Palloni Alberto, Souza Laetícia
Center for Demography and Health of Aging, University of Wisconsin-Madison.
Demogr Res. 2013;29:543-578. doi: 10.4054/DemRes.2013.29.21.
Cohorts that will attain age 60 after 2010 in the Latin American and Caribbean region (LAC) are beneficiaries of a massive mortality decline that began as early as 1930. The bulk of this decline is due to diffusion of low-cost medical technology that improved recovery rates from infectious diseases. This changes the composition of elderly cohorts in a distinct way: more among those who could experience the deleterious impact of adverse early conditions as adults survive to attain old ages.
To compute bounds for the size of effects on old age mortality of changes in cohorts' composition by exposure to early conditions. We calculate estimates for countries in the LAC region that span the entire range of post-1950 mortality decline.
We use counterfactual population projections to estimate bounds of changes in the composition of cohorts by exposure to early conditions. These are combined with empirical effects of adverse early conditions on adult mortality to generate estimates of foregone gains in life expectancy at age 60.
under somewhat conservative assumptions life expectancy at age 60 will at best increase much more slowly than in the past and at worst reach a steady state or decline. Foregone gains may be as high as 20% of projected values over a period of 30 to 50 years, the time it takes for cohorts that reaped the benefits of the secular mortality decline to become extinct.
Changing composition of cohorts by early exposures constitutes a powerful force that could drag down or halt short-run progress of life expectancy at older ages.
拉丁美洲和加勒比地区(LAC)中在2010年之后年满60岁的人群是始于1930年的大规模死亡率下降的受益者。这种下降主要归因于低成本医疗技术的普及,它提高了传染病的康复率。这以一种独特的方式改变了老年人群的构成:更多在成年后可能经历不利早期状况有害影响的人存活至老年。
计算因暴露于早期状况而导致的人群构成变化对老年死亡率影响大小的界限。我们计算了LAC地区涵盖1950年后整个死亡率下降范围的国家的估计值。
我们使用反事实人口预测来估计因暴露于早期状况而导致的人群构成变化的界限。这些与不利早期状况对成人死亡率的实证影响相结合,以生成60岁时预期寿命损失收益的估计值。
在 somewhat conservative assumptions下,60岁时的预期寿命充其量将比过去增长得慢得多,最坏的情况是达到稳定状态或下降。在30至50年的时间里,即受益于长期死亡率下降的人群消失所需的时间,损失的收益可能高达预测值的20%。
早期暴露导致的人群构成变化是一股强大的力量,可能会拖累或阻止老年人群预期寿命的短期进展。