HDE 117 Lecture 3: HDE117 - L3

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Human Development
HDE 117
James Carey

Lecture 3 I. Comparative Life Tables A. Three Dimensions of Survival Curve 1. Horizontalization – how long a cohort can live before aging-related deaths significantly decrease proportion of survivors 2. Verticalization – corresponds to how concentrated aging-related deaths are around the modal age at death 3. Longevity Extension – corresponds to how far the right-hand tail, representing the highest normal life durations, can exceed modal age at death B. Comparing 1900 vs 2000 1. Cohort Survival – l x a. The progression of the l curxes, mortality is being shaved off with each year b. Better life conditions, electricity, vaccinations improve life expectancy 2. Looking at q U.x. Females Life Table (comparing 1900 vs 2000) a. Infant mortality used to be very high b. In 1900, mortality was fairly low 3. Looking at frequency of deaths a. Early and lots of deaths in 1900s 4. Expectation of life decreases (e ) x a. After you survive through the high risk of infancy, then you have life expectancy of 59 or so C. Relationships of Life Table Parameters 1. Mortality drives everything (it’s the risk) a. l always dies off x 2. Mortality is low until age 60 a. It decreases survivorship by ~8% 3. Between 60-90, mortality is fairly high and reflected in the precipitous drop in l x a. It peaks because we’re running out of people b. exdrops off too c. Mortality gets high by about 100 D. Current vs Cohort Tables: Lag and Gap 1. Lexis Diagram (above): a. Current survival rate from 40s-50 is 0.9114 b. Life expectancy went up 5%; mortality less than 4% c. When medical improvements, public health, and better living leads to higher life expectancy E. Period and Cohort Life Expectancy 1. Lag – the number of years before that cohort life expectancy was equal to current period life expectancy 2. Gap – how much period life expectancy differs from the life expectancy of the cohort born in the current period a. The gap is the ‘bonus’ that a real cohort received from taking 3. In the United States, the lag time is increasing and gaps are decreasing 4. In populations undergoing steady mortality change, period life expectancy can be interpreted as a lagged measure of underlying mortality experience 5. The increase in the lag between periods and cohorts is a function of the greater ages at which deaths are occurring (and at which mortality improvement is taking place) 6. While period mortality has become more ‘out of date’ (i.e. greater lag), its divergence from cohort mortality has shrunk 7. Main conclusion: period life expectancy can be regarded as a lagged measure of cohort life expectancy 8. The Life table is a model – you assume that everyone is subject to the rates established, but it’s not true II. Cause of Death: Manners and Types A. 10 leading causes of death in US 2011-2012: Heart 23.6% Cerebrovascular 5.1% Influenza, pneumonia 2.0% Cancer 22.9% Accidents 5.0% Nephritis complex 1.8% Lower respiratory 5.8 % Alzheimer’s disease 3.3% Suicide 1.6% B. Manners of Death 1. Natural – the majority, die of some disease; highest manner of death 2. Accident 3. Suicide 4. Homicide C. General Principles 1. There are exceptions to every “rule,” but every rule holds true most of the time 2. There are basic, general “rules” for classifying manner of death 3. The time interval between an injury or poisoning event and death of little relevance in regard to manner of death classification 4. The “but-for” principle is commonly applicable 5. Risk-taking behavior poses challenges 6. Deaths involving active euthanasia may be classified as homicide D. Classification of Causes of Death 1. Cause of death: a. For older people, it’s not just the Grim Reaper (implying one cause for death) b. It’s more like a ‘pack of devils’ (many things contributing to death)  challenge when determining cause of death 2. Immediate (blood poisoning) 3. Intervening (pneumonia) 4. Contributory (diabetes) 5. *Underlying (cancer) – the start of the chain of events that leads ultimately to death; most important factor E. **Life Tables Overview** 1. Cohort : longitudinal; period : cross-sectional 2. Complete (every age class); abridged (the lumped age classes) 3. Decrements: single or multiple F. Important Vocabulary 1. Single decrement life tables – all causes of death lumped (i.e. only one way to exit life) 2. Multiple decrement life tables – causes of death disaggregated (i.e. more than one way to exit life) 3. Risks of death – refers to various causes of death such as cancer, heart disease, and accidents relative to exposure time 4. Competing risks – different causes of death ‘compete’ with each other for a person’s life G. Multiple Decrement Life Tables 1. Consider multiple ways to exit life (e.g. disease, accident) 2. Two probabilities—Dying in the: a. presence of all causes b. absence of selected causes 3. Stems from reliability theory a. Ex: watch with gear and spring; analogous to human life and the necessary functioning parts 4. Considers: a. Age distribution of deaths from different causes b. Probability that newborn will die of a specific cause at age x c. How life expectancy will change if a certain cause was eliminated H. Reduction in Numbers of Death by Cause with Competing Risk 1. Heart attack vs Cancer
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