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At least 19 recordsLinked to original sources

PubMed1996

Mortality decline in the twentieth century and supply of kin over the life course.

Declining mortality over the Twentieth Century has altered the supply of older relatives in the kin networks of persons at all stages of life. Mortality decline has also changed the supply of kin for older persons. Using period life tables for selected years between 1900 and 2000, I calculate the proportion of persons who, at various stages of the life course, would have grandparents, parents, spouses, siblings and children still living. The results draw attention to the unprecedented potential for kinship ties involving older persons afforded by contemporary high survival rates.

Adult↗

PubMed1998

The Australian mortality decline: cause-specific mortality 1907-1990.

This review describes the changes in composition of mortality by major attributed cause during the Australian mortality decline this century. The principal categories employed were: infectious diseases, nonrheumatic cardiovascular disease, external causes, cancer, 'other' causes and ill-defined conditions. The data were age-adjusted. Besides registration problems (which also affect all-cause mortality) artefacts due to changes in diagnostic designation and coding are evident. The most obvious trends over the period are the decline in infectious disease mortality (half the decline 1907-1990 occurs before 1949), and the epidemic of circulatory disease mortality which appears to commence around 1930, peaks during the 1950s and 1960s, and declines from 1970 to 1990 (to a rate half that at the peak). Mortality for cancer remains static for females after 1907, but increases steadily for males, reaching a plateau in the mid-1980s (owing to trends in lung cancer); trends in cancers of individual sites are diverse. External cause mortality declines after 1970. The decline in total mortality to 1930 is associated with decline in infection and 'other' causes. Stagnation of mortality decline in 1930-1940 and 1946-1970 for males is a consequence of contemporaneous movements in opposite directions of infection mortality (decrease) and circulatory disease and cancer mortality (increase). In females, declines in infections and 'other' causes of death exceed the increase in circulatory disease mortality until 1960, then stability in all major causes of death to 1970. The overall mortality decline since 1970 is a consequence of a reduction in circulatory disease, 'other' cause, external cause and infection mortality, despite the increase in cancer mortality (for males).

Adolescent↗

PubMed1978

An evaluation of Brass mortality estimates under conditions of declining mortality.

An evaluation of the Brass childhood mortality estimates under conditions of declining mortality shows them to overestimate current mortality. Error increases as the rate of mortality decline increases, as the childhood age up to which cumulative mortality is being estimated increases, and as age at onset of childbearing decreases. We use the results to develop a method for correcting the Brass estimates for the effects of quasistability. The method requires an estimate of the rate of mortality decline within the population in addition to information on the pattern of childbearing in the population.

Birth Rate↗

PubMed1998

The Australian mortality decline: all-cause mortality 1788-1990.

This review describes the Australian decline in all-cause mortality, 1788-1990, and compares this with declines in Europe and North America. The period until the 1870s shows characteristic 'crisis mortality', attributable to epidemics of infectious disease. A decline in overall mortality is evident from 1880. A precipitous fall occurs in infant mortality from 1900, similar to that in European countries. Infant mortality continues downward during this century (except during the 1930s), with periods of accelerated decline during the 1940s (antibiotics) and early 1970s. Maternal mortality remains high until a precipitous fall in 1937 coinciding with the arrival of sulphonamide. Excess mortality due to the 1919 influenza epidemic is evident. Artefactual falls in mortality occur in 1930, and for men during the war of 1939-1945. Stagnation in overall mortality decline during the 1930s and 1945-1970 is evident for adult males, and during 1960-1970 for adult females. A decline in mortality is registered in both sexes from 1970, particularly in middle and older age groups, with narrowing of the sex differential. The mortality decline in Australia is broadly similar to those of the United Kingdom and several European countries, although an Australian advantage during last century and the first part of this century may have been due to less industrialisation, lower population density and better nutrition. Australia shows no war-related interruptions in the mortality decline. Australian mortality patterns from 1970 are also similar to those observed in North America and European countries (including the United Kingdom, but excluding Eastern Europe.

Adolescent↗

PubMed2001

The role of cultural and economic determinants in mortality decline in the Netherlands, 1875/1879-1920/1924: a regional analysis.

The objective of this study was to determine the relative importance of cultural and economic factors in mortality decline in the Netherlands in the periods 1875/1879-1895/1899 and 1895/1899-1920/1924. Mortality data by region, age, sex and cause of death as well as population data were derived from Statistics Netherlands for the years 1875/1879, 1885/1889, 1895/1899, 1910/1914, 1920/1924. Regional mortality declines were estimated on the basis of Poisson regression models. In a multivariate analysis the estimated declines were associated with economic (wealth tax) and cultural variables (% Roman Catholics and secularisation) corrected for confounders (soiltype, urbanisation). In the period from 1875/1879-1895/1899, %Roman Catholics was significantly associated with all-cause mortality decline and with mortality decline from diseases other than infectious diseases. Mortality declined less rapidly in areas with a high percentage of Roman Catholics. Secularisation was significantly associated with infectious-disease mortality decline. In areas with a high percentage population without a religious affiliation, mortality declined more rapidly. In the period from 1895/1899 to 1920/1924, wealth tax was significantly associated with all-cause and infectious-disease mortality decline. Mortality declined more rapidly in wealthy areas. Intermediary factors in the relationship between cultural factors and mortality decline were fertility decline, but more importantly, the number of medical doctors per 100,000 inhabitants. No intermediary factors were found for the association between the economic variable and mortality decline. Cultural and economic factors both played an important role in mortality decline in The Netherlands, albeit in different periods of time. The analysis of intermediary factors suggests that the acceptance of new ideas on hygiene and disease processes was an important factor in the association between culture and mortality decline in the late 19th century.

Confounding Factors, Epidemiologic↗

PubMed1992

Declining mortality in international sterilization services.

Between 1973 and 1988, AVSC supported 1,516,478 female sterilizations and 401,856 vasectomies in 50 countries. Overall, 73 deaths were attributable to voluntary sterilization procedures (yielding mortality rates of 4.7 deaths per 100,000 female sterilizations and 0.5 per 100,000 vasectomies). Causes of death, in order of frequency, were anesthesia (22), intestinal injury (20), infection (19), intra-abdominal hemorrhage (6) and other (6). The female sterilization mortality rate declined from 7.1 per 100,000 procedures in 1973-1981 to 3.7 per 100,000 in 1982-1988. Safer anesthesia practices and improved infection control contributed most to this decline. The mortality rate related to surgical errors declined proportionately less than the rates related to anesthesia and infection. Contraceptive sterilization has become a very safe procedure in these 50 countries, where anesthesia (local and general), surgical technique (minilaparotomy and laparoscopy) and timing of the procedure (interval and postpartum) vary substantially. Future deaths will probably be rare. However, expert surgeons should review each case because identifying the most likely cause of death is always complex and these analyses help shape surgical contraception practices.

Cause of Death↗

PubMed1986

Infant mortality decline in Malaysia, 1946-1975: the roles of changes in variables and changes in the structure of relationships.

This analysis has identified several factors contributing to the dramatic decline in infant mortality since World War II in Malaysia, as well as one factor that prevented the infant mortality rate from declining even more rapidly. Our main findings are the following: On average, mothers' education more than doubled over the study period, contributing to the decline in their infants' mortality. In addition, the beneficial effect of mothers' education on infant survival appears to have become stronger over the study period. Hence, further advances in education should lead to further improvements in infants' survival prospects. Another analysis of these data (Peterson et al. 1985) found that education is somewhat more influential in affecting child mortality in low-mortality, high-income areas than in the opposite type of areas. Therefore, socioeconomic development may have complemented, instead of substituted for, the the beneficial effect of mothers' education in promoting infant and child survival in Malaysia. Improvements in water and sanitation also contributed to the infant mortality decline, especially for babies who did not breastfeed. However, unlike education, these influences have become less important over time, especially for babies who are not breastfed. Hence, further improvements in water and sanitation, a goal of Malaysia's Rural Environmental Sanitation Programme, may have smaller relative effects on infant mortality than did previous improvements. Targeting such improvements on areas where women breastfeed little or not at all, however, will increase their effectiveness in promoting infant survival. The substantial reductions in breastfeeding that have taken place since World War II have kept the infant mortality rate in Malaysia from declining as rapidly as it would have otherwise. We estimate that, in our sample, the detrimental effects on infant survival of the decline in breastfeeding have more than offset the beneficial effects of improvements in water and sanitation. Unlike some other researchers (e.g., Palloni 1981), we find that changes in fertility levels and in the timing and spacing of births have had negligible effect in explaining the decline in infant mortality within the samples we have considered. We have excluded births to older women from our analysis, however; this exclusion may have led to an understatement of the influence of changes in the age pattern of childbearing.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1987

Declining mortality from ischemic heart disease and changes in coronary risk factors in Japan, 1956-1980.

Mortality from ischemic heart disease has declined in Japan since 1970. This paper addresses the declining mortality from ischemic heart disease and the possible contributing factors for 1956-1980. Mortality figures were obtained from Vital Statistics reports by the Ministry of Health and Welfare in Japan. National trends in blood pressure levels, prevalence of hypertension, Keys' lipid factor phi instead of the serum cholesterol level, and body mass index were obtained from the National Nutrition Survey which is carried out annually from random samples in Japan. The smoking rate which was obtained from other national surveys was also reviewed for this purpose. The age-adjusted (30-69 years) mortality from ischemic heart disease declined by 24% and 37% for men and women, respectively, between 1968 and 1978. It seemed that the decline in blood pressure levels and in the prevalence of hypertension and the increasing treatment rate for cardiovascular disease might contribute to the declining mortality from ischemic heart disease. The decline in cigarette smoking may, in part, also play a role. On the other hand, the increase in intake of lipids which resulted in Keys' lipid factor phi was compatible with the increase in mortality from ischemic heart disease during 1956-1970. The experience in Japan shows that the treatment of hypertension or the lowering of blood pressure and the recommendation to stop smoking help to prevent ischemic heart disease.

Adult↗

PubMed1985

Socioeconomic and health effects on mortality declines in developing countries.

It has been argued that mortality declines in developing countries have not been associated with social and economic factors because of the diffusion from the developed countries to the developing countries of health and medical techniques. This paper examines the relationship between socioeconomic development and health and mortality declines in developing countries which are in two different stages of the demographic transition. A path model linking socioeconomic and health variables and mortality is developed and tested for early and late transition nations. The empirical findings indicated that the network of socioeconomic variables and their effects on mortality were much more significant in late transition countries than in early transition countries. While the impact of health services on crude death rates is large in the early transition nations, its impact declines considerably as countries reach a more transitionally 'mature' stage.

Cross-Cultural Comparison↗

PubMed1986

Mortality decline and widening social inequalities.

Mortality from coronary heart disease (CHD) is higher in manual than in non-manual occupational classes and is higher in Scotland, Wales, and the North of England than in the South. Trends in these inequalities were examined in the light of the decline in CHD mortality in Great Britain. With the use of 1979/83 death rates as standard, mortality ratios (SMRs) for all causes, lung cancer, CHD, and cerebrovascular disease in 1979/83 were compared with SMRs in 1970-72. Despite the general fall in mortality the relative disadvantage of manual compared with non-manual classes has increased for each of these 4 cause groups. The regional differences in CHD mortality persist. Among men, in every region of Great Britain, CHD mortality has declined in non-manual classes. Only in Wales has there been an appreciable decline in CHD mortality in manual classes. Among women, lung cancer and CHD mortality have fallen in non-manual classes but have increased in manual classes. Differences in smoking between social classes are likely to be important. Other differences in behaviour may be important, but the effect of unemployment and increased income differentials should also be explored.

Adult↗

PubMed2000

A universal pattern of mortality decline in the G7 countries.

Human lifespan has increased enormously this century. But we remain uncertain about the forces that reduce mortality, and about the cost implications of ageing populations and their associated social burden. The poor understanding of the factors driving mortality decline, and the difficulty of forecasting mortality are due in part to the pronounced irregularity of annual to decadal mortality change. Here we examine mortality over five decades in the G7 countries (Canada, France, Germany, Italy, Japan, UK, US). In every country over this period, mortality at each age has declined exponentially at a roughly constant rate. This trend places a constraint on any theory of society-driven mortality decline, and provides a basis for stochastic mortality forecasting. We find that median forecasts of life expectancy are substantially larger than in existing official forecasts. In terms of the costs of ageing, we forecast values of the dependency ratio (that is, the ratio of people over 65 to working people) in 2050 that are between 6% (UK) and 40% (Japan) higher than official forecasts.

Aging↗

PubMed1998

Mortality decline in The Netherlands in the period 1850-1992: a turning point analysis.

The aim of this paper is to give a detailed and fairly objective description of rapid mortality decline in The Netherlands between 1850 and 1992 with respect to the start, end, and phases of the decline. Turning points were estimated for the standardized mortality trend, and for age and sex-specific trends between 1850-1992. The technique used was derived from spline functions. The turning points divided the trends into phases with different paces of decline. Standardized mortality started to decline rapidly in The Netherlands around 1880. Four phases in the period of decline could be distinguished: 1880-1917 (1.2% annually), 1917-1955 (1.6%), 1955-1970 (0.4%), 1970-1992 (1.1%). For nearly all age groups, the most rapid decline occurred in a period comparable to 1917-1955. Causes of death which might have shaped the standardized mortality trend are, among others, respiratory tuberculosis (1917), heart disease (except ischemic) (1955), and ischemic heart disease (1970). Causes of death that shaped the mortality trend are related to trends of determinants of mortality decline. The technique used in this paper can also be applied to other trends e.g. fertility decline.

Cause of Death↗

PubMed1994

The importance of social intervention in England's mortality decline: the evidence reviewed.

This paper examines the first phase of England's mortality decline, which commenced in the middle of the eighteenth century, and proceeded fitfully down to the end of the nineteenth. It finds that recent research in population history has weakened the explanation known as the McKeown thesis, but that the alternative synthesis, developed by Szreter, does not stand up well to a scrutiny of the evidence on infant mortality and morbidity. It concludes by pointing out that, contrary to the received version, diarrhoeal diseases continued in defiance of late-Victorian public health measures, but appear to have become less lethal, sharing in the general decline in the lethality of illness found by J. C. Riley for the second half of the nineteenth century.

History, Modern 1601-↗

PubMed1992

Declining mortality rates for cancer of the rectum in the United States: 1940-1985.

BACKGROUND AND METHODS: Age-standardized and age-specific mortality rates for cancer of the rectum and cancer of the colon were calculated according to race and gender for 1940-1985; age-standardized rates were calculated according to geographic region for 1950-1980. RESULTS: Mortality rates for cancer of the rectum decreased among white and black people of each gender, in most age categories and all regions of the country. Concurrent with this decline, mortality rates for cancer of the colon increased among all race-gender groups except white females, among whom it decreased. CONCLUSIONS: The decline in mortality rates for cancer of the rectum has been largely unappreciated. When deaths occurring from 1940 to 1985 from cancer of the rectum are combined with those from cancer of the colon, mortality rates are increased. However, this combination of sites obscures the divergent trends, which suggest that these cancers have causes that are at least somewhat different.

Black or African American↗

PubMed1986

The effect of health services on mortality: decline in death rates from amenable and non-amenable causes in Finland, 1969-81.

The impact of the Finnish health services on mortality from natural causes amenable to interventions by them was estimated for the period 1969 to 1981. During this period, mortality from amenable causes fell by 63% among males and 68% among females aged 64 years or less. The respective decreases for non-amenable natural causes of death were 24% and 29%. The rate of decline in mortality from amenable causes was similar for the two sexes. It was assumed that the decline in mortality from nonamenable causes reflects the joint influences of environmental, social, nutritional, and genetic factors and that the difference between this and the decline in mortality from amenable causes approximates to the true effect of the health services. Health services were estimated to account for 50% of the total decline in mortality from amenable causes for both sexes.

Adolescent↗

PubMed1999

Explaining differential rates of mortality decline for Swedish men and women: a time-series analysis, 1945-1992.

The aim of this study is to identify social factors that could be related to differential rates of mortality decline for men and women in Sweden. The annual changes in fifteen indicators and their relationship with changes in absolute excess male mortality were analyzed by means of time series analysis for the period 1945-1992. Economic growth seems to have been more beneficial for women's survival than for that of men. A few labor market indicators (unemployment rate and the wage ratio men/women) may have had some influence on changes in excess male mortality as well. Consumption factors, such as alcohol consumption and cigarette consumption, have been important for changes in excess male mortality. Changes in excess male mortality have been particularly pronounced among 65-74 year olds, due to rapidly improved female survival in these age groups. I discuss the finding that there seem to be connections between, on the one hand, changes in general social factors such as economic growth and labor market factors, and perhaps urbanization and alcohol and cigarette consumption on the other. I therefore suggest that gender-specific consumer behavior, seen as an outcome of gender-specific norm systems, is one mechanism which links changes in general social factors to changes in excess male mortality.

Adolescent↗

PubMedDate not supplied

Prevention, declining mortality rates, and the cost of Medicare.

It is commonly assumed that with declining adult mortality rates, the elderly population will continue to increase and become a major fiscal problem for the Medicare program. However, this population, like other age groups, consists of a small number of frequent medical-care users and a large number of low-frequency users. If the decline in mortality rates occurs as a result of primary and secondary prevention efforts rather than tertiary interventions, a 26.4 percent increase in the population 65 years of age and older could result in only a 19.4 percent increase in gross Medicare expenditures and a slight decline in net Medicare expenditures.

Aged↗

PubMed1998

Explaining the modern mortality decline: what can we learn from sea voyages.

During the past two decades, scholars have attempted to quanify the mortality at sea of a large number of seaborne populations. We now have estimates of death rates associated with over 13,000 voyages between 1497 and the First World War. These include voyages of Portuguese and Dutch travellers to Asian destinations; African slaves, European convicts, and free emigrants to the Americas; British convicts to Australia; British government-assisted emigrants to South Africa and Australia; and African, Indian, Chinese, and Pacific Islander indentured labourers to various destinations in the Atlantic, Indian, and Pacific Ocean regions. Whereas the death rate on slave voyages did not decline over time, the death rate of young adults and older children on non-slave voyages plummeted in the early-to-middle nineteenth century, preceding the modern mortality decline on land. Yet, the infant death rate of babies who embarked, or who were born at sea, although steadily declining, remained very much higher than infant mortality on land. The reduction in infant maritime mortality, which lagged well behind that of voyaging adults and children, thus mirrors the difficulty in reducing infant death rates on land. This paper surveys the recent literature on mortality at sea, drawing implications for our understanding of the modern mortality decline on land.

Emigration and Immigration↗