevention technologies is briefly assessed. A final section summarizes the future impact of the epidemic on key demographic variables. The main finding of this analysis is that the HIV epidemic reached a major turning point over the past decade. The peak years of HIV incidence rates are past for all regions, and the peaks of prevalence rates are mostly in the past except in Eastern Europe, where they are expected to peak in 2008. But owing in part to the life‐prolonging effect of antiretroviral therapy and to sustained population growth, the absolute number of infected individuals is expected to keep growing slowly in sub‐Saharan Africa and to remain near current levels worldwide, thus posing a continuing challenge to public health programs. No country is expected to see a decline in its population size between 2005 and 2050 that is attributable to high mortality related to AIDS.     

Understanding population projections

This is a general introduction to how population projections are made and used for the consumers of this information. Population projections are computations of what future trends in fertility, mortality and migration of a population might be given set assumptions. They are not actual forecasts. Projections are used by planners in government and business for a clearer understanding of social changes. How to prepare projections, obtain base data, select starting and future levels of rates, variant series, and the mathematics involved are discussed. Assumptions must be carefully checked and chosen, since reliability of the projections depends on assumptions. There are 3 rules of thumb for reliability: 1) the shorter the projection period, the more reliable the projection; 2) the larger the geographic area being projected the more reliable the projection; 3) the lower the current fertility and the higher the current life expectancy, the lower the projection's margin of error. Major sources of data and projections on world, regional, national, subnational, and local areas and difficulties with data for developing countries are discussed. Available microcomputer programs for IBM PC compatible machines are listed and described briefly.     

The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007

Black–white mortality disparities remain sizable in the United States. In this study, we use the concept of avoidable/amenable mortality to estimate cause-of-death contributions to the difference in life expectancy between whites and blacks by gender in the United States in 1980, 1993, and 2007. We begin with a review of the concept of “avoidable mortality” and results of prior studies using this cause-of-death classification. We then present the results of our empirical analyses. We classified causes of death as amenable to medical care, sensitive to public health policies and health behaviors, ischemic heart disease, suicide, HIV/AIDS, and all other causes combined. We used vital statistics data on deaths and Census Bureau population estimates and standard demographic decomposition techniques. In 2007, causes of death amenable to medical care continued to account for close to 2 years of the racial difference in life expectancy among men (2.08) and women (1.85). Causes amenable to public health interventions made a larger contribution to the racial difference in life expectancy among men (1.17 years) than women (0.08 years). The contribution of HIV/AIDS substantially widened the racial difference among both men (1.08 years) and women (0.42 years) in 1993, but its contribution declined over time. Despite progress observed over the time period studied, a substantial portion of black–white disparities in mortality could be reduced given more equitable access to medical care and health interventions.     

Facing up to uncertain life expectancy: The longevity fan charts

This article uses longevity fan charts to represent the uncertainty in projections of future life expectancy. These fan charts are based on a mortality model calibrated on mortality data for English and Welsh males. The fan charts indicate strong upward sloping trends in future life expectancy. Their widths indicate the extent of uncertainty in these projections, and this uncertainty increases as the forecast horizon lengthens. Allowing for uncertainty in the parameter values of the model adds further to uncertainty in life expectancy projections. The article also illustrates how longevity fan charts can be used to stress-test longevity outcomes.     

Steep increase in best-practice cohort life expectancy

We analyze trends in best-practice life expectancy among female cohorts born from 1870 to 1950. Cohorts experience declining rather than constant death rates, and cohort life expectancy usually exceeds period life expectancy. Unobserved mortality rates in non-extinct cohorts are estimated using the Lee-Carter model for mortality in 1960–2008. Best-practice cohort and period life expectancies increased nearly linearly. Across cohorts born from 1870 to 1920 the annual increase in cohort length of life was 0.43 years. Across calendar years from 1870 to 2008, the annual increase was 0.28 years. Cohort life expectancy increased from 53.7 years in the 1870 cohort to 83.8 years in the 1950 cohort. The corresponding cohort/period longevity gap increased from 1.2 to 10.3 years. Among younger cohorts, survival to advanced ages is substantially higher than could have been anticipated by period mortality regimes when these cohorts were young or middle-aged. A large proportion of the additional expected years of life are being lived at ages 65 and older. This substantially changes the balance between the stages of the life cycle.     

Extending the Lee-Carter Method to Model the Rotation of Age Patterns of Mortality Decline for Long-Term Projections

In developed countries, mortality decline is decelerating at younger ages and accelerating at old ages, a phenomenon we call “rotation.” We expect that this rotation will also occur in developing countries as they attain high life expectancies. But the rotation is subtle and has proved difficult to handle in mortality models that include all age groups. Without taking it into account, however, long-term mortality projections will produce questionable results. We simplify the problem by focusing on the relative magnitude of death rates at two ages (0 and 15–19) while making assumptions about changes in rates of decline at other ages. We extend the Lee-Carter method to incorporate this subtle rotation in projection. We suggest that the extended Lee-Carter method could provide plausible projections of the age pattern of mortality for populations, including those that currently have very high life expectancies. Detailed examples are given using data from Japan and the United States.     

Projecting the Effect of Changes in Smoking and Obesity on Future Life Expectancy in the United States

We estimate the effects of declining smoking and increasing obesity on mortality in the United States over the period 2010–2040. Data on cohort behavioral histories are integrated into these estimates. Future distributions of body mass indices are projected using transition matrices applied to the initial distribution in 2010. In addition to projections of current obesity, we project distributions of obesity when cohorts are age 25. To these distributions, we apply death rates by current and age-25 obesity status observed in the National Health and Nutrition Examination Survey, 1988–2006. Estimates of the effects of smoking changes are based on observed relations between cohort smoking patterns and cohort death rates from lung cancer. We find that changes in both smoking and obesity are expected to have large effects on U.S. mortality. For males, the reductions in smoking have larger effects than the rise in obesity throughout the projection period. By 2040, male life expectancy at age 40 is expected to have gained 0.83 years from the combined effects. Among women, however, the two sets of effects largely offset one another throughout the projection period, with a small gain of 0.09 years expected by 2040.     

Stable growth in native-dependent multistate population dynamics

"Users of multistate life tables and projections have recognized that the Markovian assumptions underlying such models are unduly restrictive and should be relaxed whenever data permit. Efforts to include the influences of previous occupancies have included the incorporation of place-of-birth dependence. This paper addresses the stable growth properties of such generalized multistate models. It shows how place-of-birth-specific stable growth measures can be calculated without projection simply by solving the characteristic equation. An example using Canadian data illustrates the argument." (SUMMARY IN FRE)     

Lifespan Dispersion in Times of Life Expectancy Fluctuation: The Case of Central and Eastern Europe

Central and Eastern Europe (CEE) have experienced considerable instability in mortality since the 1960s. Long periods of stagnating life expectancy were followed by rapid increases in life expectancy and, in some cases, even more rapid declines, before more recent periods of improvement. These trends have been well documented, but to date, no study has comprehensively explored trends in lifespan variation. We improved such analyses by incorporating life disparity as a health indicator alongside life expectancy, examining trends since the 1960s for 12 countries from the region. Generally, life disparity was high and fluctuated strongly over the period. For nearly 30 of these years, life expectancy and life disparity varied independently of each other, largely because mortality trends ran in opposite directions over different ages. Furthermore, we quantified the impact of large classes of diseases on life disparity trends since 1994 using a newly harmonized cause-of-death time series for eight countries in the region. Mortality patterns in CEE countries were heterogeneous and ran counter to the common patterns observed in most developed countries. They contribute to the discussion about life expectancy disparity by showing that expansion/compression levels do not necessarily mean lower/higher life expectancy or mortality deterioration/improvements.     

Cohort Replacement and Homeostasis in World Population, 1950–2100

Using a simple empirical approach, we analyze world and regional‐level cohort replacement as determined by the key components of population dynamics, i.e. fertility, survival, and migration, for 1950–2010, using UN data. We define two kinds of homeostatic relationships among these components: fertility responses to mortality change (type I) and migration responses to changes in net reproduction (type II), and show that both can be observed to some degree in this period. We examine the extent of cohort replacement embodied in the medium‐variant UN population projections over 2010–2100 and consider how the international migration assumptions made in such projections would be affected by a homeostatic perspective.     

Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability?

Studies consistently document a Hispanic paradox in U.S. adult mortality, whereby Hispanics have similar or lower mortality rates than non-Hispanic whites despite lower socioeconomic status. This study extends this line of inquiry to disability, especially among foreign-born Hispanics, since their advantaged mortality seemingly should be paired with health advantages more generally. We also assess whether the paradox extends to U.S.-born Hispanics to evaluate the effect of nativity. We calculate multistate life tables of life expectancy with disability to assess whether racial/ethnic and nativity differences in the length of disability-free life parallel differences in overall life expectancy. Our results document a Hispanic paradox in mortality for foreign-born and U.S.-born Hispanics. However, Hispanics’ low mortality rates are not matched by low disability rates. Their disability rates are substantially higher than those of non-Hispanic whites and generally similar to those of non-Hispanic blacks. The result is a protracted period of disabled life expectancy for Hispanics, both foreign- and U.S.-born.