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Sample records for adult life expectancy

  1. Life expectancy without depression increases among Brazilian older adults

    PubMed Central

    Andrade, Flávia Cristina Drumond; Wu, Fan; Lebrão, Maria Lúcia; Duarte, Yeda Aparecida de Oliveira

    2016-01-01

    ABSTRACT OBJECTIVE To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. METHODS We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. RESULTS Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. CONCLUSIONS Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness. PMID:27143612

  2. Life expectancy without depression increases among Brazilian older adults.

    PubMed

    Andrade, Flávia Cristina Drumond; Wu, Fan; Lebrão, Maria Lúcia; Duarte, Yeda Aparecida de Oliveira

    2016-01-01

    To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE - Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness.

  3. Expectations of life and health among spinal cord injured adults.

    PubMed

    McColl, M A; Walker, J; Stirling, P; Wilkins, R; Corey, P

    1997-12-01

    While our understanding of aging and mortality in spinal cord injury is evolving, precise estimates are still not available for expectations of life and health following a spinal cord injury. In order to derive these estimates, information about mortality and health must be combined into a single estimate. Health expectancy estimates have been widely used in the literature of the last decade to try to understand the relationship between population health and survival, both in the general population and in special populations. This study brought the benefit of this methodology to the question of long-term survival following spinal cord injury. Specifically, the study aimed to calculate life and health expectancy in a population of spinal cord injured individuals; and to estimate the effect of factors associated with survival and health. The study involved a retrospective cohort, all of whom sustained a spinal cord injury between the ages of 25 and 34 years, and between 1945 and 1990. The study predicted a median survival time of 38 years post-injury, with 43% surviving at least 40 years. These findings suggest an increase in life expectancy of about 5 years over previous research on the same cohort. Factors affecting survival were age at injury, level and completeness of lesion. Expectations of health found in the present study are similar to those found in studies of the general population. This study showed seven remaining years of poor health expected at injury, and five remaining years expected at 40 years post injury, presumably occurring at the end of life.

  4. Gender differences in life expectancy and disability-free life expectancy among older adults in São Paulo, Brazil.

    PubMed

    Drumond Andrade, Flávia Cristina; Guevara, Pilar Egüez; Lebrão, Maria Lúcia; de Oliveira Duarte, Yeda Aparecida; Santos, Jair Lício Ferreira

    2011-01-01

    research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in São Paulo, Brazil; and discuss the implications for public policies. the sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in São Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives-twice the percentage for men-with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. among older adults in São Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs.

  5. Measuring the Impact of Diabetes on Life Expectancy and Disability-Free Life Expectancy Among Older Adults in Mexico

    PubMed Central

    2010-01-01

    Objectives. The aim of the present study is to investigate differences in total life expectancy (TLE), disability-free life expectancy (DFLE), disabled life expectancy (DLE), and personal care assistance between individuals with and without diabetes in Mexico. Methods. The sample was drawn from the nationally representative Mexican Health and Aging Study. Disability was assessed through a basic Activities of Daily Living (ADL) measure, the Instrumental Activities of Daily Living (IADL) scale, and the Nagi physical performance measure. The Interpolation of Markov Chains method was used to estimate the impact of diabetes on TLE and DFLE. Results. Results indicate that diabetes reduces TLE at ages 50 and 80 by about 10 and 4 years, respectively. Diabetes is also associated with fewer years in good health. DFLE (based on ADL measures) at age 50 is 20.8 years (95% confidence interval [CI]: 19.2–22.3) for those with diabetes, compared with 29.9 years (95% CI: 28.8–30.9) for those without diabetes. Regardless of diabetes status, Mexican women live longer but face a higher disability burden than men. Conclusion. Among older adults in Mexico, diabetes is associated with shorter TLE and DFLE. The negative effect of diabetes on the number of years lived, particularly in good health, creates significant economic, social, and individual costs for elderly Mexicans. PMID:20028950

  6. Life expectancy of young adults with follicular lymphoma.

    PubMed

    Conconi, A; Lobetti-Bodoni, C; Montoto, S; Lopez-Guillermo, A; Coutinho, R; Matthews, J; Franceschetti, S; Bertoni, F; Moccia, A; Rancoita, P M V; Gribben, J; Cavalli, F; Gaidano, G; Lister, T A; Montserrat, E; Ghielmini, M; Zucca, E

    2015-11-01

    This study was aimed at investigating the clinical features and outcomes of follicular lymphoma (FL) patients younger than 40 years, which have not been extensively investigated yet. One hundred and fifty-five patients younger than 40 years were retrospectively studied from a series of 1002 FL patients diagnosed in four different European Oncology Centres (Barcelona, Spain; Bellinzona, Switzerland; London, UK; Novara, Italy) from 1985 to 2010. Patients younger than 40 had a lower incidence of elevated LDH, high beta2-microglobulin, and a high-risk Follicular Lymphoma International Prognostic Index (FLIPI) score, whereas bone marrow involvement and bulky and disseminated lymphadenopathy were more frequent. At a median follow-up of 10 years, younger patients, in comparison with those older than 40, had significantly better overall (OS), cause-specific survival (CSS), and progression-free survival (PFS), with 10-year OS rate of 81% versus 51% (P < 0.0001), 10-year CSS rate of 82% versus 60% (P < 0.0001), and 10-year PFS of 39% versus 24% (P = 0.0098). However, there were no significant CSS and PFS differences in comparison with the patients aged 40-60. In multivariate analysis, having the lymphoma diagnosed in the last two decades and a favourable FLIPI score were associated with a significantly longer PFS and CSS in younger patients, whereas only FLIPI retained statistical significance for OS. In our series, FL patients younger than 40 have a median OS of 24 years and their outcome seems to be improving over time. However, they still have a significantly shorter life expectancy than that of an age-matched general healthy population. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Happy life expectancy among older adults: differences by sex and functional limitations.

    PubMed

    Lima, Margareth G; Belon, Ana Paula; Barros, Marilisa Ba

    2016-11-10

    To evaluate if the happy life expectancy in older adults differs according to sex and functional limitations. Life expectancy was estimated by Chiang method, and happy life expectancy was estimated by Sullivan method, combining mortality data with the prevalence of happiness. The questions on happiness and limitations came from a health survey, which interviewed 1,514 non-institutionalized older adults living in the city of Campinas, SP, Southeastern Brazil. The happy life expectancy was estimated by sex, age, and functional limitations. Based on the variance and standard error of the happy life expectancy, we estimated 95% confidence intervals, which allowed us to compare the statistical differences of the number of happy years lived among men and women. Differences by sex in happy life expectancy were significant at ages 60, 65, and 70. In absolute terms, women live more years happily. But, in relative terms, older men could expect to live proportionally more years with happiness. Happy life expectancy decreased significantly with increasing age in both men and women. Among older people living without functional limitation, differences by sex were statistically significant in all age groups, except at age 80. In the group with limitations, no significant differences by sex were found. Significant differences between the group without and with functional limitations were seen in both men and women. Older men could expect to live a greater proportion of their lives happily in comparison to same-aged women, but women show more years with happiness than men. Functional limitations have a significant impact on happy life expectancy for both sexes.

  8. Happy life expectancy among older adults: differences by sex and functional limitations

    PubMed Central

    Lima, Margareth G; Belon, Ana Paula; Barros, Marilisa BA

    2016-01-01

    ABSTRACT OBJECTIVE To evaluate if the happy life expectancy in older adults differs according to sex and functional limitations. METHODS Life expectancy was estimated by Chiang method, and happy life expectancy was estimated by Sullivan method, combining mortality data with the prevalence of happiness. The questions on happiness and limitations came from a health survey, which interviewed 1,514 non-institutionalized older adults living in the city of Campinas, SP, Southeastern Brazil. The happy life expectancy was estimated by sex, age, and functional limitations. Based on the variance and standard error of the happy life expectancy, we estimated 95% confidence intervals, which allowed us to compare the statistical differences of the number of happy years lived among men and women. RESULTS Differences by sex in happy life expectancy were significant at ages 60, 65, and 70. In absolute terms, women live more years happily. But, in relative terms, older men could expect to live proportionally more years with happiness. Happy life expectancy decreased significantly with increasing age in both men and women. Among older people living without functional limitation, differences by sex were statistically significant in all age groups, except at age 80. In the group with limitations, no significant differences by sex were found. Significant differences between the group without and with functional limitations were seen in both men and women. CONCLUSIONS Older men could expect to live a greater proportion of their lives happily in comparison to same-aged women, but women show more years with happiness than men. Functional limitations have a significant impact on happy life expectancy for both sexes. PMID:27849296

  9. Life Expectancies of South African Adults Starting Antiretroviral Treatment: Collaborative Analysis of Cohort Studies

    PubMed Central

    Johnson, Leigh F.; Mossong, Joel; Dorrington, Rob E.; Schomaker, Michael; Hoffmann, Christopher J.; Keiser, Olivia; Fox, Matthew P.; Wood, Robin; Prozesky, Hans; Giddy, Janet; Garone, Daniela Belen; Cornell, Morna; Egger, Matthias; Boulle, Andrew

    2013-01-01

    Background Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART) in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults. Methods and Findings Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV-positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2–30.2) at age 20 y and 10.1 y (95% CI: 9.3–10.8) at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0–39.7) and 14.4 y (95% CI: 13.3–15.3), respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1–46.0) if her baseline CD4 count was ≥200 cells/µl, compared to 29.5 y (95% CI: 26.2–33.0) if her baseline CD4 count was <50 cells/µl. Life expectancies of patients with baseline CD4 counts ≥200 cells/µl were between 70% and 86% of those in HIV-negative adults of the same age and sex, and life expectancies were increased by 15%–20% in patients who had survived 2 y after starting ART. However, the analysis was limited by a lack of mortality data at longer durations. Conclusions South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well. Please see later

  10. Potential years lost and life expectancy in adults with newly diagnosed epilepsy.

    PubMed

    Granbichler, Claudia A; Zimmermann, Georg; Oberaigner, Willi; Kuchukhidze, Giorgi; Ndayisaba, Jean-Pierre; Taylor, Alexandra; Luef, Gerhard; Bathke, Arne C; Trinka, Eugen

    2017-09-28

    Studies using relative measures, such as standardized mortality ratios, have shown that patients with epilepsy have an increased mortality. Reports on more direct and absolute measure such as life expectancy are sparse. We report potential years lost and how life expectancy has changed over 40 years in a cohort of patients with newly diagnosed epilepsy. We analyzed life expectancy in a cohort of adult patients diagnosed with definite epilepsy between 1970 and 2010. Those with brain tumor as cause of epilepsy were excluded. By retrospective probabilistic record linkage, living or death status was derived from the national death registry. We estimated life expectancy by a Weibull regression model using gender, age at diagnosis, epilepsy etiology, and year of diagnosis as covariates at time of epilepsy diagnosis, and 5, 10, 15, and 20 years after diagnosis. Results were compared to the general population, and 95% confidence intervals are given. There were 249 deaths (105 women, age at death 19.0-104.0 years) in 1,112 patients (11,978.4 person-years, 474 women, 638 men). A substantial decrease in life expectancy was observed for only a few subgroups, strongly depending on epilepsy etiology and time of diagnosis: time of life lost was highest in patients with symptomatic epilepsy diagnosed between 1970 and 1980; the impact declined with increasing time from diagnosis. Over half of the analyzed subgroups did not differ significantly from the general population. This effect was reversed in the later decades, and life expectancy was prolonged in some subgroups, reaching a maximum in those with newly diagnosed idiopathic and cryptogenic epilepsy between 2001 and 2010. Life expectancy is reduced in symptomatic epilepsies. However, in other subgroups, a prolonged life expectancy was found, which has not been reported previously. Reasons may be manifold and call for further study. © 2017 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International

  11. Cumulative Childhood Adversity, Educational Attainment, and Active Life Expectancy Among U.S. Adults

    PubMed Central

    Montez, Jennifer Karas; Hayward, Mark D.

    2015-01-01

    Studies of the early-life origins of adult physical functioning and mortality have found that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies have generally assessed functioning and mortality as distinct processes and used cross-sectional prevalence estimates that neglect the interplay of disability incidence, recovery, and mortality. Here, we examine whether early-life disadvantages both shorten lives and increase the number and fraction of years lived with functional impairment. We also examine the degree to which educational attainment mediates and moderates the health consequences of early-life disadvantages. Using the 1998–2008 Health and Retirement Study, we examine these questions for non-Hispanic whites and blacks aged 50–100 years using multistate life tables. Within levels of educational attainment, adults from disadvantaged childhoods lived fewer total and active years, and spent a greater portion of life impaired compared with adults from advantaged childhoods. Higher levels of education did not ameliorate the health consequences of disadvantaged childhoods. However, because education had a larger impact on health than did childhood socioeconomic context, adults from disadvantaged childhoods who achieved high education levels often had total and active life expectancies that were similar to or better than those of adults from advantaged childhoods who achieved low education levels. PMID:24281740

  12. Cumulative childhood adversity, educational attainment, and active life expectancy among U.S. adults.

    PubMed

    Montez, Jennifer Karas; Hayward, Mark D

    2014-04-01

    Studies of the early-life origins of adult physical functioning and mortality have found that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies have generally assessed functioning and mortality as distinct processes and used cross-sectional prevalence estimates that neglect the interplay of disability incidence, recovery, and mortality. Here, we examine whether early-life disadvantages both shorten lives and increase the number and fraction of years lived with functional impairment. We also examine the degree to which educational attainment mediates and moderates the health consequences of early-life disadvantages. Using the 1998-2008 Health and Retirement Study, we examine these questions for non-Hispanic whites and blacks aged 50-100 years using multistate life tables. Within levels of educational attainment, adults from disadvantaged childhoods lived fewer total and active years, and spent a greater portion of life impaired compared with adults from advantaged childhoods. Higher levels of education did not ameliorate the health consequences of disadvantaged childhoods. However, because education had a larger impact on health than did childhood socioeconomic context, adults from disadvantaged childhoods who achieved high education levels often had total and active life expectancies that were similar to or better than those of adults from advantaged childhoods who achieved low education levels.

  13. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment

    PubMed Central

    Bor, Jacob; Herbst, Abraham J; Newell, Marie-Louise; Bärnighausen, Till

    2013-01-01

    The scale-up of antiretroviral therapy (ART) is expected to raise adult life expectancy in populations with high HIV prevalence. Using data from a population cohort of over 101,000 individuals in rural KwaZulu-Natal, South Africa, we measured changes in adult life expectancy for 2000–2011. In 2003, the year before ART became available in the public sector health system, adult life expectancy was 49.2 years; by 2011, adult life expectancy had increased to 60.5 years – an 11.3-year gain. Based on standard monetary valuation of life, the survival benefits of ART far outweigh the costs of providing treatment in this community. These gains in adult life expectancy signify the social value of ART and have implications for investment decisions of individuals, governments, and donors. PMID:23430655

  14. Expected value information improves financial risk taking across the adult life span.

    PubMed

    Samanez-Larkin, Gregory R; Wagner, Anthony D; Knutson, Brian

    2011-04-01

    When making decisions, individuals must often compensate for cognitive limitations, particularly in the face of advanced age. Recent findings suggest that age-related variability in striatal activity may increase financial risk-taking mistakes in older adults. In two studies, we sought to further characterize neural contributions to optimal financial risk taking and to determine whether decision aids could improve financial risk taking. In Study 1, neuroimaging analyses revealed that individuals whose mesolimbic activation correlated with the expected value estimates of a rational actor made more optimal financial decisions. In Study 2, presentation of expected value information improved decision making in both younger and older adults, but the addition of a distracting secondary task had little impact on decision quality. Remarkably, provision of expected value information improved the performance of older adults to match that of younger adults at baseline. These findings are consistent with the notion that mesolimbic circuits play a critical role in optimal choice, and imply that providing simplified information about expected value may improve financial risk taking across the adult life span.

  15. Predicting life expectancy for community-dwelling older adults from Medicare claims data.

    PubMed

    Tan, Alai; Kuo, Yong-Fang; Goodwin, James S

    2013-09-15

    Estimates of life expectancy are useful in assessing whether different prevention strategies are appropriate in different populations. We developed sex-specific Cox proportional-hazard models that use Medicare claims data to predict life expectancy and risk of death at up to 10 years for older adults. We identified a cohort of Medicare beneficiaries 66-90 years of age from the 5% Medicare claims data in 2000 (n = 1,137,311) and tracked each subject's vital status until December 31, 2009. Subjects were split randomly into training and validation samples. Models were developed from the training sample and validated by comparison of predicted to actual survival in the validation sample. The C statistics for the models including predictors of age and Elixhauser comorbidities were 0.76-0.79 for men and women for prediction of death at the 1-, 5-, 7-, and 10-year follow-up periods. More than 80% of subjects with <25% risk of death at 5, 7, and 10 years survived longer than the chosen cutoff years. More than 80% of subjects with ≥75% risk of death at 5, 7, and 10 years died by those cutoff years. The models overestimated the risk of death at 1 year for the high-risk groups. Sex-specific models that use age and Elixhauser comorbidities can accurately predict patient life expectancy and risk of death at 5-10 years.

  16. Obesity in older adults and life expectancy with and without cardiovascular disease.

    PubMed

    Dhana, K; Berghout, M A; Peeters, A; Ikram, M A; Tiemeier, H; Hofman, A; Nusselder, W; Kavousi, M; Franco, O H

    2016-10-01

    The prevalence of overweight and obesity is increasing globally and is an established risk factor for cardiovascular disease (CVD). Our objective was to evaluate the impact of overweight and obesity on life expectancy and years lived with and without CVD in older adults. The study included 6636 individuals (3750 women) aged 55 years and older from the population-based Rotterdam Study. We developed multistate life tables by using prevalence, incidence rate and hazard ratios (HR) for three transitions (free-of-CVD-to-CVD, free-of-CVD-to-death and CVD-to-death), stratifying by the categories of body mass index (BMI) at baseline and adjusting for confounders. During 12 years of follow-up, we observed 1035 incident CVD events and 1902 overall deaths. Obesity was associated with an increased risk of CVD among men (HR 1.57 (95% confidence interval (CI) 1.17, 2.11)) and women (HR 1.49 (95% CI 1.19, 1.86)), compared with normal weight individuals. Overweight and obesity were not associated with mortality in men and women without CVD. Among men with CVD, obesity compared with normal weight, was associated with a lower risk of mortality (HR 0.67 (95% CI 0.49, 0.90)). Overweight and obesity did not influence total life expectancy. However, obesity was associated with 2.6 fewer years (95% CI -4.8, -0.4) lived free from CVD in men and 1.9 (95% CI -3.3, -0.9) in women. Moreover, men and women with obesity lived 2.9 (95% CI 1.1, 4.8) and 1.7 (95% CI 0.6, 2.8) more years suffering from CVD compared with normal weight counterparts. Obesity had no effect on total life expectancy in older individuals, but increased the risk of having CVD earlier in life and consequently extended the number of years lived with CVD. Owing to increasing prevalence of obesity and improved treatment of CVD, we might expect more individuals living with CVD and for a longer period of time.

  17. Decomposition of educational differences in life expectancy by age and causes of death among South Korean adults.

    PubMed

    Jung-Choi, Kyunghee; Khang, Young-Ho; Cho, Hong-Jun; Yun, Sung-Cheol

    2014-06-05

    Decomposition of socioeconomic inequalities in life expectancy by ages and causes allow us to better understand the nature of socioeconomic mortality inequalities and to suggest priority areas for policy and intervention. This study aimed to quantify age- and cause-specific contributions to socioeconomic differences in life expectancy at age 25 by educational level among South Korean adult men and women. We used National Death Registration records in 2005 (129,940 men and 106,188 women) and national census data in 2005 (15, 215, 523 men and 16,077,137 women aged 25 and over). Educational attainment as the indicator of socioeconomic position was categorized into elementary school graduation or less, middle or high school graduation, and college graduation or higher. Differences in life expectancy at age 25 by educational level were estimated by age- and cause-specific mortality differences using Arriaga's decomposition method. Differences in life expectancy at age 25 between college or higher education and elementary or less education were 16.23 years in men and 7.69 years in women. Young adult groups aged 35-49 in men and aged 25-39 in women contributed substantially to the differences between college or higher education and elementary or less education in life expectancy. Suicide and liver disease were the most important causes of death contributing to the differences in life expectancy in young adult groups. For older age groups, cerebrovascular disease and lung cancer were important to explain educational differential in life expectancy at 25-29 between college or higher education and middle or higher education. The contribution of the causes of death to socioeconomic inequality in life expectancy at age 25 in South Korea varied by age groups and differed by educational comparisons. The age specific contributions for different causes of death to life expectancy inequalities by educational attainment should be taken into account in establishing effective policy

  18. Cancer Screening of Older Adults in Israel According to Life Expectancy: Cross Sectional Study.

    PubMed

    Bareket, Ronen; Schonberg, Mara A; Comaneshter, Doron; Schonmann, Yochai; Shani, Michal; Cohen, Arnon; Vinker, Shlomo

    2017-09-05

    To examine over-screening of older Israelis for colon and breast cancer. Cross sectional. Clalit Health Services (CHS), Israel's largest health maintenance organization (HMO), provides care for more than half of the country's population and operates a national age-based programs for cancer screening. All community-dwelling members aged 65 to 79 in 2014 (N = 370,876). We used CHS data warehouse to evaluate cancer screening during 2014. Life expectancy (LE) was estimated using the validated Schonberg index. Almost one-quarter (23.1%; 15.6% of adults aged 65-74, 42.7% of adults aged 75-79) of the study population had an estimated LE of less than 10 years. Annual fecal occult blood test and biannual mammography rates among adults aged 65 to 74 with a LE of 10 years or longer were 37.1% and 70.0%, respectively. Rates dropped after age 75 (4.0%, 19.5%) and to a lesser extent with a LE of less than 10 years (31.6%, 56.4%). Prostate-specific antigen testing is not part of the national screening program, and the proportion of people tested (42.6%), did not vary similarly with age of 75 and older (43.2%) or LE of less than 10 years (38.1%). The cancer screening inclusion criteria of the national referral system have a strong effect on receipt of screening; LE considerations are less influential. Some method of estimating LE could be incorporated into algorithms to improve individualized cancer screening to reduce over- and underscreening of older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  19. Life expectancy trends in adults on antiretroviral treatment in South Africa.

    PubMed

    Johnson, Leigh F; Keiser, Olivia; Fox, Matthew P; Tanser, Frank; Cornell, Morna; Hoffmann, Chris J; Prozesky, Hans; Boulle, Andrew; Davies, Mary-Ann

    2016-10-23

    Previous studies have reported improvements in life expectancies of patients on antiretroviral treatment (ART) over time, but it is not clear whether these improvements are explained by changes in baseline clinical characteristics, longer duration on ART or changes in clinical practices. Two parametric survival models were fitted to mortality data from South African ART cohorts that had linked patient records to the national vital registration system. The first model estimated mortality by age, sex, cohort, baseline CD4 cell count, time since ART initiation and period of ART initiation; the second model included only age, sex, cohort and period of follow-up. Life expectancies were calculated from the estimated mortality rates. The first model estimated little change in mortality over time: women starting ART at age 35 years, at CD4 cell counts of 200 cells/μl or higher, had life expectancies of 32.7 years [95% confidence interval (CI): 31.6-33.6], 32.4 years (95% CI: 31.3-33.4) and 33.0 years (95% CI: 32.0-34.1) in the 2001-2006, 2007-2009 and 2010-2014 periods, respectively. However, the second model estimated a significant improvement in life expectancy; for all women on ART at age 35 years, corresponding life expectancies were 13.0 years (95% CI: 12.1-14.2), 20.4 years (95% CI: 19.5-21.4) and 26.1 years (95% CI: 25.2-26.9), respectively. Although life expectancies in South African ART patients have improved over time, these improvements are not observed after controlling for changes in baseline CD4 cell count and ART duration. This suggests that changes in clinical practice and programme scale have had little impact on ART mortality in South Africa.

  20. Sex and life expectancy.

    PubMed

    Seifarth, Joshua E; McGowan, Cheri L; Milne, Kevin J

    2012-12-01

    A sexual dimorphism in human life expectancy has existed in almost every country for as long as records have been kept. Although human life expectancy has increased each year, females still live longer, on average, than males. Undoubtedly, the reasons for the sex gap in life expectancy are multifaceted, and it has been discussed from both sociological and biological perspectives. However, even if biological factors make up only a small percentage of the determinants of the sex difference in this phenomenon, parity in average life expectancy should not be anticipated. The aim of this review is to highlight biological mechanisms that may underlie the sexual dimorphism in life expectancy. Using PubMed, ISI Web of Knowledge, and Google Scholar, as well as cited and citing reference histories of articles through August 2012, English-language articles were identified, read, and synthesized into categories that could account for biological sex differences in human life expectancy. The examination of biological mechanisms accounting for the female-based advantage in human life expectancy has been an active area of inquiry; however, it is still difficult to prove the relative importance of any 1 factor. Nonetheless, biological differences between the sexes do exist and include differences in genetic and physiological factors such as progressive skewing of X chromosome inactivation, telomere attrition, mitochondrial inheritance, hormonal and cellular responses to stress, immune function, and metabolic substrate handling among others. These factors may account for at least a part of the female advantage in human life expectancy. Despite noted gaps in sex equality, higher body fat percentages and lower physical activity levels globally at all ages, a sex-based gap in life expectancy exists in nearly every country for which data exist. There are several biological mechanisms that may contribute to explaining why females live longer than men on average, but the complexity of the

  1. Increasing disability-free life expectancy among older adults in Palestine from 2006 to 2010.

    PubMed

    Brønnum-Hansen, Henrik; Duraidi, Mohammed; Qalalwa, Khaled; Jeune, Bernard

    2015-04-01

    The population of Palestine comprises almost 200 000 Palestinians aged 60 or older. The purpose of the study was to estimate disability-free life expectancy for Palestinians living in the West Bank and Gaza Strip and to evaluate changes from 2006 to 2010. The study combined mortality data and prevalence of activity limitation derived from the Palestinian Family Health Surveys carried out in 2006 and 2010. Based on questions about the ability to perform five basic daily activities, disability-free life expectancy was estimated. Changes between 2006 and 2010 were decomposed into contributions from changes in mortality and disability. Life expectancy at age 60 increased from 17.1 years in 2006 to 17.3 years in 2010 for men and from 18.7 years to 19.0 years for women. Disability-free life expectancy increased significantly, by 1.3 years for 60-year-old men (from 12.8 years to 14.1 years) and 1.8 years for 60-year-old women (from 12.6 years to 14.4 years). This increase was seen in the Gaza Strip as well as in the West Bank. While the modest contribution of the mortality effect did not differ between gender and regions, the strong contributions from the disability effects varied, being greatest for women in the Gaza Strip. The significant increase in disability-free life expectancy for both genders is remarkable and, to our knowledge, not seen in other low-income countries. This change may be due to decreasing incidence of disability and greater recovery from disability as a result of better prevention, care and rehabilitation of chronic diseases. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. Future orientation and life expectations of adolescents and young adults with thalassemia major.

    PubMed

    Bush, S; Mandel, F S; Giardina, P J

    1998-06-30

    Until recently, Thalassemia Major was considered a fatal disease and patients did not usually live into adulthood. Advances in the medical management of the disease have greatly increased the life expectancy of these patients. The present study aims to evaluate the future orientation and other aspects of psychosocial functioning of thalassemics compared to healthy controls. Thirty patients and 33 healthy subjects of similar age, ethnicity, education, and geographic area were compared on measures of future expectations, perceived social support, life orientation, health locus of control and hopelessness. Results show no significant differences between thalassemics and controls on all measures except for higher levels of internal health locus of control among the patient group. Results and implications of perceptions of thalassemics' future orientation relevant to patient care are discussed.

  3. Gender differences in life expectancy with and without disability among older adults in Ecuador.

    PubMed

    Egüez-Guevara, Pilar; Andrade, Flávia Cristina Drumond

    2015-01-01

    Knowledge on disability's impact among older women and men in Ecuador is limited. This paper provides gender-specific estimates of disability prevalence, life expectancy with and without disability, and the factors associated with gender differences in disability at older age in Ecuador (2009-2010). Data from the Health, Well-Being, and Aging Survey (SABE) Ecuador 2009 was used. Participants were 4480 men and women aged 60 and over. Life expectancy with and without disability was calculated using the Sullivan method. Logistic regression analyses were used to explore gender differences in disability prevalence. Two disability measures, indicating limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), were used. 60-year-old women in Ecuador can expect to live 16.3 years without ADL limitations compared to 16.9 years for men. Life expectancy without IADL limitations was 12.5 years for women and 15.5 years for men. At age 60, women's length of life with ADL and IADL disability was higher (7.9 years for women vs. 4.9 years for men with ADL, and 11.7 years for women vs. 6.3 years for men with IADL). After controlling for socioeconomic characteristics, chronic conditions and lifestyle factors, gender differences in ADL disability were not statistically significant. However, older women were 58% more likely (OR=1.58, 95% CI 1.27, 1.95) to report having IADL limitations than men, even after including control variables. Interventions should tackle chronic disease, physical inactivity, and socioeconomic differences to reduce women's vulnerability to disability in older age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. The life course in the making: gender and the development of adolescents' expected timing of adult role transitions.

    PubMed

    Crockett, Lisa J; Beal, Sarah J

    2012-11-01

    Adolescents' expectations about the timing of adult role transitions have the potential to shape their actual transitions, setting the stage for their adult lives. Although expectations about timing emerge by early adolescence, little is known about how these expectations develop across adolescence. This longitudinal study examined developmental trajectories of adolescents' anticipated ages of school completion, job entry, marriage, and parenthood over the high school years, focusing on gender differences. Latent growth curve analysis of data from 411 rural youths followed from Grades 9 through 12 (age at Grade 9: M = 14.35, SD = 0.77) indicated a significant increase in adolescents' anticipated ages of entry into work and parenthood as well as gender differences in the trajectory of the expected age of marriage. Gender role attitudes, school performance, romantic relationships, and expected educational and occupational attainment were associated with the anticipated timing of role transitions, with significant variations by gender. Adolescents' expected ages of entry into adult family roles predicted their educational attainment and family role transitions in early adulthood. The findings provide insights into the process through which adolescent boys and girls construct their expectations regarding the transition to adulthood and, in turn, their future life course.

  5. Colon cancer screening in U.S. adults aged 65 and older according to life expectancy and age.

    PubMed

    Schonberg, Mara A; Breslau, Erica S; Hamel, Mary Beth; Bellizzi, Keith M; McCarthy, Ellen P

    2015-04-01

    To examine receipt of colorectal cancer (CRC) screening according to age and life expectancy (LE) in adults aged 65 and older. Population-based survey. United States. Community dwelling adults aged 65 and older who participated in the 2008 or 2010 National Health Interview Survey (N = 7,747). Receipt of CRC screening (e.g., colonoscopy within 10 years) was examined according to age and LE (≥10 and <10 years), adjusting for sociodemographic characteristics and survey year. Frequency of CRC screening was also examined according to age and LE at time of screening (e.g., age at colonoscopy rather than at interview). Participants screened when they were aged 75 and older or had less than a 10-year LE were considered to have received screening inconsistent with guidelines. Overall, 38.5% of participants had less than a 10-year LE; 40.2% were aged 75 and older, and 56.3% had received recent CRC screening (90.1% by colonoscopy). CRC screening was higher in 2010 (58.9%) than 2008 (53.7%, P <.001) and was associated with longer LE and younger age, although 51.1% of adults aged 75 and older reported receiving CRC screening, as did 50.9% of adults with less than a 10-year LE. Based on age and LE at time of screening (rather than at interview), 28.4% of CRC screening of adults aged 65 and older was targeted to those aged 75 and older and those with less than a 10-year LE. Of adults aged 65 to 75 with a 10-year LE or more (adults recommended for screening by guidelines), 39.2% had not recently been screened. Older adults with little chance of benefit because of limited LE commonly undergo CRC screening, whereas many adults aged 65 to 75 with a 10-year LE or greater are not screened. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  6. The Life Course in the Making: Gender and the Development of Adolescents' Expected Timing of Adult Role Transitions

    ERIC Educational Resources Information Center

    Crockett, Lisa J.; Beal, Sarah J.

    2012-01-01

    Adolescents' expectations about the timing of adult role transitions have the potential to shape their actual transitions, setting the stage for their adult lives. Although expectations about timing emerge by early adolescence, little is known about how these expectations develop across adolescence. This longitudinal study examined developmental…

  7. The Life Course in the Making: Gender and the Development of Adolescents' Expected Timing of Adult Role Transitions

    ERIC Educational Resources Information Center

    Crockett, Lisa J.; Beal, Sarah J.

    2012-01-01

    Adolescents' expectations about the timing of adult role transitions have the potential to shape their actual transitions, setting the stage for their adult lives. Although expectations about timing emerge by early adolescence, little is known about how these expectations develop across adolescence. This longitudinal study examined developmental…

  8. Sibling Status Effects: Adult Expectations.

    ERIC Educational Resources Information Center

    Baskett, Linda Musun

    1985-01-01

    This study attempted to determine what expectations or beliefs adults might hold about a child based on his or her sibling status alone. Ratings on 50 adjective pairs for each of three sibling status types, only, oldest, and youngest child, were assessed in relation to adult expectations, birth order, and parental status of rater. (Author/DST)

  9. Sibling Status Effects: Adult Expectations.

    ERIC Educational Resources Information Center

    Baskett, Linda Musun

    1985-01-01

    This study attempted to determine what expectations or beliefs adults might hold about a child based on his or her sibling status alone. Ratings on 50 adjective pairs for each of three sibling status types, only, oldest, and youngest child, were assessed in relation to adult expectations, birth order, and parental status of rater. (Author/DST)

  10. Physical activity extends life expectancy

    Cancer.gov

    Leisure-time physical activity is associated with longer life expectancy, even at relatively low levels of activity and regardless of body weight, according to a study by a team of researchers led by the NCI.

  11. [A comparison of the causes of adult mortality and its effects on life-expectancy across the regions of Colombia].

    PubMed

    López, Elizabeth; Arce, Patricia

    2008-09-01

    When determining some populations state of health, an understanding of the causes of mortality is essential. Changes in mortality due to causes was established to determine their contribution to the life-expectancy by gender and region of the Colombian population aged 15 to 74, between 1985 and 1999, by gender and region. This was a descriptive, retrospective study; the sources of information were records of deaths from 1983 to 2001 and population projections according to Departamento Administrativo Nacional de Estadística. The age selected as a sample population was 15 to 74. Changes in mortality were measured by using Eduardo Arriagas methodology, which is based on calculating temporary life-expectancy, absolute and relative change indices, and how changes in mortality due to cause of death contribute to life-expectancy. The main cause of reduced temporary life-expectancy in both genders was the increase in deaths by suicide, homicide and other violent causes (the reduction was greater for men than women in all regions studied). The greatest positive contribution to longevity was by the reduction in circulatory system diseases and accidents. A minimal gain in temporary life-expectancy was achieved as the positive affect of reduced mortality due to natural causes. This gain was annulled by the negative contributions of increased mortality due to suicide, homicide and other violent avoidable acts.

  12. Skin Cancer in U.S. Elderly Adults: Does Life Expectancy Play a Role in Treatment Decisions?

    PubMed

    Linos, Eleni; Chren, Mary-Margaret; Stijacic Cenzer, Irena; Covinsky, Kenneth E

    2016-08-01

    To examine whether life expectancy influences treatment pattern of nonmelanoma skin cancer, or keratinocyte carcinoma (KC), the most common malignancy and the fifth most costly cancer to Medicare. Nationally representative cross-sectional study. Nationally representative Health and Retirement Study linked to Medicare claims. Treatments (N = 9,653) from individuals aged 65 and older treated for basal or squamous cell carcinoma between 1992 and 2012 (N = 2,702) were included. Limited life expectancy defined according to aged 85 and older, medical comorbidities, Charlson Comorbidity Index score of 3 or greater, difficulty in at least one activity of daily living (ADL), and a Lee index of 13 or greater. Treatment type (Mohs micrographic surgery (MMS) (most intensive, highest cost), excision, or electrodesiccation and curettage (ED&C) (least intensive, lowest cost)), according to procedure code. Most KCs (61%) were treated surgically. Rates of MMS (19%), excision (42%), and ED&C (39%) were no different in participants with limited life expectancy and those with normal life expectancy. For example, 19% of participants with difficulty or dependence in ADLs, 20% of those with a Charlson comorbidity score greater than 3, and 15% of those in their last year of life underwent MMS; participants who died within 1 year of diagnosis were treated in the same way as those who lived longer. A one-size-fits-all approach in which advanced age, health status, functional status, and prognosis are not associated with intensiveness of treatment appears to guide treatment for KC, a generally nonfatal condition. Although intensive treatment of skin cancer when it causes symptoms may be indicated regardless of life expectancy, persons with limited life expectancy should be given choices to ensure that the treatment matches their goals and preferences. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics

  13. Life expectancy of kibbutz members.

    PubMed

    Leviatan, U; Cohen, J; Jaffe-Katz, A

    1986-01-01

    Data are presented demonstrating that the life expectancy (LE) of kibbutz members--both men and women--is higher than that of the overall Jewish population in Israel. Closer inspection of the death rates at various ages reveals that, from age thirty, those of kibbutz women are lower than those of the Jewish population. Although those of kibbutz men are actually higher until age forty-nine, nevertheless the LE of kibbutz members (based on death rates) surpasses that of Jews in Israel. These data add to and support other research findings illustrating the more positive mental health and well-being found among kibbutz members than among other comparative populations. Similarly, the factors contributing to kibbutz members' life expectancy evolve from this quality of life, especially as this quality of life affects old age.

  14. Major League Baseball Players’ Life Expectancies*

    PubMed Central

    Saint Onge, Jarron M.; Rogers, Richard G.; Krueger, Patrick M.

    2009-01-01

    Objective We examine the importance of anthropometric and performance measures, and age, period, and cohort effects in explaining life expectancies among major league baseball (MLB) players over the past century. Methods We use discrete time hazard models to calculate life tables with covariates with data from Total Baseball, a rich source of information on all players who played in the major league. Results Compared to 20-year-old U.S. males, MLB players can expect almost five additional years of life. Height, weight, handedness, and player ratings are unassociated with the risk of death in this population of highly active and successful adults. Career length is inversely associated with the risk of death, likely because those who play longer gain additional incomes, physical fitness, and training. Conclusions Our results indicate improvements in life expectancies with time for all age groups and indicate possible improvements in longevity in the general U.S. population. PMID:19756205

  15. Life Expectancy of Kibbutz Members.

    ERIC Educational Resources Information Center

    Leviatan, Uri; And Others

    1986-01-01

    Data are presented demonstrating that the life expectancy of kibbutz members--both men and women--is higher than that of the overall Jewish population in Israel. These data add to and support other research findings illustrating the more positive mental health and well-being found among kibbutz members than among other comparative populations.…

  16. Life Expectancy of Kibbutz Members.

    ERIC Educational Resources Information Center

    Leviatan, Uri; And Others

    1986-01-01

    Data are presented demonstrating that the life expectancy of kibbutz members--both men and women--is higher than that of the overall Jewish population in Israel. These data add to and support other research findings illustrating the more positive mental health and well-being found among kibbutz members than among other comparative populations.…

  17. Development of a 5 year life expectancy index in older adults using predictive mining of electronic health record data

    PubMed Central

    Mathias, Jason Scott; Agrawal, Ankit; Feinglass, Joe; Cooper, Andrew J; Baker, David William; Choudhary, Alok

    2013-01-01

    Objective Incorporating accurate life expectancy predictions into clinical decision making could improve quality and decrease costs, but few providers do this. We sought to use predictive data mining and high dimensional analytics of electronic health record (EHR) data to develop a highly accurate and clinically actionable 5 year life expectancy index. Materials and methods We developed the index using EHR data for 7463 patients ≥50 years old with ≥1 visit(s) in 2003 to a large, academic, multispecialty group practice. We extracted 980 attributes from the EHRs of the practices and affiliated hospitals. Correlation feature selection with greedy stepwise search was used to find the attribute subset with best average merit. Rotation forest ensembling with alternating decision tree as underlying classifier was used to predict 5 year mortality. Model performance was compared with the modified Charlson Comorbidity Index and the Walter life expectancy method. Results Within 5 years of the last visit in 2003, 838 (11%) patients had died. The final model included 24 attributes: two demographic (age, sex), 10 comorbidity (eg, cardiovascular disease), one vital sign (mean diastolic blood pressure), two medications (loop diuretic use, digoxin use), six laboratory (eg, mean albumin), and three healthcare utilization (eg, the number of hospitalizations 1 year prior to the last visit in 2003). The index showed very good discrimination (c-statistic 0.86) and outperformed comparators. Conclusions The EHR based index successfully distinguished adults ≥50 years old with life expectancy >5 years from those with life expectancy ≤5 years. This information could be used clinically to optimize preventive service use (eg, cancer screening in the elderly). PMID:23538722

  18. Methodological Aspects of Subjective Life Expectancy: Effects of Culture-Specific Reporting Heterogeneity Among Older Adults in the United States

    PubMed Central

    Smith, Jacqui

    2016-01-01

    Objectives. Subjective life expectancy (SLE) has been suggested as a predictor of mortality and mortality-related behaviors. Although critical for culturally diverse societies, these findings do not consider cross-cultural methodological comparability. Culture-specific reporting heterogeneity is a well-known phenomenon introducing biases, and research on this issue with SLE is not established. Method. Using data from the Health and Retirement Study, we examined reporting heterogeneity in SLE focusing on item nonresponse, focal points, and reports over time for five ethnic-cultural groups: non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic other races, English-interviewed Hispanics, and Spanish-interviewed Hispanics. Results. On item nonresponse, Spanish-interviewed Hispanics said, “I don’t know,” to SLE significantly more than any other groups. Nearly half of the respondents chose 0, 50, or 100, making them focal points. However, the focal points differed: 50 for Whites, 100 for Blacks, and 0 for Spanish-interviewed Hispanics. The relationship of SLE measured at two time points was higher for Whites than minorities. Moreover, those who said “I don’t know” to SLE showed higher subsequent mortality than those who gave an answer. SLE was not a significant mortality predictor for Hispanics. Discussion. Overall, SLE is not free from culture-specific reporting heterogeneity. This warrants further research about its culture-relevant measurement mechanisms. PMID:26297708

  19. Aging in the Americas: Disability-free Life Expectancy Among Adults Aged 65 and Older in the United States, Costa Rica, Mexico, and Puerto Rico.

    PubMed

    Payne, Collin F

    2015-09-07

    To estimate and compare disability-free life expectancy (DFLE) and current age patterns of disability onset and recovery from disability between the United States and countries in Latin America and the Caribbean. Disability is measured using the activities of daily living scale. Data come from longitudinal surveys of older adult populations in Costa Rica, Mexico, Puerto Rico, and the United States. Age patterns of transitions in and out of disability are modeled with a discrete-time logistic hazard model, and a microsimulation approach is used to estimate DFLE. Overall life expectancy for women aged 65 is 20.11 years in Costa Rica, 19.2 years in Mexico, 20.4 years in Puerto Rico, and 20.5 years in the United States. For men, these figures are 19.0 years in Costa Rica, 18.4 years in Mexico, 18.1 years in Puerto Rico, and 18.1 years in the United States. Proportion of remaining life spent free of disability for women at age 65 is comparable between Mexico, Puerto Rico, and the United States, with Costa Rica trailing slightly. Male estimates of DFLE are similar across the four populations. Though the older adult population of Latin America and the Caribbean lived many years exposed to poor epidemiological and public health conditions, their functional health in later life is comparable with the older adult population of the United States. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Ambitious mothers--successful daughters: mothers' early expectations for children's education and children's earnings and sense of control in adult life.

    PubMed

    Flouri, Eirini; Hawkes, Denise

    2008-09-01

    Mothers' expectations for their children's educational attainment are related to children's educational and occupational attainment. Studies have yet to establish, however, the long-term links between maternal expectations and offspring earnings, which are not always related to occupational attainment especially in women, or between maternal expectations and offspring sense of control and self-efficacy, which are pivotal factors in career choice and development. To explore the role of mothers' expectations for their children's educational attainment in children's earnings attainment and sense of control later in life. Data from sweeps of the 1970 British Cohort Study (BCS70) were used. The study sample was those cohort members with complete information on all the variables of interest. The study sample (N=3,285) was more educated and less disadvantaged than the whole sample. If cohort members of this type are more likely to have a mother who has high expectations, then our results are biased downwards, which suggests that we underestimate the effect of expectations on our two outcome variables. Mothers' expectations at the age of 10 were positively related to daughters' sense of control at the age of 30 even after controlling for ethnicity, educational attainment, and concurrent partner, parent, and labour market participation status, as well as the following confounding variables (measured at the ages of 0-10): general ability and general ability squared, locus of control, emotional and behavioural problems and emotional and behavioural problems squared, socio-economic disadvantage, parental social class, parental family structure, and mothers' education, child-rearing attitudes, and mental health. Mothers' expectations had no effect on sons' adult outcomes. Given that women are particularly at risk for poor psychological and economic outcomes in adulthood, and that this study likely underestimated the effect of expectations on these two outcomes, this is an

  1. Methodological Aspects of Subjective Life Expectancy: Effects of Culture-Specific Reporting Heterogeneity Among Older Adults in the United States.

    PubMed

    Lee, Sunghee; Smith, Jacqui

    2016-05-01

    Subjective life expectancy (SLE) has been suggested as a predictor of mortality and mortality-related behaviors. Although critical for culturally diverse societies, these findings do not consider cross-cultural methodological comparability. Culture-specific reporting heterogeneity is a well-known phenomenon introducing biases, and research on this issue with SLE is not established. Using data from the Health and Retirement Study, we examined reporting heterogeneity in SLE focusing on item nonresponse, focal points, and reports over time for five ethnic-cultural groups: non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic other races, English-interviewed Hispanics, and Spanish-interviewed Hispanics. On item nonresponse, Spanish-interviewed Hispanics said, "I don't know," to SLE significantly more than any other groups. Nearly half of the respondents chose 0, 50, or 100, making them focal points. However, the focal points differed: 50 for Whites, 100 for Blacks, and 0 for Spanish-interviewed Hispanics. The relationship of SLE measured at two time points was higher for Whites than minorities. Moreover, those who said "I don't know" to SLE showed higher subsequent mortality than those who gave an answer. SLE was not a significant mortality predictor for Hispanics. Overall, SLE is not free from culture-specific reporting heterogeneity. This warrants further research about its culture-relevant measurement mechanisms. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. FastStats: Life Expectancy

    MedlinePlus

    ... Whooping Cough or Pertussis Family Life Marriage and Divorce Health Care and Insurance Access to Health Care ... 2014 Mortality in the United States, 2015 The Effect of Changes in Selected Age-Specific Causes of ...

  3. Regional-level estimation of expected years of life lost attributable to overweight and obesity among Mexican adults

    PubMed Central

    Murillo-Zamora, Efrén; García-Ceballos, Raúl; Delgado-Enciso, Iván; Garza-Guajardo, Raquel; Barboza-Quintana, Oralia; Rodríguez-Sánchez, Irám P.; Mendoza-Cano, Oliver

    2016-01-01

    Background Excess body weight has become a major public health problem worldwide, and the burden of overweight and obesity was calculated in this work from a health economics perspective. Objective To estimate the burden of disease attributable to overweight and obesity among males and females aged 20 years and older using years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to rank the leading causes of premature death. Design A cross-sectional study took place (2010–2014) and 6,054 deaths were analyzed. Thirteen basic causes of death associated with overweight or obesity were included. The population attributable fraction (PAF), YLL, and ASYLL were calculated. Results The overall burden attributable to overweight and obesity was 36,087 YLL, and the estimated ASYLL per 10,000 persons was 1,098 and 1,029 in males and females, respectively. Type 2 diabetes mellitus was the main cause of premature death (males, 968 ASYLL; females, 772 ASYLL). Conclusions Overweight and obesity are major risk factors of chronic diseases that are main causes of premature death in the study population. Strategies for preventing overweight and obesity may decrease the incidence and mortality associated with these non-communicable diseases. ASYLL seems to be an indicator that is particularly well adapted to decision-making in public health. PMID:27606969

  4. Regional-level estimation of expected years of life lost attributable to overweight and obesity among Mexican adults.

    PubMed

    Murillo-Zamora, Efrén; García-Ceballos, Raúl; Delgado-Enciso, Iván; Garza-Guajardo, Raquel; Barboza-Quintana, Oralia; Rodríguez-Sánchez, Irám P; Mendoza-Cano, Oliver

    2016-01-01

    Excess body weight has become a major public health problem worldwide, and the burden of overweight and obesity was calculated in this work from a health economics perspective. To estimate the burden of disease attributable to overweight and obesity among males and females aged 20 years and older using years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to rank the leading causes of premature death. A cross-sectional study took place (2010-2014) and 6,054 deaths were analyzed. Thirteen basic causes of death associated with overweight or obesity were included. The population attributable fraction (PAF), YLL, and ASYLL were calculated. The overall burden attributable to overweight and obesity was 36,087 YLL, and the estimated ASYLL per 10,000 persons was 1,098 and 1,029 in males and females, respectively. Type 2 diabetes mellitus was the main cause of premature death (males, 968 ASYLL; females, 772 ASYLL). Overweight and obesity are major risk factors of chronic diseases that are main causes of premature death in the study population. Strategies for preventing overweight and obesity may decrease the incidence and mortality associated with these non-communicable diseases. ASYLL seems to be an indicator that is particularly well adapted to decision-making in public health.

  5. Regional-level estimation of expected years of life lost attributable to overweight and obesity among Mexican adults.

    PubMed

    Murillo-Zamora, Efrén; García-Ceballos, Raúl; Delgado-Enciso, Iván; Garza-Guajardo, Raquel; Barboza-Quintana, Oralia; Rodríguez-Sánchez, Irám P; Mendoza-Cano, Oliver

    2016-01-01

    Background Excess body weight has become a major public health problem worldwide, and the burden of overweight and obesity was calculated in this work from a health economics perspective. Objective To estimate the burden of disease attributable to overweight and obesity among males and females aged 20 years and older using years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to rank the leading causes of premature death. Design A cross-sectional study took place (2010-2014) and 6,054 deaths were analyzed. Thirteen basic causes of death associated with overweight or obesity were included. The population attributable fraction (PAF), YLL, and ASYLL were calculated. Results The overall burden attributable to overweight and obesity was 36,087 YLL, and the estimated ASYLL per 10,000 persons was 1,098 and 1,029 in males and females, respectively. Type 2 diabetes mellitus was the main cause of premature death (males, 968 ASYLL; females, 772 ASYLL). Conclusions Overweight and obesity are major risk factors of chronic diseases that are main causes of premature death in the study population. Strategies for preventing overweight and obesity may decrease the incidence and mortality associated with these non-communicable diseases. ASYLL seems to be an indicator that is particularly well adapted to decision-making in public health.

  6. Reasonable Expectation of Adult Behavior.

    ERIC Educational Resources Information Center

    Todaro, Julie

    1999-01-01

    Discusses staff behavioral problems that prove difficult for successful library management. Suggests that reasonable expectations for behavior need to be established in such areas as common courtesies, environmental issues such as temperature and noise levels, work relationships and values, diverse work styles and ways of communicating, and…

  7. Global Health Observatory (GHO): Life Expectancy

    MedlinePlus

    ... globally in 2015 Life tables The global population aged 60 years could expect to live another 20 years on average in 2015 MORE MORTALITY AND GLOBAL HEALTH ESTIMATES DATA PRODUCTS Maps Country profiles About Global Health Estimates Global Health Estimates ...

  8. Chronic kidney disease and life expectancy.

    PubMed

    Turin, Tanvir Chowdhury; Tonelli, Marcello; Manns, Braden J; Ravani, Pietro; Ahmed, Sofia B; Hemmelgarn, Brenda R

    2012-08-01

    Life expectancy is commonly used as an indicator of health and reflects disease burden in the population. The life expectancy for patients with lower levels of kidney function has not been reported. The abridged life table method was applied to calculate the life expectancies of men and women from age 30 to 85 years, by levels of kidney function as defined by estimated glomerular filtration rate (eGFR): ≥ 60, 45-59, 30-44 and 15-29 mL/min/1.73 m(2). Men and women aged 40 years had a life expectancy of 30.5 and 34.6 years at eGFR ≥ 60 mL/min/1.73 m(2), 24.5 and 28.7 years at eGFR 45-59 mL/min/1.73 m(2), 14.5 and 16.5 years at eGFR 30-44 mL/min/1.73 m(2) and 10.4 and 9.1 years at eGFR 15-29 mL/min/1.73 m(2), respectively. Life expectancy was longer for women compared with men at all ages and eGFR categories, other than for eGFR 15-29 mL/min/1.73 m(2) where there was no difference in life expectancy by gender. A lower level of kidney function is associated with a reduction in life expectancy for both men and women.

  9. A multistate analysis of active life expectancy.

    PubMed

    Rogers, A; Rogers, R G; Branch, L G

    1989-01-01

    With today's lower mortality rates, longer expectations of life, and new medical technologies, the nation's health policy focus has shifted from emphasis on individual survival to emphasis on personal health and independent living. Using longitudinal data sets and new methodological techniques, researchers have begun to assess active life expectancies, estimating not only how long a subpopulation can expect to live beyond each age, but what fractions of the expected remaining lifetime will be lived as independent, dependent, or institutionalized. New ideas are addressed, applying recently developed multistate life table methods to Waves One and Two of the Massachusetts Health Care Panel Study. Expectations of active life are presented for those 65 and older who initially are in one of two functional states of well-being. Included are expectations of life, for those, for example, who were independent and remained so, or those who were dependent and became independent. Although public health officials are concerned about the number of elderly who cease being independent, preliminary analysis shows that a significant number of the dependent elderly regain their independence, a situation which needs to be addressed in health care planning.

  10. On the decomposition of life expectancy and limits to life.

    PubMed

    Mayhew, Les; Smith, David

    2015-01-01

    Life expectancy is a measure of how long people are expected to live and is widely used as a measure of human development. Variations in the measure reflect not only the process of ageing but also the impacts of such events as epidemics, wars, and economic recessions. Since 1950, the influence of these events in the most developed countries has waned and life expectancy continues to lengthen unabated. As a result, it has become more difficult to forecast long-run trends accurately, or identify possible upper limits. We present new methods for comparing past improvements in life expectancy and also future prospects, using data from five developed, low-mortality countries. We consider life expectancy in 10-year age intervals rather than over the remaining lifetime, and show how natural limits to life expectancy can be used to extrapolate trends. We discuss the implications and compare our approach with other commonly used methods.

  11. [Assessment of life expectancy in older people].

    PubMed

    Vaucher, Yves; Monod, Stéfanie; Büla, Christophe; Rochat, Stéphane

    2012-11-07

    Evaluation of the remaining life expectancy in elderly persons plays an important role in their care, most importantly when treatments are associated with severe side effects or when they reduce the quality of life. Prognostic scores, incorporating the functional status in addition to age and comorbidities, enable evaluation of the mortality risk during different periods of time. Despite some limitations, these scores are useful in establishing individualized treatment plans.

  12. [Regional disparity on life expectancy, active life expectancy in the elderly from Beijing].

    PubMed

    Zhang, Zhong-ying; Tang, Zhe; Feng, Ming

    2011-09-01

    To explore the regional disparity in life expectancy (LE), active life expectancy (ALE), active life expectancy/life expectancy (ALE/LE) of the elderly in Beijing and to express the impact of hypertension upon those indices. The sample was derived from a "Beijing multidimensional longitudinal study on aging", including those from urban district (Xuanwu), rural district (Daxing and Huairou) by well-established statistical sampling techniques. Baseline survey comprised 1847 people aged 60 years or over, living in the communities in Beijing in 2004. The subjects under research were investigated with questionnaires at home by well-trained interviews and the contents would include: degree of education, occupation, medical history of hypertension together with repeated blood pressure measurements. Someone being "active" was defined as the ability in performing activities of daily life (ADL). IMaCH software for multi-state life table method was used to calculate the life expectancy (LE), active life expectancy (ALE) and active life expectancy/life expectancy (ALE/LE) in different district and the hypertensive exert influence on those indices. Data from the study showed that people inhabited in the rural district had lower LE, ALE and degree of education (illiteracy account for 66.2 percentage), but with more physical activities (account for 95.5 percentage) and higher ALE/LE than urban district people. Regional disparity in Females was obvious than in males while hypertension would exert more influence on LE of the urban women, which widened the gap in LE, ALE of males and ALE of females between the urban and rural areas. Regional disparity was found existing in LE, ALE, ALE/LE of the elderly from Beijing, particularly in females. Hypertension widened the gap and decreased the quality of life on senior citizens in the rural areas. This finding underlined the influence of habitation on the quality of life which manifested the importance of prevention regarding high blood

  13. Life Expectancy Among U.S.-born and Foreign-born Older Adults in the United States: Estimates From Linked Social Security and Medicare Data.

    PubMed

    Mehta, Neil K; Elo, Irma T; Engelman, Michal; Lauderdale, Diane S; Kestenbaum, Bert M

    2016-08-01

    In recent decades, the geographic origins of America's foreign-born population have become increasingly diverse. The sending countries of the U.S. foreign-born vary substantially in levels of health and economic development, and immigrants have arrived with distinct distributions of socioeconomic status, visa type, year of immigration, and age at immigration. We use high-quality linked Social Security and Medicare records to estimate life tables for the older U.S. population over the full range of birth regions. In 2000-2009, the foreign-born had a 2.4-year advantage in life expectancy at age 65 relative to the U.S.-born, with Asian-born subgroups displaying exceptionally high longevity. Foreign-born individuals who migrated more recently had lower mortality compared with those who migrated earlier. Nonetheless, we also find remarkable similarities in life expectancy among many foreign-born subgroups that were born in very different geographic and socioeconomic contexts (e.g., Central America, western/eastern Europe, and Africa).

  14. Life Expectancy Among U.S.-born and Foreign-born Older Adults in the United States: Estimates From Linked Social Security and Medicare Data

    PubMed Central

    Mehta, Neil K.; Elo, Irma T.; Engelman, Michal; Lauderdale, Diane S.; Kestenbaum, Bert M.

    2016-01-01

    In recent decades, the geographic origins of America’s foreign-born population have become increasingly diverse. The sending countries of the U.S. foreign-born vary substantially in levels of health and economic development, and immigrants have arrived with distinct distributions of socioeconomic status, visa type, year of immigration, and age at immigration. We use high-quality linked Social Security and Medicare records to estimate life tables for the older U.S. population over the full range of birth regions. In 2000–2009, the foreign-born had a 2.4-year advantage in life expectancy at age 65 relative to the U.S.-born, with Asian-born subgroups displaying exceptionally high longevity. Foreign-born individuals who migrated more recently had lower mortality compared with those who migrated earlier. Nonetheless, we also find remarkable similarities in life expectancy among many foreign-born subgroups that were born in very different geographic and socioeconomic contexts (e.g., Central America, western/eastern Europe, and Africa). PMID:27383845

  15. Life Expectancy in Pleural and Peritoneal Mesothelioma

    PubMed Central

    Vavra-Musser, Kate; Lee, Jessica; Brooks, Jordan

    2017-01-01

    Background. Mesothelioma is a rare cancer with a historically dire prognosis. We sought to calculate life expectancies for patients with pleural or peritoneal mesothelioma, both at time of diagnosis and several years later, and to examine whether survival has improved in recent years. Methods. Data on 10,258 pleural and 1,229 peritoneal patients from the SEER US national cancer database, 1973–2011, were analyzed using the Cox proportional hazards regression model. Results. The major factors related to survival were age, sex, stage, grade, histology, and treatment. Survival improved only modestly over the study period: 0.5% per year for pleural and 2% for peritoneal. Conclusions. Life expectancies were markedly reduced from normal, even amongst 5-year survivors with the most favorable characteristics and treatment options. PMID:28239496

  16. Age differences in expected satisfaction with life in retirement.

    PubMed

    Gutierrez, Helen C; Hershey, Douglas A

    2014-01-01

    Research on expected quality of life in retirement has focused on the perceptions of individuals either living in retirement or nearing retirement age. In this article, data are reported that examine expectations of (future) retirement quality of life among younger and middle-aged adults. Toward this end, a new scale--the Satisfaction with Life in Retirement Scale--is introduced. As part of the study, a pair of age-specific, theoretically-driven, hierarchically-structured path models were tested in which individuals' perceptions of future retirement satisfaction were regressed on indicators of financial knowledge, future time perspective, financial risk tolerance, and parental financial values. Models from both age groups were successful in accounting for variability in perceptions of future retirement satisfaction; however, age differences in the model were observed. The results of this investigation have implications for retirement counselors and intervention specialists who seek to cultivate positive perceptions of late life among individuals of different ages.

  17. Dental Status and Compression of Life Expectancy with Disability.

    PubMed

    Matsuyama, Y; Aida, J; Watt, R G; Tsuboya, T; Koyama, S; Sato, Y; Kondo, K; Osaka, K

    2017-08-01

    This study examined whether the number of teeth contributes to the compression of morbidity, measured as a shortening of life expectancy with disability, an extension of healthy life expectancy, and overall life expectancy. A prospective cohort study was conducted. A self-reported baseline survey was given to 126,438 community-dwelling older people aged ≥65 y in Japan in 2010, and 85,161 (67.4%) responded. The onset of functional disability and all-cause mortality were followed up for 1,374 d (follow-up rate = 96.1%). A sex-stratified illness-death model was applied to estimate the adjusted hazard ratios (HRs) for 3 health transitions (healthy to dead, healthy to disabled, and disabled to dead). Absolute differences in life expectancy, healthy life expectancy, and life expectancy with disability according to the number of teeth were also estimated. Age, denture use, socioeconomic status, health status, and health behavior were adjusted. Compared with the edentulous participants, participants with ≥20 teeth had lower risks of transitioning from healthy to dead (adjusted HR, 0.58 [95% confidence interval (CI), 0.50-0.68] for men and 0.70 [95% CI, 0.57-0.85] for women) and from healthy to disabled (adjusted HR, 0.52 [95% CI, 0.44-0.61] for men and 0.58 [95% CI, 0.49-0.68] for women). They also transitioned from disabled to dead earlier (adjusted HR, 1.26 [95% CI, 0.99-1.60] for men and 2.42 [95% CI, 1.72-3.38] for women). Among the participants aged ≥85 y, those with ≥20 teeth had a longer life expectancy (men: +57 d; women: +15 d) and healthy life expectancy (men: +92 d; women: +70 d) and a shorter life expectancy with disability (men: -35 d; women: -55 d) compared with the edentulous participants. Similar associations were observed among the younger participants and those with 1 to 9 or 10 to 19 teeth. The presence of remaining teeth was associated with a significant compression of morbidity: older Japanese adults' life expectancy with disability was

  18. Smoking, physical activity, and active life expectancy.

    PubMed

    Ferrucci, L; Izmirlian, G; Leveille, S; Phillips, C L; Corti, M C; Brock, D B; Guralnik, J M

    1999-04-01

    The effect of smoking and physical activity on active and disabled life expectancy was estimated using data from the Established Populations for Epidemiologic Studies of the Elderly (EPESE). Population-based samples of persons aged > or = 65 years from the East Boston, Massachusetts, New Haven, Connecticut, and Iowa sites of the EPESE were assessed at baseline between 1981 and 1983 and followed for mortality and disability over six annual follow-ups. A total of 8,604 persons without disability at baseline were classified as "ever" or "never" smokers and doing "low," "moderate," or "high" level physical activity. Active and disabled life expectancies were estimated using a Markov chain model. Compared with smokers, men and women nonsmokers survived 1.6-3.9 and 1.6-3.6 years longer, respectively, depending on level of physical activity. When smokers were disabled and close to death, most nonsmokers were still nondisabled. Physical activity, from low to moderate to high, was significantly associated with more years of life expectancy in both smokers (9.5, 10.5, 12.9 years in men and 11.1, 12.6, 15.3 years in women at age 65) and nonsmokers (11.0, 14.4, 16.2 years in men and 12.7, 16.2, 18.4 years in women at age 65). Higher physical activity was associated with fewer years of disability prior to death. These findings provide strong and explicit evidence that refraining from smoking and doing regular physical activity predict a long and healthy life.

  19. Differences in Life Expectancy and Disability Free Life Expectancy in Italy. A Challenge to Health Systems

    ERIC Educational Resources Information Center

    Burgio, A.; Murianni, L.; Folino-Gallo, P.

    2009-01-01

    Background: Measures of health expectancy such as Disability Free Life Expectancy are used to evaluate and compare regional/national health statuses. These indicators are useful for understanding changes in the health status and defining health policies and decisions on the provision of services because provide useful information on possible areas…

  20. Differences in Life Expectancy and Disability Free Life Expectancy in Italy. A Challenge to Health Systems

    ERIC Educational Resources Information Center

    Burgio, A.; Murianni, L.; Folino-Gallo, P.

    2009-01-01

    Background: Measures of health expectancy such as Disability Free Life Expectancy are used to evaluate and compare regional/national health statuses. These indicators are useful for understanding changes in the health status and defining health policies and decisions on the provision of services because provide useful information on possible areas…

  1. Obesity and Life Expectancy with and without Diabetes in Adults Aged 55 Years and Older in the Netherlands: A Prospective Cohort Study.

    PubMed

    Dhana, Klodian; Nano, Jana; Ligthart, Symen; Peeters, Anna; Hofman, Albert; Nusselder, Wilma; Dehghan, Abbas; Franco, Oscar H

    2016-07-01

    Overweight and obesity are associated with increased risk of type 2 diabetes. Limited evidence exists regarding the effect of excess weight on years lived with and without diabetes. We aimed to determine the association of overweight and obesity with the number of years lived with and without diabetes in a middle-aged and elderly population. The study included 6,499 individuals (3,656 women) aged 55 y and older from the population-based Rotterdam Study. We developed a multistate life table to calculate life expectancy for individuals who were normal weight, overweight, and obese and the difference in years lived with and without diabetes. For life table calculations, we used prevalence, incidence rate, and hazard ratios (HRs) for three transitions (healthy to diabetes, healthy to death, and diabetes to death), stratifying by body mass index (BMI) at baseline and adjusting for confounders. During a median follow-up of 11.1 y, we observed 697 incident diabetes events and 2,192 overall deaths. Obesity was associated with an increased risk of developing diabetes (HR: 2.13 [p < 0.001] for men and 3.54 [p < 0.001] for women). Overweight and obesity were not associated with mortality in men and women with or without diabetes. Total life expectancy remained unaffected by overweight and obesity. Nevertheless, men with obesity aged 55 y and older lived 2.8 (95% CI -6.1 to -0.1) fewer y without diabetes than normal weight individuals, whereas, for women, the difference between obese and normal weight counterparts was 4.7 (95% CI -9.0 to -0.6) y. Men and women with obesity lived 2.8 (95% CI 0.6 to 6.2) and 5.3 (95% CI 1.6 to 9.3) y longer with diabetes, respectively, compared to their normal weight counterparts. Since the implications of these findings could be limited to middle-aged and older white European populations, our results need confirmation in other populations. Obesity in the middle aged and elderly is associated with a reduction in the number of years lived free of

  2. Obesity and Life Expectancy with and without Diabetes in Adults Aged 55 Years and Older in the Netherlands: A Prospective Cohort Study

    PubMed Central

    Ligthart, Symen; Peeters, Anna; Hofman, Albert; Nusselder, Wilma; Franco, Oscar H.

    2016-01-01

    Background Overweight and obesity are associated with increased risk of type 2 diabetes. Limited evidence exists regarding the effect of excess weight on years lived with and without diabetes. We aimed to determine the association of overweight and obesity with the number of years lived with and without diabetes in a middle-aged and elderly population. Methods and Findings The study included 6,499 individuals (3,656 women) aged 55 y and older from the population-based Rotterdam Study. We developed a multistate life table to calculate life expectancy for individuals who were normal weight, overweight, and obese and the difference in years lived with and without diabetes. For life table calculations, we used prevalence, incidence rate, and hazard ratios (HRs) for three transitions (healthy to diabetes, healthy to death, and diabetes to death), stratifying by body mass index (BMI) at baseline and adjusting for confounders. During a median follow-up of 11.1 y, we observed 697 incident diabetes events and 2,192 overall deaths. Obesity was associated with an increased risk of developing diabetes (HR: 2.13 [p < 0.001] for men and 3.54 [p < 0.001] for women). Overweight and obesity were not associated with mortality in men and women with or without diabetes. Total life expectancy remained unaffected by overweight and obesity. Nevertheless, men with obesity aged 55 y and older lived 2.8 (95% CI −6.1 to −0.1) fewer y without diabetes than normal weight individuals, whereas, for women, the difference between obese and normal weight counterparts was 4.7 (95% CI −9.0 to −0.6) y. Men and women with obesity lived 2.8 (95% CI 0.6 to 6.2) and 5.3 (95% CI 1.6 to 9.3) y longer with diabetes, respectively, compared to their normal weight counterparts. Since the implications of these findings could be limited to middle-aged and older white European populations, our results need confirmation in other populations. Conclusions Obesity in the middle aged and elderly is associated

  3. Religious activity, life expectancy, and disability-free life expectancy in Taiwan.

    PubMed

    Hidajat, Mira; Zimmer, Zachary; Saito, Yasuhiko; Lin, Hui-Sheng

    2013-09-01

    Research has implicated religious activity as a health determinant, but questions remain, including whether associations persist in places where Judeo-Christian religions are not the majority; whether public versus private religious expressions have equivalent impacts, and the precise advantage expressed as years of life. This article addresses these issues in Taiwan. 3,739 Taiwanese aged 53+ were surveyed in 1999, 2003, and 2007. Mortality and disability were recorded. Religious activities in public and private settings were measured at baseline. Multistate life-tables produced estimates of total life expectancy and activity of daily living (ADL) disability-free life expectancy across levels of public and private religious activity. There is a consistent positive gradient between religious activity and expectancy with greater activity related to longer life and more years without disability. Life and ADL disability-free life expectancies for those with no religious affiliation fit in between the lowest and highest religious activity groups. Results corroborate evidence in the West. Mechanisms that intervene may be similar in Eastern religions despite differences in the ways in which popular religions are practiced. Results for those with no affiliation suggest benefits of religion can be accrued in alternate ways.

  4. The future of life expectancy and life expectancy inequalities in England and Wales: Bayesian spatiotemporal forecasting.

    PubMed

    Bennett, James E; Li, Guangquan; Foreman, Kyle; Best, Nicky; Kontis, Vasilis; Pearson, Clare; Hambly, Peter; Ezzati, Majid

    2015-07-11

    To plan for pensions and health and social services, future mortality and life expectancy need to be forecast. Consistent forecasts for all subnational units within a country are very rare. Our aim was to forecast mortality and life expectancy for England and Wales' districts. We developed Bayesian spatiotemporal models for forecasting of age-specific mortality and life expectancy at a local, small-area level. The models included components that accounted for mortality in relation to age, birth cohort, time, and space. We used geocoded mortality and population data between 1981 and 2012 from the Office for National Statistics together with the model with the smallest error to forecast age-specific death rates and life expectancy to 2030 for 375 of England and Wales' 376 districts. We measured model performance by withholding recent data and comparing forecasts with this withheld data. Life expectancy at birth in England and Wales was 79·5 years (95% credible interval 79·5-79·6) for men and 83·3 years (83·3-83·4) for women in 2012. District life expectancies ranged between 75·2 years (74·9-75·6) and 83·4 years (82·1-84·8) for men and between 80·2 years (79·8-80·5) and 87·3 years (86·0-88·8) for women. Between 1981 and 2012, life expectancy increased by 8·2 years for men and 6·0 years for women, closing the female-male gap from 6·0 to 3·8 years. National life expectancy in 2030 is expected to reach 85·7 (84·2-87·4) years for men and 87·6 (86·7-88·9) years for women, further reducing the female advantage to 1·9 years. Life expectancy will reach or surpass 81·4 years for men and reach or surpass 84·5 years for women in every district by 2030. Longevity inequality across districts, measured as the difference between the 1st and 99th percentiles of district life expectancies, has risen since 1981, and is forecast to rise steadily to 8·3 years (6·8-9·7) for men and 8·3 years (7·1-9·4) for women by 2030. Present forecasts underestimate

  5. The future of life expectancy and life expectancy inequalities in England and Wales: Bayesian spatiotemporal forecasting

    PubMed Central

    Bennett, James E; Li, Guangquan; Foreman, Kyle; Best, Nicky; Kontis, Vasilis; Pearson, Clare; Hambly, Peter; Ezzati, Majid

    2015-01-01

    Summary Background To plan for pensions and health and social services, future mortality and life expectancy need to be forecast. Consistent forecasts for all subnational units within a country are very rare. Our aim was to forecast mortality and life expectancy for England and Wales' districts. Methods We developed Bayesian spatiotemporal models for forecasting of age-specific mortality and life expectancy at a local, small-area level. The models included components that accounted for mortality in relation to age, birth cohort, time, and space. We used geocoded mortality and population data between 1981 and 2012 from the Office for National Statistics together with the model with the smallest error to forecast age-specific death rates and life expectancy to 2030 for 375 of England and Wales' 376 districts. We measured model performance by withholding recent data and comparing forecasts with this withheld data. Findings Life expectancy at birth in England and Wales was 79·5 years (95% credible interval 79·5–79·6) for men and 83·3 years (83·3–83·4) for women in 2012. District life expectancies ranged between 75·2 years (74·9–75·6) and 83·4 years (82·1–84·8) for men and between 80·2 years (79·8–80·5) and 87·3 years (86·0–88·8) for women. Between 1981 and 2012, life expectancy increased by 8·2 years for men and 6·0 years for women, closing the female–male gap from 6·0 to 3·8 years. National life expectancy in 2030 is expected to reach 85·7 (84·2–87·4) years for men and 87·6 (86·7–88·9) years for women, further reducing the female advantage to 1·9 years. Life expectancy will reach or surpass 81·4 years for men and reach or surpass 84·5 years for women in every district by 2030. Longevity inequality across districts, measured as the difference between the 1st and 99th percentiles of district life expectancies, has risen since 1981, and is forecast to rise steadily to 8·3 years (6·8–9·7) for men and 8·3 years (7·1

  6. [Healthy life expectancy to Brazilian elders, 2003].

    PubMed

    Camargos, Mirela Castro Santos; Rodrigues, Roberto do Nascimento; Machado, Carla Jorge

    2009-01-01

    The increase of the percentage of elderly population in Brazil and the increase in longevity incite a demand for information on the quantity of years spent in good health. The aim of the present study is to measure the life expectancy for the elderly of 60 years and above, by sex and age, in the year of 2003. The Sullivan method was used, which combined the life-table with the current experience of mortality and the self-perceived health. The mortality information was obtained from the life tables published by the IBGE (Brazilian Institute of Geography and Statistics), 2003. The self-perceived health was used and it was dichotomized in good and bad. This information came from the National Research of Household Sample (PNAD), 2003. The results indicate that women live longer, but spend a higher number of years perceiving their health as bad, as compared to men. The results also highlights to the need of considering the differences between sexes in relation to the demand for health care. It is also important to consider the need to have policies designed to allow the increase in the number of years that the elderly can live in good health conditions.

  7. Past, Present and Future of Healthy Life Expectancy*

    PubMed Central

    Beltrán-Sánchez, Hiram; Soneji, Samir; Crimmins, Eileen M.

    2017-01-01

    The success of the current biomedical paradigm based on a “disease model” may be limited in the future because of large number of comorbidities inflicting older people. In recent years, there has been growing empirical evidence, based on animal models, suggesting that the aging process could be delayed and that this process may lead to increases in life expectancy accompanied by improvements in health at older ages. In this review, we explore past, present, and future prospects of healthy life expectancy and examine whether increases in average length of life associated with delayed aging link with additional years lived disability-free at older ages. Trends in healthy life expectancy suggest improvements among older people in the United States, although younger cohorts appear to be reaching old age with increasing levels of frailty and disability. Trends in health risk factors, such as obesity and smoking, show worrisome signs of negative impacts on adult health and mortality in the near future. However, results based on a simulation model of delayed aging in humans indicate that it has the potential to increase not only the length of life but also the fraction and number of years spent disability-free at older ages. Delayed aging would likely come with additional aggregate costs. These costs could be offset if delayed aging is widely applied and people are willing to convert their greater healthiness into more years of work. PMID:26525456

  8. Forecasting differences in life expectancy by education.

    PubMed

    van Baal, Pieter; Peters, Frederik; Mackenbach, Johan; Nusselder, Wilma

    2016-07-01

    Forecasts of life expectancy (LE) have fuelled debates about the sustainability and dependability of pension and healthcare systems. Of relevance to these debates are inequalities in LE by education. In this paper, we present a method of forecasting LE for different educational groups within a population. As a basic framework we use the Li-Lee model that was developed to forecast mortality coherently for different groups. We adapted this model to distinguish between overall, sex-specific, and education-specific trends in mortality, and extrapolated these time trends in a flexible manner. We illustrate our method for the population aged 65 and over in the Netherlands, using several data sources and spanning different periods. The results suggest that LE is likely to increase for all educational groups, but that differences in LE between educational groups will widen. Sensitivity analyses illustrate the advantages of our proposed method.

  9. High Life Expectancy of Bacteria on Lichens.

    PubMed

    Cernava, Tomislav; Berg, Gabriele; Grube, Martin

    2016-10-01

    Self-sustaining lichen symbioses potentially can become very old, sometimes even thousands of years in nature. In the joint structures, algal partners are sheltered between fungal structures that are externally colonized by bacterial communities. With this arrangement lichens survive long periods of drought, and lichen thalli can be revitalized even after decades of dry storage in a herbarium. To study the effects of long-term ex situ storage on viability of indigenous bacterial communities we comparatively studied herbarium-stored material of the lung lichen, Lobaria pulmonaria. We discovered that a significant fraction of the lichen-associated bacterial community survives herbarium storage of nearly 80 years, and living bacteria can still be found in even older material. As the bacteria reside in the upper surface layers of the lichen material, we argue that the extracellular polysaccharides of lichens contribute to superior life expectancy of bacteria. Deeper understanding of underlying mechanisms could provide novel possibilities for biotechnological applications.

  10. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

    PubMed Central

    2017-01-01

    system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with

  11. Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016.

    PubMed

    2017-09-16

    -specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised

  12. Ambitious Mothers--Successful Daughters: Mothers' Early Expectations for Children's Education and Children's Earnings and Sense of Control in Adult Life

    ERIC Educational Resources Information Center

    Flouri, Eirini; Hawkes, Denise

    2008-01-01

    Background: Mothers' expectations for their children's educational attainment are related to children's educational and occupational attainment. Studies have yet to establish, however, the long-term links between maternal expectations and offspring earnings, which are not always related to occupational attainment especially in women, or between…

  13. State-Level Variations in Racial Disparities in Life Expectancy

    PubMed Central

    Bharmal, Nazleen; Tseng, Chi-Hong; Kaplan, Robert; Wong, Mitchell D

    2012-01-01

    Objective To explore state patterns in the racial life expectancy gap. Data Sources The 1997–2004 Multiple Cause of Death PUF, 2000 U.S. Census. Study Design We calculated life expectancy at birth for black and white men and women. Data Extraction Methods Data were obtained by the NCHS and U.S. Census Bureau. Principal Findings States with small racial differences are due to higher-than-expected life expectancy for blacks or lower-than-expected for whites. States with large disparity are explained by higher-than-average life expectancy among whites or lower-than-average life expectancy among blacks. Conclusions Heterogeneous state patterns in racial disparity in life expectancy exist. Eliminating disparity in states with large black populations would make the greatest impact nationally. PMID:22092060

  14. A long life in good health: subjective expectations regarding length and future health-related quality of life.

    PubMed

    Rappange, David R; Brouwer, Werner B F; van Exel, Job

    2016-06-01

    Subjective life expectancy is considered relevant in predicting mortality and future demand for health services as well as for explaining peoples' decisions in several life domains, such as the perceived impact of health behaviour changes on future health outcomes. Such expectations and in particular subjective expectations regarding future health-related quality of life remain understudied. The purpose of this study was to investigate individuals' subjective quality adjusted life years (QALYs) expectation from age 65 onwards in a representative sample of the Dutch generic public. A web-based questionnaire was administered to a sample of the adult population from the Netherlands. Information on subjective expectations regarding length and future health-related quality of life were combined into one single measure of subjective expected QALYs from age 65 onwards. This subjective QALY expectation was related to background, health and lifestyle variables. The implications of using different methods to construct our main outcome measure were addressed. Mean subjective expected QALYs from age 65 onwards was 11 QALYs (range -9 to 40 QALYs). Individuals with unhealthier lifestyles, chronic diseases, severe disorders or lower age of death of next of kin reported lower QALY expectations. Indicators were varyingly associated with either subjective life expectancy or future health-related quality of life, or both. Extending the concept of subjective life expectancy by correcting for expected quality of life appears to generate important additional information contributing to our understanding of people's perceptions regarding ageing and lifestyle choices.

  15. [Rapid increase in maximal country specific life expectancy across cohorts].

    PubMed

    Shkol'nikov, V M; Zhdanov, D A; Andreev, E M; Vopel', Dzh V

    2014-01-01

    Linear increase in the best-practice (maximal among countries) life expectancy, known as the Oeppen-Vaupel line, is the most demonstrative image of longevity progress. This study is devoted to the analysis of trends in best-practice life expectancy across cohorts born in 1870 to 1950. Other than the conventional period life expectancy, cohort life expectancy measures the lifetime of real individuals from the population under consideration. Since mortality is mostly decreasing with time, period life expectancy in a given year is usually lower than cohort life expectancy for people born in the same year. The corresponding gap between period and cohort life expectancies increases with time. Our analysis is based on data for 24 developed countries from the Human Mortality Database for the period 1870 to 2008. To estimate life expectancy for non-extinct cohorts, we apply the Lee-Carter model to extrapolate mortality rates until the year 2050. The annual increase in the best-practice cohort life expectancy across cohorts born in 1870 to 1950 is 0,43 year, while the annual increment in the period life expectancy across the same range of years is equal to 0,28 year. The best-practice cohort life expectancy has increased from 53,7 years in 1870 to 83,8 years in 1950. During this time the gap between period and cohort life expectancies has increased from 1,2 to 10,3 years. Cohorts born in 1920 to 1950 will live longer than one can expect by looking at respective period mortality patterns. For these cohorts, the longest part of their additionally gained lifetime will be spent at ages 65 and older. This substantially changes the distribution of human lifetime among different stages of the life cycle.

  16. Factors Associated With Subjective Life Expectancy: Comparison With Actuarial Life Expectancy.

    PubMed

    Bae, Jaekyoung; Kim, Yeon-Yong; Lee, Jin-Seok

    2017-07-01

    Subjective life expectancy (SLE) has been found to show a significant association with mortality. In this study, we aimed to investigate the major factors affecting SLE. We also examined whether any differences existed between SLE and actuarial life expectancy (LE) in Korea. A cross-sectional survey of 1000 individuals in Korea aged 20-59 was conducted. Participants were asked about SLE via a self-reported questionnaire. LE from the National Health Insurance database in Korea was used to evaluate differences between SLE and actuarial LE. Age-adjusted least-squares means, correlations, and regression analyses were used to test the relationship of SLE with four categories of predictors: demographic factors, socioeconomic factors, health behaviors, and psychosocial factors. Among the 1000 participants, women (mean SLE, 83.43 years; 95% confidence interval, 82.41 to 84.46 years; 48% of the total sample) had an expected LE 1.59 years longer than that of men. The socioeconomic factors of household income and housing arrangements were related to SLE. Among the health behaviors, smoking status, alcohol status, and physical activity were associated with SLE. Among the psychosocial factors, stress, self-rated health, and social connectedness were related to SLE. SLE had a positive correlation with actuarial estimates (r=0.61, p<0.001). Gender, household income, history of smoking, and distress were related to the presence of a gap between SLE and actuarial LE. Demographic factors, socioeconomic factors, health behaviors, and psychosocial factors showed significant associations with SLE, in the expected directions. Further studies are needed to determine the reasons for these results.

  17. Factors Associated With Subjective Life Expectancy: Comparison With Actuarial Life Expectancy

    PubMed Central

    2017-01-01

    Objectives Subjective life expectancy (SLE) has been found to show a significant association with mortality. In this study, we aimed to investigate the major factors affecting SLE. We also examined whether any differences existed between SLE and actuarial life expectancy (LE) in Korea. Methods A cross-sectional survey of 1000 individuals in Korea aged 20-59 was conducted. Participants were asked about SLE via a self-reported questionnaire. LE from the National Health Insurance database in Korea was used to evaluate differences between SLE and actuarial LE. Age-adjusted least-squares means, correlations, and regression analyses were used to test the relationship of SLE with four categories of predictors: demographic factors, socioeconomic factors, health behaviors, and psychosocial factors. Results Among the 1000 participants, women (mean SLE, 83.43 years; 95% confidence interval, 82.41 to 84.46 years; 48% of the total sample) had an expected LE 1.59 years longer than that of men. The socioeconomic factors of household income and housing arrangements were related to SLE. Among the health behaviors, smoking status, alcohol status, and physical activity were associated with SLE. Among the psychosocial factors, stress, self-rated health, and social connectedness were related to SLE. SLE had a positive correlation with actuarial estimates (r=0.61, p<0.001). Gender, household income, history of smoking, and distress were related to the presence of a gap between SLE and actuarial LE. Conclusions Demographic factors, socioeconomic factors, health behaviors, and psychosocial factors showed significant associations with SLE, in the expected directions. Further studies are needed to determine the reasons for these results. PMID:28768402

  18. Growing Disparities in Life Expectancy. Economic and Budget Issue Brief

    ERIC Educational Resources Information Center

    Manchester, Joyce; Topoleski, Julie

    2008-01-01

    In a continuation of long-term trends, life expectancy has been steadily increasing in the United States for the past several decades. Accompanying the recent increases, however, is a growing disparity in life expectancy between individuals with high and low income and between those with more and less education. The difference in life expectancy…

  19. Cardiopulmonary Resuscitation and Older Adults' Expectations.

    ERIC Educational Resources Information Center

    Godkin, M. Dianne; Toth, Ellen L.

    1994-01-01

    Examined knowledge, attitudes, and opinions of 60 older adults about cardiopulmonary resuscitation (CPR). Most had little or no accurate knowledge of CPR. Knowledge deficits and misconceptions of older adults should be addressed so that they may become informed and active participants in CPR decision-making process. (BF)

  20. [Life expectancy of people with physical disabilities in China].

    PubMed

    Zheng, Xiao-ying; Chen, San-jun

    2011-07-01

    To estimate the life expectancy of persons with physical disabilities in China based on data related to representative national disability. Life table technique was used to estimate the life expectancy and its standard error by various characteristics on the basis of average mortality rates from the monitoring cases during 2007 - 2010. (1) Females were expected to live longer than males. The life expectancy at birth for females was 63 years with standard error (SE) = 2.6 while for males it was 55 years (SE = 3.1). (2) Persons aged 35 - 50 in urban areas had higher life expectancy than those in rural areas. (3) Life expectancy of persons with mild disability [62.5 years (SE = 2.4)] was higher than that of persons with severe disability [42 years (SE = 5.4)]. (4) Life expectancies of persons with physical disability were much lower than that of the Chinese general population. Gaps of male and female life expectancy at birth were 17.1 years and 12.7 years, respectively. Persons with physical disability had higher mortality and actions should be taken to improve their life expectancy, accordingly.

  1. Impact of diabetes mellitus on life expectancy and health-adjusted life expectancy in Canada

    PubMed Central

    2012-01-01

    The objectives of this study were to estimate life expectancy (LE) and health-adjusted life expectancy (HALE) for Canadians with and without diabetes and to evaluate the impact of diabetes on population health using administrative and survey data. Mortality data from the Canadian Chronic Disease Surveillance System (2004 to 2006) and Health Utilities Index data from the Canadian Community Health Survey (2000 to 2005) were used. Life table analysis was applied to calculate LE, HALE, and their confidence intervals using the Chiang and the adapted Sullivan methods. LE and HALE were significantly lower among people with diabetes than for people without the disease. LE and HALE for females without diabetes were 85.0 and 73.3 years, respectively (males: 80.2 and 70.9 years). Diabetes was associated with a loss of LE and HALE of 6.0 years and 5.8 years, respectively, for females, and 5.0 years and 5.3 years, respectively, for males, living with diabetes at 55 years of age. The overall gains in LE and HALE after the hypothetical elimination of prevalent diagnosed diabetes cases in the population were 1.4 years and 1.2 years, respectively, for females, and 1.3 years for both LE and HALE for males. The results of the study confirm that diabetes is an important disease burden in Canada impacting the female and male populations differently. The methods can be used to calculate LE and HALE for other chronic conditions, providing useful information for public health researchers and policymakers. PMID:22531113

  2. Joint Probabilistic Projection of Female and Male Life Expectancy

    PubMed Central

    Raftery, Adrian E.; Lalic, Nevena; Gerland, Patrick

    2014-01-01

    BACKGROUND The United Nations (UN) produces population projections for all countries every two years. These are used by international organizations, governments, the private sector and researchers for policy planning, for monitoring development goals, as inputs to economic and environmental models, and for social and health research. The UN is considering producing fully probabilistic population projections, for which joint probabilistic projections of future female and male life expectancy at birth are needed. OBJECTIVE We propose a methodology for obtaining joint probabilistic projections of female and male life expectancy at birth. METHODS We first project female life expectancy using a one-sex method for probabilistic projection of life expectancy. We then project the gap between female and male life expectancy. We propose an autoregressive model for the gap in a future time period for a particular country, which is a function of female life expectancy and a t-distributed random perturbation. This method takes into account mortality data limitations, is comparable across countries, and accounts for shocks. We estimate all parameters based on life expectancy estimates for 1950–2010. The methods are implemented in the bayesLife and bayesPop R packages. RESULTS We evaluated our model using out-of-sample projections for the period 1995–2010, and found that our method performed better than several possible alternatives. CONCLUSIONS We find that the average gap between female and male life expectancy has been increasing for female life expectancy below 75, and decreasing for female life expectancy above 75. Our projections of the gap are lower than the UN’s 2008 projections for most countries and so lead to higher projections of male life expectancy. PMID:25580082

  3. Adolescent Expectations of Early Death Predict Young Adult Socioeconomic Status

    PubMed Central

    Nguyen, Quynh C.; Hussey, Jon M.; Halpern, Carolyn T.; Villaveces, Andres; Marshall, Stephen W.; Siddiqi, Arjumand; Poole, Charles

    2013-01-01

    Among adolescents, expectations of early death have been linked to future risk behaviors. These expectations may also reduce personal investment in education and training, thereby lowering adult socioeconomic status attainment. The importance of socioeconomic status is highlighted by pervasive health inequities and dramatic differences in life expectancy among education and income groups. The objectives of this study were to investigate patterns of change in perceived chances of living to age 35 (Perceived Survival Expectations; PSE), predictors of PSE, and associations between PSE and future socioeconomic status attainment. We utilized the U.S. National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994-95 among 20,745 adolescents in grades 7-12 with follow-up interviews in 1996 (Wave II), 2001-02 (Wave III) and 2008 (Wave IV; ages 24-32). At Wave I, 14% reported ≤ 50% chance of living to age 35 and older adolescents reported lower PSE than younger adolescents. At Wave III, PSE were similar across age. Changes in PSE from Wave I to III were moderate, with 89% of respondents reporting no change (56%), one level higher (22%) or one level lower (10%) in a 5-level PSE variable. Higher block group poverty rate, perceptions that the neighborhood is unsafe, and less time in the U.S. (among the foreign-born) were related to low PSE at Waves I and III. Low PSE at Waves I and III predicted lower education attainment and personal earnings at Wave IV in multinomial logistic regression models controlling for confounding factors such as previous family socioeconomic status, individual demographic characteristics, and depressive symptoms. Anticipation of an early death is prevalent among adolescents and predictive of lower future socioeconomic status. Low PSE reported early in life may be a marker for worse health trajectories. PMID:22405687

  4. Gompertz-Makeham life expectancies: expressions and applications.

    PubMed

    Missov, Trifon I; Lenart, Adam

    2013-12-01

    In a population of individuals, whose mortality is governed by a Gompertz-Makeham hazard, we derive closed-form solutions to the life-expectancy integral, corresponding to the cases of homogeneous and gamma-heterogeneous populations, as well as in the presence/absence of the Makeham term. Derived expressions contain special functions that aid constructing high-accuracy approximations, which can be used to study the elasticity of life expectancy with respect to model parameters. Knowledge of Gompertz-Makeham life expectancies aids constructing life-table exposures.

  5. Political conditions and life expectancy in Europe, 1900-2008.

    PubMed

    Mackenbach, Johan P

    2013-04-01

    The rise of life expectancy in Europe has been a very uneven process, both in time and space. This paper aims to identify instances in which major political conditions are likely to have influenced the rise of life expectancy, focusing on formation and dissolution of states and supranational blocs and on differences between political regimes (democratic vs. authoritarian non-communist and communist rule). Data on life expectancy, cause-specific mortality and political conditions were compiled from existing data sources. Possible relations between political conditions and life expectancy were studied by direct comparisons of changes in life expectancy in countries with different political conditions but similar starting levels of life expectancy. We found that formation and dissolution of states often went together with convergence and divergence of life expectancy, respectively, and that otherwise similar countries that did or did not become part of the Soviet bloc had distinctly different life expectancy trajectories. Democratically governed states had higher life expectancies than authoritarian states throughout the 20th century. The gap narrowed between 1920 and 1960 due to rapid catching up of infectious disease control in both non-communist and communist authoritarian states. It widened again after 1960 due to earlier and more rapid progress in democratic states against cardiovascular disease, breast cancer, motor vehicle accidents and other causes of death that have become amenable to intervention. We conclude that the history of life expectancy in Europe contains many instances in which political conditions are likely to have had a temporary or more lasting impact on population health. This suggests that there is scope for further in-depth studies of the impact of specific political determinants on the development of population health in Europe.

  6. Increasing life expectancy of water resources literature

    NASA Astrophysics Data System (ADS)

    Heistermann, M.; Francke, T.; Georgi, C.; Bronstert, A.

    2014-06-01

    In a study from 2008, Larivière and colleagues showed, for the field of natural sciences and engineering, that the median age of cited references is increasing over time. This result was considered counterintuitive: with the advent of electronic search engines, online journal issues and open access publications, one could have expected that cited literature is becoming younger. That study has motivated us to take a closer look at the changes in the age distribution of references that have been cited in water resources journals since 1965. Not only could we confirm the findings of Larivière and colleagues. We were also able to show that the aging is mainly happening in the oldest 10-25% of an average reference list. This is consistent with our analysis of top-cited papers in the field of water resources. Rankings based on total citations since 1965 consistently show the dominance of old literature, including text books and research papers in equal shares. For most top-cited old-timers, citations are still growing exponentially. There is strong evidence that most citations are attracted by publications that introduced methods which meanwhile belong to the standard toolset of researchers and practitioners in the field of water resources. Although we think that this trend should not be overinterpreted as a sign of stagnancy, there might be cause for concern regarding how authors select their references. We question the increasing citation of textbook knowledge as it holds the risk that reference lists become overcrowded, and that the readability of papers deteriorates.

  7. Recent perspectives on active life expectancy for older women.

    PubMed

    Laditka, Sarah B; Laditka, James N

    2002-01-01

    This article provides a critical review of recent active life expectancy literature, describing trends of special interest to women. We review findings from leading perspectives used to study life expectancy and active life expectancy, including gender, racial and socioeconomic differences, disease-specific effects, and biodemography. We examine three competing theories of population health that frame active life expectancy research-compression of morbidity, expansion of morbidity, and dynamic equilibrium-concluding there is support for both the compression of morbidity and dynamic equilibrium theories. Policy implications for women include a greater understanding of the role of education and racial and ethnic diversity in active life trends, and an increased public policy emphasis on prevention and treatment of chronic disease, together with adoption of more healthy lifestyles.

  8. Effects of physical activity on life expectancy with cardiovascular disease.

    PubMed

    Franco, Oscar H; de Laet, Chris; Peeters, Anna; Jonker, Jacqueline; Mackenbach, Johan; Nusselder, Wilma

    2005-11-14

    Physical inactivity is a modifiable risk factor for cardiovascular disease. However, little is known about the effects of physical activity on life expectancy with and without cardiovascular disease. Our objective was to calculate the consequences of different physical activity levels after age 50 years on total life expectancy and life expectancy with and without cardiovascular disease. We constructed multistate life tables using data from the Framingham Heart Study to calculate the effects of 3 levels of physical activity (low, moderate, and high) among populations older than 50 years. For the life table calculations, we used hazard ratios for 3 transitions (healthy to death, healthy to disease, and disease to death) by levels of physical activity and adjusted for age, sex, smoking, any comorbidity (cancer, left ventricular hypertrophy, arthritis, diabetes, ankle edema, or pulmonary disease), and examination at start of follow-up period. Moderate and high physical activity levels led to 1.3 and 3.7 years more in total life expectancy and 1.1 and 3.2 more years lived without cardiovascular disease, respectively, for men aged 50 years or older compared with those who maintained a low physical activity level. For women the differences were 1.5 and 3.5 years in total life expectancy and 1.3 and 3.3 more years lived free of cardiovascular disease, respectively. Avoiding a sedentary lifestyle during adulthood not only prevents cardiovascular disease independently of other risk factors but also substantially expands the total life expectancy and the cardiovascular disease-free life expectancy for men and women. This effect is already seen at moderate levels of physical activity, and the gains in cardiovascular disease-free life expectancy are twice as large at higher activity levels.

  9. Facing Up to Uncertain Life Expectancy: The Longevity Fan Charts

    PubMed Central

    DOWD, KEVIN; BLAKE, DAVID; CAIRNS, ANDREW J.G.

    2010-01-01

    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. PMID:20355684

  10. Does low meat consumption increase life expectancy in humans?

    PubMed

    Singh, Pramil N; Sabaté, Joan; Fraser, Gary E

    2003-09-01

    Since meat products represent a major source of protein in the Western diet, findings on whether meat intake significantly contributes to the burden of fatal disease have important clinical and public health implications. The objective was to examine whether a very low meat intake (less than weekly) contributes to greater longevity. We reviewed data from 6 prospective cohort studies and report new findings on the life expectancy of long-term vegetarians from the Adventist Health Study. Our review of the 6 studies found the following trends: 1) a very low meat intake was associated with a significant decrease in risk of death in 4 studies, a nonsignificant decrease in risk of death in the fifth study, and virtually no association in the sixth study; 2) 2 of the studies in which a low meat intake significantly decreased mortality risk also indicated that a longer duration (>/= 2 decades) of adherence to this diet contributed to a significant decrease in mortality risk and a significant 3.6-y (95% CI: 1.4, 5.8 y) increase in life expectancy; and 3) the protective effect of a very low meat intake seems to attenuate after the ninth decade. Some of the variation in the survival advantage in vegetarians may have been due to marked differences between studies in adjustment for confounders, the definition of vegetarian, measurement error, age distribution, the healthy volunteer effect, and intake of specific plant foods by the vegetarians. Current prospective cohort data from adults in North America and Europe raise the possibility that a lifestyle pattern that includes a very low meat intake is associated with greater longevity.

  11. Life expectancy living with HIV: recent estimates and future implications.

    PubMed

    Nakagawa, Fumiyo; May, Margaret; Phillips, Andrew

    2013-02-01

    The life expectancy of people living with HIV has dramatically increased since effective antiretroviral therapy has been available, and still continues to improve. Here, we review the latest literature on estimates of life expectancy and consider the implications for future research. With timely diagnosis, access to a variety of current drugs and good lifelong adherence, people with recently acquired infections can expect to have a life expectancy which is nearly the same as that of HIV-negative individuals. Modelling studies suggest that life expectancy could improve further if there were increased uptake of HIV testing, better antiretroviral regimens and treatment strategies, and the adoption of healthier lifestyles by those living with HIV. In particular, earlier diagnosis is one of the most important factors associated with better life expectancy. A consequence of improved survival is the increasing number of people with HIV who are aged over 50 years old, and further research into the impact of ageing on HIV-positive people will therefore become crucial. The development of age-specific HIV treatment and management guidelines is now called for. Analyses on cohort studies and mathematical modelling studies have been used to estimate life expectancy of those with HIV, providing useful insights of importance to individuals and healthcare planning.

  12. Improvements in the Life Expectancy of Type 1 Diabetes

    PubMed Central

    Miller, Rachel G.; Secrest, Aaron M.; Sharma, Ravi K.; Songer, Thomas J.; Orchard, Trevor J.

    2012-01-01

    Survival in type 1 diabetes has improved, but the impact on life expectancy in the U.S. type 1 diabetes population is not well established. Our objective was to estimate the life expectancy of the Pittsburgh Epidemiology of Diabetes Complications (EDC) study cohort and quantify improvements by comparing two subcohorts based on year of diabetes diagnosis (1950–1964 [n = 390] vs. 1965–1980 [n = 543]). The EDC study is a prospective cohort study of 933 participants with childhood-onset (aged <17 years) type 1 diabetes diagnosed at Children’s Hospital of Pittsburgh from 1950 to 1980. Mortality ascertainment was censored 31 December 2009. Abridged cohort life tables were constructed to calculate life expectancy. Death occurred in 237 (60.8%) of the 1950–1964 subcohort compared with 88 (16.2%) of the 1965–1980 subcohort. The life expectancy at birth for those diagnosed 1965–1980 was ∼15 years greater than participants diagnosed 1950–1964 (68.8 [95% CI 64.7–72.8] vs. 53.4 [50.8–56.0] years, respectively) (P < 0.0001); this difference persisted regardless of sex or pubertal status at diagnosis. This improvement in life expectancy emphasizes the need for insurance companies to update analysis of the life expectancy of those with childhood-onset type 1 diabetes because weighting of insurance premiums is based on outdated estimates. PMID:22851572

  13. Estimating life expectancies for US small areas: a regression framework

    NASA Astrophysics Data System (ADS)

    Congdon, Peter

    2014-01-01

    Analysis of area mortality variations and estimation of area life tables raise methodological questions relevant to assessing spatial clustering, and socioeconomic inequalities in mortality. Existing small area analyses of US life expectancy variation generally adopt ad hoc amalgamations of counties to alleviate potential instability of mortality rates involved in deriving life tables, and use conventional life table analysis which takes no account of correlated mortality for adjacent areas or ages. The alternative strategy here uses structured random effects methods that recognize correlations between adjacent ages and areas, and allows retention of the original county boundaries. This strategy generalizes to include effects of area category (e.g. poverty status, ethnic mix), allowing estimation of life tables according to area category, and providing additional stabilization of estimated life table functions. This approach is used here to estimate stabilized mortality rates, derive life expectancies in US counties, and assess trends in clustering and in inequality according to county poverty category.

  14. Race, Socioeconomic Status, and Life Expectancy After Acute Myocardial Infarction

    PubMed Central

    Bucholz, Emily M.; Ma, Shuangge; Normand, Sharon-Lise T.; Krumholz, Harlan M.

    2016-01-01

    Background Prior studies have been unable to disentangle the negative associations of black race and low socioeconomic status (SES) with long-term outcomes of patients after acute myocardial infarction (AMI). Such information could assist in efforts to address both racial and socioeconomic disparities. Methods and Results We used data from the Cooperative Cardiovascular Project, a prospective cohort study of Medicare beneficiaries hospitalized with AMI with 17-years of follow-up, to evaluate the relationship between race, area-level SES (measured by ZIP code level median household income), and life expectancy after AMI. Life expectancy was estimated using Cox proportional hazards regression with extrapolation using exponential models. Of the 141,095 patients with AMI, 6.3% were black and 6.8% resided in low SES areas; 26% of black patients lived in low SES areas compared with 5.7% of white patients. Post-myocardial infarction life expectancy estimates were shorter for black than white patients across all socioeconomic levels in patients ≤75 years of age. After adjustment for patient and treatment characteristics, the association between race and life expectancy persisted but was attenuated. Younger black patients (<68 years) had shorter life expectancies than white patients whereas older black patients had longer life expectancies. The largest white-black gap in life expectancy occurred in patients residing in high and medium SES areas (p=0.02 interaction). Conclusions Black and white patients residing in low SES areas have similar life expectancies after AMI, which are lower than those living in higher SES areas. Racial disparities were most prominent among patients living in high SES areas. PMID:26369354

  15. Race, Socioeconomic Status, and Life Expectancy After Acute Myocardial Infarction.

    PubMed

    Bucholz, Emily M; Ma, Shuangge; Normand, Sharon-Lise T; Krumholz, Harlan M

    2015-10-06

    Previous studies have been unable to disentangle the negative associations of black race and low socioeconomic status (SES) with long-term outcomes of patients after acute myocardial infarction (AMI). Such information could assist in efforts to address both racial and socioeconomic disparities. We used data from the Cooperative Cardiovascular Project, a prospective cohort study of Medicare beneficiaries hospitalized with AMI with 17 years of follow-up, to evaluate the relationship between race, area-level SES (measured by zip code-level median household income), and life expectancy after AMI. Life expectancy was estimated by using Cox proportional hazards regression with extrapolation using exponential models. Of the 141 095 patients with AMI, 6.3% were black and 6.8% resided in low-SES areas; 26% of black patients lived in low-SES areas in comparison with 5.7% of white patients. Post-myocardial infarction life expectancy estimates were shorter for black patients than for white patients across all socioeconomic levels in patients ≤ 75 years of age. After adjustment for patient and treatment characteristics, the association between race and life expectancy persisted but was attenuated. Younger black patients (<68 years) had shorter life expectancies than white patients, whereas older black patients had longer life expectancies. The largest white-black gap in life expectancy occurred in patients residing in high- and medium-SES areas (P=0.02 interaction). Black and white patients residing in low-SES areas have similar life expectancies after AMI, which are lower than those living in higher-SES areas. Racial disparities were most prominent among patients living in high-SES areas. © 2015 American Heart Association, Inc.

  16. [Income inequality, corruption, and life expectancy at birth in Mexico].

    PubMed

    Idrovo, Alvaro Javier

    2005-01-01

    To ascertain if the effect of income inequality on life expectancy at birth in Mexico is mediated by corruption, used as a proxy of social capital. An ecological study was carried out with the 32 Mexican federative entities. Global and by sex correlations between life expectancy at birth were estimated by federative entity with the Gini coefficient, the Corruption and Good Government Index, the percentage of Catholics, and the percentage of the population speaking indigenous language. Robust linear regressions, with and without instrumental variables, were used to explore if corruption acts as intermediate variable in the studied relationship. Negative correlations with Spearman's rho near to -0.60 (p < 0.05) and greater than -0.66 (p < 0.05) between life expectancy at birth, the Gini coefficient and the population speaking indigenous language, respectively, were observed. Moreover, the Corruption and Good Government Index correlated with men's life expectancy at birth with Spearman's rho -0.3592 (p < 0.05). Regressions with instruments were more consistent than conventional ones and they show a strong negative effect (p < 0.05) of income inequality on life expectancy at birth. This effect was greater among men. The findings suggest a negative effect of income inequality on life expectancy at birth in Mexico, mediated by corruption levels and other related cultural factors.

  17. Expectations of Adult Graduate Students in an Online Degree Program

    ERIC Educational Resources Information Center

    Deggs, David; Grover, Kenda; Kacirek, Kit

    2010-01-01

    This study was conducted to examine the expectations of adult graduate students enrolled in an online degree program at a research university in the mid-South United States. Students who were pursuing their master of education degree were invited to participate in an e-Focus group regarding their expectations of the degree program. Focus groups…

  18. Expectations of Adult Graduate Students in an Online Degree Program

    ERIC Educational Resources Information Center

    Deggs, David; Grover, Kenda; Kacirek, Kit

    2010-01-01

    This study was conducted to examine the expectations of adult graduate students enrolled in an online degree program at a research university in the mid-South United States. Students who were pursuing their master of education degree were invited to participate in an e-Focus group regarding their expectations of the degree program. Focus groups…

  19. Factors that affect life expectancy of patients with gastric adenocarcinoma.

    PubMed

    Chen, Wei-Ying; Cheng, Hsiu-Chi; Wang, Jung-Der; Sheu, Bor-Shyang

    2013-12-01

    We used a new, semi-parametric method to estimate life expectancy and expected years of life lost (EYLL) after diagnosis of gastric cancer and assess whether patients' sex or tumor type or location had any effects. We performed a nationwide retrospective cohort study of 35,576 patients with gastric cancer who were registered in the Taiwan Cancer Registry from 1998 through 2007; data were collected until the end of 2010. The Monte Carlo method and tables in Taiwan National Vital Statistics database were matched to the cohort reference populations on the basis of age and sex. The estimated regression line and the survival curve of reference populations were used to extrapolate the survival curve beyond 2010. We compared patients' age at diagnosis, life expectancy, and EYLL based on sex, tumor type, and location. In Taiwan, gastric cancer is more prevalent among men, and 88.6% of tumors are adenocarcinomas. Patients with adenocarcinoma of the gastric cardia have shorter life expectancies and greater EYLL than those with noncardia tumors (P < .05). Women with gastric adenocarcinoma are diagnosed at a younger age and have longer life expectancies but more EYLL than men with such tumors (P < .05). The estimated years of life saved if gastric adenocarcinoma is diagnosed at an early stage and cured are 22,827 years (2.62 years/case) for women and 33,700 years (1.97 years/case) for men. Among patients with gastric cancer, men and patients with adenocarcinomas of the cardia have shorter life expectancies and more EYLL. Early detection of gastric adenocarcinoma can increase life expectancy. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  20. Life expectancy after initiation of combination antiretroviral therapy in Thailand.

    PubMed

    Teeraananchai, Sirinya; Chaivooth, Suchada; Kerr, Stephen J; Bhakeecheep, Sorakij; Avihingsanon, Anchalee; Teeraratkul, Achara; Sirinirund, Petchsri; Law, Matthew G; Ruxrungtham, Kiat

    2017-01-05

    Access to combination antiretroviral therapy (cART) has decreased mortality in HIV-positive people. We aimed to estimate the expected additional years of life in HIV-positive Thai people after starting cART through the National AIDS Program (NAP), administered by the Thai National Health Security Office (NHSO). The NHSO database collects characteristics of all Thai HIV-infected patients through the National AIDS Program, including linkage with the National Death Registry for vital status. This study included patients aged ≥15 years at cART initiation between 2008 and 2014. The abridged life table method was used to construct life tables stratified by sex and baseline CD4(+) T-cell count. Life expectancy was defined as the additional years of life from age at starting cART. 201,688 eligible patients were included in analyses, contributing 618,837 person-years of follow-up. Median CD4(+) T-cell count was 109 cells/mm(3) and median age 37 years. The overall life expectancy after cART initiation at age 20 was 25.4 (95% CI, 25.3, 25.6) years and 20.6 (95% CI, 20.5, 20.7) at age 35 years. Life expectancy at baseline CD4(+) T-cell count ≥350 cells/mm(3) was 51.9 (95% CI, 51.0, 52.9) years for age 20 years and 43.2 (95% CI, 42.4, 44.1) years for age 35 years, close to life expectancy in the general Thai population. Increasing life expectancy with higher baseline CD4(+) T-cell counts supports the guideline recommendations to start cART irrespective of CD4(+) T-cell count. These results are beneficial to forecast the treatment cost and develop health policies for people living with HIV in Thailand and Asia.

  1. Marital, reproductive, and educational behaviors covary with life expectancy.

    PubMed

    Krupp, Daniel Brian

    2012-12-01

    Theories of "life history evolution" suggest that individuals might adjust the timing of marriage and reproduction, as well as their propensity to terminate a marriage or pregnancy and invest in skill development, in response to indicators of the locally prevailing level of life expectancy. In particular, such theories generate the hypothesis that foreshortened time horizons lead to hastened reproduction and marriage whereas lengthier time horizons increase the likelihood of reproductive and marital termination and lead to greater investment in education. Here, I show that the scheduling and occurrence of marital and reproductive behavior (including both initiation and termination), as well as levels of educational attainment and investment, covary with life expectancy, even after controlling for the effects of affluence. In analyses of variation in marital, reproductive, and educational behaviors at two jurisdictional levels in Canada, life expectancy was positively correlated with patterns of age-specific fertility, age at first marriage, divorce, abortion, conferral of high school and higher education degrees (with the exception of the trades) and mean number of years of schooling. The large and highly consistent relationships observed between life expectancy and the behaviors under investigation suggest that these associations may be mediated by individual "perceptions" of life expectancy, though more research is needed before conclusions can be firmly reached.

  2. Understanding the rapid increase in life expectancy in South Korea.

    PubMed

    Yang, Seungmi; Khang, Young-Ho; Harper, Sam; Davey Smith, George; Leon, David A; Lynch, John

    2010-05-01

    We assessed life expectancy increases in the past several decades in South Korea by age and specific causes of death. We applied Arriaga's decomposition method to life table data (1970-2005) and mortality statistics (1983-2005) to estimate age- and cause-specific contributions to changes in life expectancy. Reductions in infant mortality made the largest age-group contribution to the life expectancy increase. Reductions in cardiovascular diseases (particularly stroke and hypertensive diseases) contributed most to longer life expectancy between 1983 and 2005 (30% in males and 28% in females). Lower rates of stomach cancer, liver disease, tuberculosis, and external-cause mortality accounted for 30% of the male and 20% of the female increase in longevity. However, higher mortality from ischemic heart disease, lung and bronchial cancer, colorectal cancer, breast cancer, diabetes, and suicide offset gains by 10% in both genders. Rapid increases in life expectancy in South Korea were mostly achieved by reductions in infant mortality and in diseases related to infections and blood pressure.

  3. Life expectancy after HIV diagnosis based on data from the counseling center for behavioral diseases

    PubMed Central

    Mohammadi-Moein, Hassan Reza; Maracy, Mohammad Reza; Tayeri, Katayoun

    2013-01-01

    Background: Predicting life expectancy is an important component of public health, in that, it may affect policy making in fields such as social security and medical care., To estimate the life expectancy and the average years of life lost (AYLL) of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)-infected population, compared with that of the general population, and also to assess the impact of the CD4 count, risk factors of transmission, marital status, and employment status on life expectancy. Material and Methods: This study is a population-based cohort study. The sample consisted of HIV/AIDS-infected patients receiving care from 2001-2011. The patients were all adults (20-64 years) who were recruited from the Counseling Center of Behavioral Diseases. Life expectancy was measured based on an abridged life table, according to age-specific mortality rates and average years of life lost (AYLL) during the study period. Results: Forty-three of the 205 eligible patients died during 853 person-years follow-up. Compared to the general population, the life expectancy for patients with HIV infection at age 20 is about 36 years less. We have found that out a total of 1597 years of life lost during 2001-2011, compared to an overall AYLL for all HIV/AIDS, the deaths had occurred 36 years earlier than the life expectancy. Conclusion: Life expectancy in HIV/AIDS-infected patients is about 38 years less than that of the general population at the exact age of 20. The deaths caused by HIV/AIDS occurred about 36 years before what was expected in the general population at ages 20-64, and many of these years of life lost could be saved if the health care system was implemented against the risk factors of HIV/AIDS. PMID:24523793

  4. Multilevel survival analysis of health inequalities in life expectancy.

    PubMed

    Yang, Min; Eldridge, Sandra; Merlo, Juan

    2009-08-23

    The health status of individuals is determined by multiple factors operating at both micro and macro levels and the interactive effects of them. Measures of health inequalities should reflect such determinants explicitly through sources of levels and combining mean differences at group levels and the variation of individuals, for the benefits of decision making and intervention planning. Measures derived recently from marginal models such as beta-binomial and frailty survival, address this issue to some extent, but are limited in handling data with complex structures. Beta-binomial models were also limited in relation to measuring inequalities of life expectancy (LE) directly. We propose a multilevel survival model analysis that estimates life expectancy based on survival time with censored data. The model explicitly disentangles total health inequalities in terms of variance components of life expectancy compared to the source of variation at the level of individuals in households and parishes and so on, and estimates group differences of inequalities at the same time. Adjusted distributions of life expectancy by gender and by household socioeconomic level are calculated. Relative and absolute health inequality indices are derived based on model estimates. The model based analysis is illustrated on a large Swedish cohort of 22,680 men and 26,474 women aged 6569 in 1970 and followed up for 30 years. Model based inequality measures are compared to the conventional calculations. Much variation of life expectancy is observed at individual and household levels. Contextual effects at Parish and Municipality level are negligible. Women have longer life expectancy than men and lower inequality. There is marked inequality by the level of household socioeconomic status measured by the median life expectancy in each socio-economic group and the variation in life expectancy within each group. Multilevel survival models are flexible and efficient tools in studying health

  5. Rapid increase in Japanese life expectancy after World War II.

    PubMed

    Sugiura, Yasuo; Ju, Young-Su; Yasuoka, Junko; Jimba, Masamine

    2010-02-01

    Japanese life expectancy increased by about 13.7 years during the first decade after World War II, despite the country's post-war poverty. Although it is known that medical progress explains part of this increase, roles of non-medical factors have not been systematically studied. This study hypothesizes that non-medical factors, in addition to medical factors, are associated with the rapid increase in life expectancy in Japan. We analyzed the time trends of potential explanatory factors and used regression analysis with historical data from the Ministry of Internal Affairs and Communications' Historical Statistics of Japan during the period between 1946 and 1983. Time trends analysis revealed that the rapid increase in life expectancy preceded the dramatic growth of per capita Gross Domestic Product (GDP) by 10 years. In education, the nearly universal enrollment in elementary schools and increased advancement to upper secondary schools for both sexes were associated with better health. Regarding legislation, 32 health laws were passed in the first decade after the war and these laws were associated with improved health. Using regression analysis, we found that the enrollment rate in elementary schools, the number of health laws, and expansion of community-based activity staff were significantly associated with the increased life expectancy during the first decade after World War II. To conclude, in addition to medical factors, non-medical factors applied across the country, particularly education, community-based activities and legislation were associated with the rapid increase in Japanese life expectancy after World War II.

  6. Leaving Sweden behind: Gains in life expectancy in Canada.

    PubMed

    Auger, Nathalie; Le Serbon, Emilie; Rostila, Mikael

    2015-06-01

    Sweden and Canada are known for quality of living and exceedingly high life expectancy, but recent data on how these countries compare are lacking. We measured life expectancy in Canada and Sweden during the past decade, and identified factors responsible for changes over time. We calculated life expectancy at birth for Canada and Sweden annually from 2000 to 2010, and determined the ages and causes of death responsible for the gap between the two countries using Arriaga's method. We determined how population growth, ageing, and mortality influenced the number of deaths over time. During 2000-2010, life expectancy in Canada caught up with Sweden for men, and surpassed Sweden by 0.4 years for women. Sweden lost ground owing to a slower reduction in circulatory and tumour mortality after age 65 years compared with Canada. Nonetheless, population ageing increased the number of deaths in Canada, especially for mental and nervous system disorders. In Sweden, the number of deaths decreased. In only one decade, life expectancy in Canada caught up and surpassed Sweden due to rapid improvements in circulatory and tumour mortality. Population ageing increased the number of deaths in Canada, potentially stressing the health care system more than in Sweden. © 2015 the Nordic Societies of Public Health.

  7. Family (Dis)Advantage and Life Course Expectations*

    PubMed Central

    Johnson, Monica Kirkpatrick; Hitlin, Steven

    2016-01-01

    Optimistic assessments of life chances can positively influence life outcomes, but conflicting theories suggest these assessments either reflect structural privilege or develop as a result of childhood hardship. In addition, competing hypotheses suggest that these assessments may matter differently depending on who holds them. We examine whether family socioeconomic status shapes adolescents’ expectations about how successful their lives will turn out. We distinguish generalized life expectations (GLE), capturing anticipated success in life across multiple domains, from intergenerational comparative expectations (ICE), which register expectations about improvement relative to observed success within the respondent’s family lineage. We find that adolescents from higher socioeconomic status families are simultaneously more optimistic about their likely success in life (GLE) but less likely to anticipate relative improvement in life success across generations (ICE). Holding high GLE in combination with low ICE predicted doing better in adulthood across a range of health, attainment, and well-being outcomes, though in most cases high GLE, regardless of ICE, was the key. These beneficial patterns are, for the most part, at least as beneficial for socioeconomically disadvantaged youth as they are for advantaged youth. PMID:28408766

  8. Family (Dis)Advantage and Life Course Expectations.

    PubMed

    Johnson, Monica Kirkpatrick; Hitlin, Steven

    2017-03-01

    Optimistic assessments of life chances can positively influence life outcomes, but conflicting theories suggest these assessments either reflect structural privilege or develop as a result of childhood hardship. In addition, competing hypotheses suggest that these assessments may matter differently depending on who holds them. We examine whether family socioeconomic status shapes adolescents' expectations about how successful their lives will turn out. We distinguish generalized life expectations (GLE), capturing anticipated success in life across multiple domains, from intergenerational comparative expectations (ICE), which register expectations about improvement relative to observed success within the respondent's family lineage. We find that adolescents from higher socioeconomic status families are simultaneously more optimistic about their likely success in life (GLE) but less likely to anticipate relative improvement in life success across generations (ICE). Holding high GLE in combination with low ICE predicted doing better in adulthood across a range of health, attainment, and well-being outcomes, though in most cases high GLE, regardless of ICE, was the key. These beneficial patterns are, for the most part, at least as beneficial for socioeconomically disadvantaged youth as they are for advantaged youth.

  9. Measurement and utilization of healthy life expectancy: conceptual issues.

    PubMed Central

    Robine, J. M.; Michel, J. P.; Branch, L. G.

    1992-01-01

    The periodic calculation of healthy life expectancies permits the evaluation of the impact of new health policies at a given moment, as well as the assessment of trends under changing health conditions. In spite of their apparent simplicity, the results obtained will have to be interpreted by experts. Useful reference values can be provided by international comparisons. However, several choices remain to be made, such as (i) the types of morbidity and disability data to be associated with mortality data; (ii) the multiple indicators available; (iii) the type of observations to be recorded, i.e., "abilities" or "performances"; (iv) whether or not the recovery of lost functions should be considered; (v) the mode of computation, i.e., life expectancy before the first morbid event or global healthy life expectancy; and (vi) the determination of thresholds based on either relative or absolute criteria. PMID:1486677

  10. Assessment of marital and family expectations of a group of urban single young adults.

    PubMed

    Henry, J A; Parthasarathy, R

    2010-01-01

    The lack of baseline understanding of what young adults' needs and expectations are from marital and family life is the context in which this study has evolved. The author believes that the findings from this study could fee into the contents of a more relevant and useful Family Life Education program for young adults in urban India. To explore and analyze the needs and expectations of single young adults with respect to marital and family life. A college in Bangalore with students from graduate and post-graduate courses in the age group of 18 to 25 years. A semi-structure interview schedule prepared by the author was administered on 100 students. Qualitative and Quantitative. The results showed that a large number of the participants had very specific emotional, cognitive and physiological expectations from marital and family life. They also expressed an active need for education on mate selection, sexuality, parenting, interpersonal relationships, intimacy, conflict resolution, among other areas of need. The findings from this study would find great relevance in the preparation of a relevant and practical Family Life Education program for single young adults which in turn would be useful in colleges, workplaces, family counseling centers or any platform where single young adults wish to access such family base services.

  11. Trends in Life Expectancy and Lifespan Variation by Educational Attainment: United States, 1990-2010.

    PubMed

    Sasson, Isaac

    2016-04-01

    The educational gradient in life expectancy is well documented in the United States and in other low-mortality countries. Highly educated Americans, on average, live longer than their low-educated counterparts, who have recently seen declines in adult life expectancy. However, limiting the discussion on lifespan inequality to mean differences alone overlooks other dimensions of inequality and particularly disparities in lifespan variation. The latter represents a unique form of inequality, with higher variation translating into greater uncertainty in the time of death from an individual standpoint, and higher group heterogeneity from a population perspective. Using data from the National Vital Statistics System from 1990 to 2010, this is the first study to document trends in both life expectancy and S25--the standard deviation of age at death above 25--by educational attainment. Among low-educated whites, adult life expectancy declined by 3.1 years for women and by 0.6 years for men. At the same time, S25 increased by about 1.5 years among high school-educated whites of both genders, becoming an increasingly important component of total lifespan inequality. By contrast, college-educated whites benefited from rising life expectancy and record low variation in age at death, consistent with the shifting mortality scenario. Among blacks, adult life expectancy increased, and S25 plateaued or declined in nearly all educational attainment groups, although blacks generally lagged behind whites of the same gender on both measures. Documenting trends in lifespan variation can therefore improve our understanding of lifespan inequality and point to diverging trajectories in adult mortality across socioeconomic strata.

  12. Terminal costs, improved life expectancy and future public health expenditure.

    PubMed

    Bjørner, Thomas Bue; Arnberg, Søren

    2012-06-01

    This paper presents an empirical analysis of public health expenditure on individuals in Denmark. The analysis separates out the individual effects of age and proximity to death (reflecting terminal costs of dying) and employs unique micro data from the period 2000 to 2009, covering a random sample of 10% of the Danish population. Health expenditure includes treatment in hospitals, subsidies to prescribed medication and health care provided by general practitioners and specialists and covers about 80% of public health care expenditure on individuals. The results confirm findings from previous studies showing that proximity to death has a significant impact on health care expenditure. However, it is also found that cohort effects (the baby boom generation) as well as improvements in life expectancy have a substantial effect on future health care expenditure even when proximity to death is controlled for. These results are obtained by combining the empirical estimates with a long term population forecast. When life expectancy increases, terminal costs are postponed but the increases in health expenditure that follow from longer life expectancy are not as large as the increase in the number of elderly persons would suggest (due to "healthy ageing"). Based on the empirical estimates, healthy ageing is expected to reduce the impact of increased life expectancy on real health expenditure by 50% compared to a situation without healthy ageing.

  13. Siblings of Adults With Schizophrenia: Expectations About Future Caregiving Roles

    PubMed Central

    Smith, Matthew J.; Greenberg, Jan S.; Seltzer, Marsha Mailick

    2008-01-01

    Sibling expectations to provide future instrumental or emotional support for a brother or sister with schizophrenia when parents became disabled or died were examined. Data came from a sample of 137 siblings participating in a longitudinal study of aging families of adults with schizophrenia. Early socialization experiences, the quality of the sibling relationship, and personal caregiver gains propel siblings toward a future caregiving role, whereas geographic distance and beliefs about the controllability of psychiatric symptoms reduce expectations of future involvement. PMID:17352582

  14. Counseling Adults for Life Transitions.

    ERIC Educational Resources Information Center

    Walz, Garry R.; Benjamin, Libby

    Adult counseling is assuming increasing importance in counselor education and training. Most important is the developmental aspect of growth all through life, since adulthood is not a static period but can be as fraught with conflict and choice as childhood or adolescence. Outlines describe some important differences between young people and…

  15. Clinical life: expectation and the double edge of medical promise.

    PubMed

    Shim, Janet K; Russ, Ann J; Kaufman, Sharon R

    2007-04-01

    This article introduces the concept of clinical life to capture a form of life produced in the pursuit and wake of medically achieved longevity. Relying on the retrospective accounts of 28 individuals over age 70 who have undergone cardiac bypass surgery, angioplasty or a stent procedure, as well as interviews with their families and with clinicians, we examine three features of clinical life. First, patients do not distinguish between clinical possibility and clinical promise, and thus assume that life can and will be improved by medical intervention in late life. Rather than anticipating a range of potential treatment outcomes, patients therefore expect the best-case scenario: that medical procedures will reverse aging, disease and the march of time. Second, patients then assess the value of their post-procedure lives in accordance with that expectation. Norms regarding what life 'should be like' at particular ages are continually recalibrated to the horizon of what is clinically possible. And third, the price of living longer entails a double-edged relationship with the clinic--it generates opportunities for bodily restoration and increased self-worth but also creates ambivalence about the value of life. This latter feature of clinical life is rarely publicly acknowledged in an environment that emphasizes medical promise.

  16. Adults seeking orthodontic treatment: expectations, periodontal and TMD issues.

    PubMed

    Christensen, L; Luther, F

    2015-02-16

    The growth in adult orthodontics presents new challenges to both the general dental practitioner and the orthodontist. Although many of the main objectives of orthodontic treatment are similar for adults, young adults and children, adult patients frequently bring significant challenges in several areas not often seen in the younger patient group. In areas such as planning realistic treatment outcomes, it is paramount that the patient's expectations are identified, respected and managed where appropriate. The adult patient's dental health often dictates deviation from the ideal treatment plan and periodontal problems are a common example. Based on current evidence, this paper presents an overview of some of the difficulties in the management of these issues, as well as highlighting developments with regard to pain conditions and their relevance to orthodontic treatment and its effects on temporomandibular joint disorders (TMD) management.

  17. Long and happy living: Trends and patterns of happy life expectancy in the U.S., 1970–2000

    PubMed Central

    Yang, Yang

    2013-01-01

    This study assesses the trends and differentials in length of quality life in the U.S. population as measured by happy life expectancy in 1970, 1980, 1990, and 2000. The analysis combines age-specific prevalence rates of subjective well-being from a large nationally representative survey and life table estimates of mortality in decennial Census years. Employing the period prevalence-rate life table method—Sullivan method, the analysis finds evidence for improvement in quality of life in the U.S. Happy life expectancy largely increased in both absolute terms (number of years) and relative terms (proportion of life) over time at all adult ages examined. And increases in total life expectancy were mainly contributed by increases in expectancy in happy years rather than unhappy years. Happy life expectancy is longer than active life expectancy. And there has been greater compression of unhappiness than compression of morbidity. There are substantial differentials in happy life expectancy by sex and race because of differential prevalence rates of happiness. Women and whites had longer years of total and happy life expectancies at most ages and dates, while men and blacks had greater proportions of happy life expectancies across the three decades. Although race differentials generally decreased at older ages and with time, relative disadvantages of blacks persisted. PMID:19227700

  18. Long and happy living: trends and patterns of happy life expectancy in the U.S., 1970-2000.

    PubMed

    Yang, Yang

    2008-12-01

    This study assesses the trends and differentials in length of quality life in the U.S. population as measured by happy life expectancy in 1970, 1980, 1990, and 2000. The analysis combines age-specific prevalence rates of subjective well-being from a large nationally representative survey and life table estimates of mortality in decennial Census years. Employing the period prevalence-rate life table method--Sullivan method, the analysis finds evidence for improvement in quality of life in the U.S. Happy life expectancy largely increased in both absolute terms (number of years) and relative terms (proportion of life) over time at all adult ages examined. And increases in total life expectancy were mainly contributed by increases in expectancy in happy years rather than unhappy years. Happy life expectancy is longer than active life expectancy. And there has been greater compression of unhappiness than compression of morbidity. There are substantial differentials in happy life expectancy by sex and race because of differential prevalence rates of happiness. Women and whites had longer years of total and happy life expectancies at most ages and dates, while men and blacks had greater proportions of happy life expectancies across the three decades. Although race differentials generally decreased at older ages and with time, relative disadvantages of blacks persisted.

  19. The Life Expectancy of People with Intellectual Disabilities in Germany

    ERIC Educational Resources Information Center

    Dieckmann, Friedrich; Giovis, Christos; Offergeld, Jana

    2015-01-01

    Background: This study presents age group-specific mortality rates and the average life expectancy of people with intellectual disabilities in Germany. Method: For two samples from Westphalia-Lippe and Baden-Wuerttemberg, person-related data for the years 2007-2009 were analysed. Age group-specific mortality rates were estimated by exponential…

  20. Rise, stagnation, and rise of Danish women's life expectancy.

    PubMed

    Lindahl-Jacobsen, Rune; Rau, Roland; Jeune, Bernard; Canudas-Romo, Vladimir; Lenart, Adam; Christensen, Kaare; Vaupel, James W

    2016-04-12

    Health conditions change from year to year, with a general tendency in many countries for improvement. These conditions also change from one birth cohort to another: some generations suffer more adverse events in childhood, smoke more heavily, eat poorer diets, etc., than generations born earlier or later. Because it is difficult to disentangle period effects from cohort effects, demographers, epidemiologists, actuaries, and other population scientists often disagree about cohort effects' relative importance. In particular, some advocate forecasts of life expectancy based on period trends; others favor forecasts that hinge on cohort differences. We use a combination of age decomposition and exchange of survival probabilities between countries to study the remarkable recent history of female life expectancy in Denmark, a saga of rising, stagnating, and now again rising lifespans. The gap between female life expectancy in Denmark vs. Sweden grew to 3.5 y in the period 1975-2000. When we assumed that Danish women born 1915-1945 had the same survival probabilities as Swedish women, the gap remained small and roughly constant. Hence, the lower Danish life expectancy is caused by these cohorts and is not attributable to period effects.

  1. Tropics, Income, and School Life Expectancy: An Intercountry Study.

    ERIC Educational Resources Information Center

    Ram, Rati

    1999-01-01

    Using UNESCO's recent data, explores effects of a country's income and "tropicality" on school life expectancy. Although income's effect is important, distance from the equator also matters. Effects of tropicality were larger in 1980 than in 1992. Implications are discussed. (13 references) (MLH)

  2. Tropics, Income, and School Life Expectancy: An Intercountry Study.

    ERIC Educational Resources Information Center

    Ram, Rati

    1999-01-01

    Using UNESCO's recent data, explores effects of a country's income and "tropicality" on school life expectancy. Although income's effect is important, distance from the equator also matters. Effects of tropicality were larger in 1980 than in 1992. Implications are discussed. (13 references) (MLH)

  3. Swedish medical students' expectations of their future life

    PubMed Central

    Andersson, Jenny; Johansson, Eva E.; Verdonk, Petra; Lagro-Janssen, Antoine; Hamberg, Katarina

    2011-01-01

    Objectives: To investigate future life expectations among male and female medical students in their first and final year. Methods The study was cross-sectional and conducted at a Swedish medical school. Out of 600 invited students, 507 (85%) answered an open-ended question about their future life, 298 (59%) first-year students and 209 (41%) last-year students. Women constituted 60% of the respondents. A mixed model design was applied; qualitative content analysis was utilized to create statistically comparable themes and categories. Results Students’ written answers were coded, categorized and clustered into four themes: “Work”, “Family”, “Leisure” and “Quality of personal life”. Almost all students included aspects of work in their answers. Female students were more detailed than male ones in their family concerns. Almost a third of all students reflected on a future work-life balance, but considerations regarding quality of personal life and leisure were more common among last-year students. Conclusions Today’s medical students expect more of life than work, especially those standing on the doorstep of working life. They intend to balance work not only with a family but also with leisure activities. Our results reflect work attitudes that challenge the health care system for more adaptive working conditions. We suggest that discussions about work-life balance should be included in medical curricula.

  4. Receipt of Cancer Screening Is a Predictor of Life Expectancy.

    PubMed

    Goodwin, James S; Sheffield, Kristin; Li, Shuang; Tan, Alai

    2016-11-01

    Obtaining cancer screening on patients with limited life expectancy has been proposed as a measure for low quality care for primary care physicians (PCPs). However, administrative data may underestimate life expectancy in patients who undergo screening. To determine the association between receipt of screening mammography or PSA and overall survival. Retrospective cohort study from 1/1/1999 to 12/31/2012. Receipt of screening was assessed for 2001-2002 and survival from 1/1/2003 to 12/31/2012. Life expectancy was estimated as of 1/1/03 using a validated algorithm, and was compared to actual survival for men and women, stratified by receipt of cancer screening. A 5 % sample of Medicare beneficiaries aged 69-90 years as of 1/1/2003 (n = 906,723). Receipt of screening mammography in 2001-2002 for women, or a screening PSA test in 2002 for men. Survival from 1/1/2003 through 12/31/2012. Subjects were stratified by life expectancy based on age and comorbidity. Within each stratum, the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men. In a Cox model, non-receipt of screening in women had an impact on survival (HR = 1.52; 95 % CI = 1.51, 1.54) similar in magnitude to a diagnosis of complicated diabetes or heart failure, and was comparable to uncomplicated diabetes or liver disease in men (HR = 1.23; 1.22, 1.25). Receipt of cancer screening is a powerful marker of health status that is not captured by comorbidity measures in administrative data. Because life expectancy algorithms using administrative data underestimate the life expectancy of patients who undergo screening, they can overestimate the problem of cancer screening in patients with limited life expectancy.

  5. The effect of life expectancy on aggression and generativity: a life history perspective.

    PubMed

    Dunkel, Curtis S; Mathes, Eugene; Papini, Dennis R

    2010-09-23

    Following a model that is inclusive of both dispositional and situational influences on life-history behaviors and attitudes, the effect of life expectancies on aggression and generativity was examined. Consistent with the hypotheses it was found that shorter life expectancies led to an increase in the desire to aggress and a decrease in the desire to engage in generative behaviors. The results are discussed in terms of how life history theory can be used to frame research on person-situation interactions.

  6. How long do centenarians survive? Life expectancy and maximum lifespan.

    PubMed

    Modig, K; Andersson, T; Vaupel, J; Rau, R; Ahlbom, A

    2017-08-01

    The purpose of this study was to explore the pattern of mortality above the age of 100 years. In particular, we aimed to examine whether Scandinavian data support the theory that mortality reaches a plateau at particularly old ages. Whether the maximum length of life increases with time was also investigated. The analyses were based on individual level data on all Swedish and Danish centenarians born from 1870 to 1901; in total 3006 men and 10 963 women were included. Birth cohort-specific probabilities of dying were calculated. Exact ages were used for calculations of maximum length of life. Whether maximum age changed over time was analysed taking into account increases in cohort size. The results confirm that there has not been any improvement in mortality amongst centenarians in the past 30 years and that the current rise in life expectancy is driven by reductions in mortality below the age of 100 years. The death risks seem to reach a plateau of around 50% at the age 103 years for men and 107 years for women. Despite the rising life expectancy, the maximum age does not appear to increase, in particular after accounting for the increasing number of individuals of advanced age. Mortality amongst centenarians is not changing despite improvements at younger ages. An extension of the maximum lifespan and a sizeable extension of life expectancy both require reductions in mortality above the age of 100 years. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  7. Life Expectancy after Myocardial Infarction by Hospital Performance

    PubMed Central

    Bucholz, Emily M.; Butala, Neel M.; Ma, Shuangge; Normand, Sharon-Lise T.; Krumholz, Harlan M.

    2016-01-01

    Background Thirty-day risk-standardized mortality rates after acute myocardial infarction are commonly used to evaluate and compare hospital performance. However, it is not known whether differences between hospitals in early patient survival are associated with differences in long-term survival. Methods We analyzed data from the Cooperative Cardiovascular Project, a study of Medicare beneficiaries hospitalized for acute myocardial infarction between 1994-96 with 17 years of follow-up. We grouped hospitals into five strata based on case-mix severity. Within each case-mix stratum, we compared life expectancy in patients admitted to high and low-performing hospitals, as defined by quintiles of thirty-day risk-standardized mortality rates. Cox proportional hazards models were used to calculate life expectancy. Results The study sample included 119,735 patients with acute myocardial infarction admitted to 1,824 hospitals. Within each case-mix stratum, survival curves for patients admitted to hospitals in each risk-standardized mortality rate quintile separated within the first 30 days and then remained parallel over 17 years of follow-up. Estimated life expectancy declined as hospital risk-standardized mortality rate quintile increased. On average, patients treated at high-performing hospitals lived between 1.14 and 0.84 years longer than patients treated at low-performing hospitals, depending on hospital case-mix. When 30-day survivors were examined separately, there was no difference in unadjusted or adjusted life expectancy across hospital risk-standardized mortality rate quintiles. Conclusion Patients admitted to high-performing hospitals after acute myocardial infarction had longer life expectancies than patients treated in low-performing hospitals. This survival benefit arose in the first 30 days and persisted over the long term. PMID:27705249

  8. Gains in Life Expectancy Associated with Higher Education in Men

    PubMed Central

    Bijwaard, Govert E.; van Poppel, Frans; Ekamper, Peter; Lumey, L. H.

    2015-01-01

    Background Many studies show large differences in life expectancy across the range of education, intelligence, and socio-economic status. As educational attainment, intelligence, and socio-economic status are highly interrelated, appropriate methods are required to disentangle their separate effects. The aim of this paper is to present a novel method to estimate gains in life expectancy specifically associated with increased education. Our analysis is based on a structural model in which education level, IQ at age 18 and mortality all depend on (latent) intelligence. The model allows for (selective) educational choices based on observed factors and on an unobserved factor capturing intelligence. Our estimates are based on information from health examinations of military conscripts born in 1944–1947 in The Netherlands and their vital status through age 66 (n = 39,798). Results Our empirical results show that men with higher education have lower mortality. Using structural models to account for education choice, the estimated gain in life expectancy for men moving up one educational level ranges from 0.3 to 2 years. The estimated gain in months alive over the observational period ranges from -1.2 to 5.7 months. The selection effect is positive and amounts to a gain of one to two months. Decomposition of the selection effect shows that the gain from selection on (latent) intelligence is larger than the gain from selection on observed factors and amounts to 1.0 to 1.7 additional months alive. Conclusion Our findings confirm the strong selection into education based on socio-economic status and intelligence. They also show significant higher life expectancy among individuals with higher education after the selectivity of education choice has been taken into account. Based on these estimates, it is plausible therefore that increases in education could lead to increases in life expectancy. PMID:26496647

  9. Democratization and life expectancy in Europe, 1960-2008.

    PubMed

    Mackenbach, Johan P; Hu, Yannan; Looman, Caspar W N

    2013-09-01

    Over the past five decades, two successive waves of political reform have brought democracy to, first, Spain, Portugal and Greece, and, more recently, Central and Eastern European countries. We assessed whether democratization was associated with improvements in population health, as indicated by life expectancy and cause-specific mortality rates. Data on life expectancy at birth, age-standardized total and cause-specific mortality rates, levels of democracy and potential time-variant confounding variables were collected from harmonized international databanks. In two pooled cross-sectional time-series analyses with country-fixed effects, life expectancy and cause-specific mortality were regressed on measures of current and cumulative democracy, controlling for confounders. A first analysis covered the 1960-1990 period, a second covered the 1987-2008 period. In the 1960-1990 period, current democracy was more strongly associated with higher life expectancy than cumulative democracy. The positive effects of current democracy on total mortality were mediated mainly by lower mortality from heart disease, pneumonia, liver cirrhosis, and suicide. In the 1987-2008 period, however, current democracy was associated with lower, and cumulative democracy with higher life expectancy, particularly among men. The positive effects of cumulative democracy on total mortality were mediated mainly by lower mortality from circulatory diseases, cancer of the breast, and external causes. Current democracy was associated with higher mortality from motor vehicle accidents in both periods, and also with higher mortality from cancer and all external causes in the second. Our results suggest that in Europe during these two periods democratization has had mixed effects. That short-term changes in levels of democracy had positive effects in the first but not in the second period is probably due to the fact that democratization in Central and Eastern Europe was part of a complete system change

  10. Gains in Life Expectancy Associated with Higher Education in Men.

    PubMed

    Bijwaard, Govert E; van Poppel, Frans; Ekamper, Peter; Lumey, L H

    2015-01-01

    Many studies show large differences in life expectancy across the range of education, intelligence, and socio-economic status. As educational attainment, intelligence, and socio-economic status are highly interrelated, appropriate methods are required to disentangle their separate effects. The aim of this paper is to present a novel method to estimate gains in life expectancy specifically associated with increased education. Our analysis is based on a structural model in which education level, IQ at age 18 and mortality all depend on (latent) intelligence. The model allows for (selective) educational choices based on observed factors and on an unobserved factor capturing intelligence. Our estimates are based on information from health examinations of military conscripts born in 1944-1947 in The Netherlands and their vital status through age 66 (n = 39,798). Our empirical results show that men with higher education have lower mortality. Using structural models to account for education choice, the estimated gain in life expectancy for men moving up one educational level ranges from 0.3 to 2 years. The estimated gain in months alive over the observational period ranges from -1.2 to 5.7 months. The selection effect is positive and amounts to a gain of one to two months. Decomposition of the selection effect shows that the gain from selection on (latent) intelligence is larger than the gain from selection on observed factors and amounts to 1.0 to 1.7 additional months alive. Our findings confirm the strong selection into education based on socio-economic status and intelligence. They also show significant higher life expectancy among individuals with higher education after the selectivity of education choice has been taken into account. Based on these estimates, it is plausible therefore that increases in education could lead to increases in life expectancy.

  11. Gender differences in healthy life expectancy among Brazilian elderly.

    PubMed

    Belon, Ana Paula; Lima, Margareth G; Barros, Marilisa B A

    2014-06-06

    This study examined gender differences in healthy life expectancy (HLE) and unhealthy life expectancy (UHLE) among people aged 60 years or older living in a large Brazilian city. Based on Chiang method, abridged life tables were constructed for men and for women. To calculate HLE, the Sullivan method was applied. Estimates of the prevalence of self-rated health and self-reported functional disability (global, mild/moderate, and severe) were obtained from a population-based household survey carried out in 2008, which involved non-institutionalized individuals. Findings showed that women live longer and these extra years would be spent in good self-rated health. For example, women aged 60 would live, on average, 4 more years in good health in comparison to men. In terms of global limitations and mild/moderate limitations, no gender differences were detected for HLE. However, UHLE was statistically higher among women than among men at all ages in the global limitations and mild/moderate limitations (except for the age 80). Women at age 60, for instance, could expect to live 3.1 years longer with mild/moderate limitations compared to men. Gender differences were identified for severe limitations for either HLE or UHLE. In comparison to men, women at age 60, for example, would expect to live 2.5 and 2.0 more years without and with severe limitations. By showing that the advantage of longer life expectancy among women is not necessarily accompanied by worse health conditions, these findings add some evidence to the debate about male-female health-survival paradox. Policy efforts are necessary to reduce gender differences in the quantity and quality of years to be lived, providing equal opportunities to women and men live longer with quality of life, autonomy, and independence.

  12. Gender differences in healthy life expectancy among Brazilian elderly

    PubMed Central

    2014-01-01

    Background This study examined gender differences in healthy life expectancy (HLE) and unhealthy life expectancy (UHLE) among people aged 60 years or older living in a large Brazilian city. Methods Based on Chiang method, abridged life tables were constructed for men and for women. To calculate HLE, the Sullivan method was applied. Estimates of the prevalence of self-rated health and self-reported functional disability (global, mild/moderate, and severe) were obtained from a population-based household survey carried out in 2008, which involved non-institutionalized individuals. Results Findings showed that women live longer and these extra years would be spent in good self-rated health. For example, women aged 60 would live, on average, 4 more years in good health in comparison to men. In terms of global limitations and mild/moderate limitations, no gender differences were detected for HLE. However, UHLE was statistically higher among women than among men at all ages in the global limitations and mild/moderate limitations (except for the age 80). Women at age 60, for instance, could expect to live 3.1 years longer with mild/moderate limitations compared to men. Gender differences were identified for severe limitations for either HLE or UHLE. In comparison to men, women at age 60, for example, would expect to live 2.5 and 2.0 more years without and with severe limitations. Conclusions By showing that the advantage of longer life expectancy among women is not necessarily accompanied by worse health conditions, these findings add some evidence to the debate about male-female health-survival paradox. Policy efforts are necessary to reduce gender differences in the quantity and quality of years to be lived, providing equal opportunities to women and men live longer with quality of life, autonomy, and independence. PMID:24906547

  13. Assessment of Marital and Family Expectations of a Group of Urban Single Young Adults

    PubMed Central

    Henry, J. A.; Parthasarathy, R.

    2010-01-01

    Background: The lack of baseline understanding of what young adults’ needs and expectations are from marital and family life is the context in which this study has evolved. The author believes that the findings from this study could fee into the contents of a more relevant and useful Family Life Education program for young adults in urban India. Aims: To explore and analyze the needs and expectations of single young adults with respect to marital and family life. Materials and Methods: A college in Bangalore with students from graduate and post-graduate courses in the age group of 18 to 25 years. A semi-structure interview schedule prepared by the author was administered on 100 students. Qualitative and Quantitative. Results and Conclusion: The results showed that a large number of the participants had very specific emotional, cognitive and physiological expectations from marital and family life. They also expressed an active need for education on mate selection, sexuality, parenting, interpersonal relationships, intimacy, conflict resolution, among other areas of need. The findings from this study would find great relevance in the preparation of a relevant and practical Family Life Education program for single young adults which in turn would be useful in colleges, workplaces, family counseling centers or any platform where single young adults wish to access such family base services. PMID:21799559

  14. Expectations of later life support among lesbian and gay Queenslanders.

    PubMed

    Hughes, Mark

    2010-12-01

      To examine lesbian and gay people's expectations of support, socialising and cohabitation in older age.   The study involved secondary data analysis of a subsample of 371 lesbian and gay people taken from a survey conducted by the Queensland Association for Healthy Communities.   Lesbian and gay people expected to receive support from diverse sources, including same-sex partners, lesbian, gay, bisexual and transgender friends and heterosexual friends. Women were more likely to expect to receive support from others than men, and men were more likely to expect to live alone in later life.   Aged care providers need to be responsive to the different sources of support that may be provided to older lesbian and gay people. Services that are lesbian- and gay-friendly may facilitate service uptake and reduce pressures on lesbian and gay people's informal networks of support. © 2010 The Author. Journal compilation © 2010 ACOTA.

  15. Factors Affecting Recreation Preferences and Expectations of Disabled Adult Learners

    ERIC Educational Resources Information Center

    Arslan, Sibel

    2014-01-01

    Generalizing recreation services, one of the essential well-being sources of disabled persons who experience deprivation in many dimensions of life and which fulfill their learning needs, is a social responsibility. The present study aims to determine factors effective on recreation preferences and expectations of the disabled individuals who…

  16. Factors Affecting Recreation Preferences and Expectations of Disabled Adult Learners

    ERIC Educational Resources Information Center

    Arslan, Sibel

    2014-01-01

    Generalizing recreation services, one of the essential well-being sources of disabled persons who experience deprivation in many dimensions of life and which fulfill their learning needs, is a social responsibility. The present study aims to determine factors effective on recreation preferences and expectations of the disabled individuals who…

  17. Active life expectancy in people with and without diabetes.

    PubMed

    Jagger, Carol; Goyder, Elizabeth; Clarke, Michael; Brouard, Nicolas; Arthur, Antony

    2003-03-01

    The aim of the study was to investigate the feasibility of monitoring older people's health by measuring active life expectancy among older people with and without diabetes using routinely collected primary care data. The study comprised the first five rounds of a routine health assessment of those aged 75 years and over belonging to a large Midlands general practice (list size 32,500). A nurse carried out the health assessments in the participant's home. Being active was defined as the ability to perform (without difficulty, help or use of aids) at least six of seven activities of daily living (ADLs). Mortality data were collected through the practice register together with regular linkage to information from the Office for National Statistics. Period health expectancies were calculated for those known or found to be diabetic through the health assessments and for non-diabetic individuals. Calculation of active life expectancies (ALE) was based on 2,474 persons (212 with and 2,262 without diabetes). At all ages, people with diabetes had lower life expectancy and spent fewer years active. The proportion of remaining life spent active was, however, similar for both groups at younger ages, but by age 85 years people with diabetes spent only 32 per cent of remaining life active compared with 42 per cent for those without diabetes. Annual health assessments of the over-75s in primary care together with linkage to mortality data provide a feasible method of monitoring older people's health, particularly for subgroups at greater risk of disability. At Strategic Health Authority or Primary Care Trust level these methods can monitor health needs, highlight health inequalities and evaluate intervention strategies.

  18. Life Expectancy after Myocardial Infarction, According to Hospital Performance.

    PubMed

    Bucholz, Emily M; Butala, Neel M; Ma, Shuangge; Normand, Sharon-Lise T; Krumholz, Harlan M

    2016-10-06

    Thirty-day risk-standardized mortality rates after acute myocardial infarction are commonly used to evaluate and compare hospital performance. However, it is not known whether differences among hospitals in the early survival of patients with acute myocardial infarction are associated with differences in long-term survival. We analyzed data from the Cooperative Cardiovascular Project, a study of Medicare beneficiaries who were hospitalized for acute myocardial infarction between 1994 and 1996 and who had 17 years of follow-up. We grouped hospitals into five strata that were based on case-mix severity. Within each case-mix stratum, we compared life expectancy among patients admitted to high-performing hospitals with life expectancy among patients admitted to low-performing hospitals. Hospital performance was defined by quintiles of 30-day risk-standardized mortality rates. Cox proportional-hazards models were used to calculate life expectancy. The study sample included 119,735 patients with acute myocardial infarction who were admitted to 1824 hospitals. Within each case-mix stratum, survival curves of the patients admitted to hospitals in each risk-standardized mortality rate quintile separated within the first 30 days and then remained parallel over 17 years of follow-up. Estimated life expectancy declined as hospital risk-standardized mortality rate quintile increased. On average, patients treated at high-performing hospitals lived between 0.74 and 1.14 years longer, depending on hospital case mix, than patients treated at low-performing hospitals. When 30-day survivors were examined separately, there was no significant difference in unadjusted or adjusted life expectancy across hospital risk-standardized mortality rate quintiles. In this study, patients admitted to high-performing hospitals after acute myocardial infarction had longer life expectancies than patients treated in low-performing hospitals. This survival benefit occurred in the first 30 days and

  19. Health inequalities in Rio de Janeiro, Brazil: lower healthy life expectancy in socioeconomically disadvantaged areas.

    PubMed

    Szwarcwald, Célia Landmann; da Mota, Jurema Corrêa; Damacena, Giseli Nogueira; Pereira, Tatiana Guimarães Sardinha

    2011-03-01

    We investigated deprivation and inequalities in life expectancy and healthy life expectancy by location in Rio de Janeiro, Brazil. We conducted a health survey of 576 adults in 2006. Census tracts were stratified by income level and categorization as a slum. We determined health status by degree of functional limitation, according to the approach proposed by the World Health Organization. We calculated healthy life expectancies by Sullivan's method with abridged life table. We found the worst indicators in the slum stratum. The life expectancy at birth of men living in the richest parts of the city was 12.8 years longer than that of men living in deprived areas. For both men and women older than age 65 years, healthy life expectancy was more than twice as high in the richest sector as in the slum sector. Our analysis detailed the excess burden of poor health experienced by disadvantaged populations of Rio de Janeiro. Policy efforts are needed to reduce social inequalities in health in this city, especially among the elderly.

  20. Perceived Life Expectancy Is Associated with Colorectal Cancer Screening in England.

    PubMed

    Kobayashi, Lindsay C; von Wagner, Christian; Wardle, Jane

    2017-06-01

    Cancer screening is a behavior that represents investment in future health. Such investment may depend on how much 'future' a person expects. The purpose of this study was to investigate the prospective association between perceived personal life expectancy and participation in fecal occult blood test screening for colorectal cancer (CRC) in a national program. Data were from interviews with 3975 men and women in the English Longitudinal Study of Ageing (ELSA) within the eligible age range for the national screening program (60 to 74 years). Perceived life expectancy was indexed as the individual's estimate of their chance of living another 10-15 years (exact time varied by age), assessed in 2008/2009. Participation in CRC screening from 2010 to 2012/2013 was assessed in 2012/2013. Logistic regression was used to estimate the association between perceived life expectancy and screening participation, adjusted for numeracy and known mortality risk factors. Overall, 71% of respondents (2817/3975) reported completing at least one fecal occult blood test (FOBt) during the follow-up. Screening uptake was 76% (1272/1683) among those who estimated their 10-15-year life expectancy as 75-100%, compared with 52% (126/243) among those who estimated theirs as 0-25% (adjusted OR 1.74, 95% CI 1.29-2.34). A longer perceived life expectancy is associated with greater likelihood of participating in CRC screening in England. However, half of people with a low perceived life expectancy still participated in screening. Given that CRC screening is recommended for adults with a remaining life expectancy of ≥10 years, future research should investigate how to communicate the aims of screening more effectively.

  1. Characterization of dementia and Alzheimer's disease in an older population: updated incidence and life expectancy with and without dementia.

    PubMed

    Tom, Sarah E; Hubbard, Rebecca A; Crane, Paul K; Haneuse, Sebastien J; Bowen, James; McCormick, Wayne C; McCurry, Susan; Larson, Eric B

    2015-02-01

    We estimated dementia incidence rates, life expectancies with and without dementia, and percentage of total life expectancy without dementia. We studied 3605 members of Group Health (Seattle, WA) aged 65 years or older who did not have dementia at enrollment to the Adult Changes in Thought study between 1994 and 2008. We estimated incidence rates of Alzheimer's disease and dementia, as well as life expectancies with and without dementia, defined as the average number of years one is expected to live with and without dementia, and percentage of total life expectancy without dementia. Dementia incidence increased through ages 85 to 89 years (74.2 cases per 1000 person-years) and 90 years or older (105 cases per 1000 person-years). Life expectancy without dementia and percentage of total life expectancy without dementia decreased with age. Life expectancy with dementia was longer in women and people with at least a college degree. Percentage of total life expectancy without dementia was greater in younger age groups, men, and those with more education. Efforts to delay onset of dementia, if successful, would likely benefit older adults of all ages.

  2. The maximum life expectancy for a micro-fabricated diaphragm

    NASA Astrophysics Data System (ADS)

    Cǎlimǎnescu, Ioan; Stan, Liviu-Constantin; Popa, Viorica

    2015-02-01

    Micro-fabricated diaphragms can be used to provide pumping action in microvalve and microfluidic applications. The functionality of the microdiaphragm in a wirelessly actuated micropump plays a major role in low-powered device actuation. In developing micropumps and their components, it is becoming an increasing trend to predict the performance before the prototype is fabricated. Because performance prediction allows for an accurate estimation of yield and lifetime, in addition to developing better understanding of the device while taking into account the details of the device structure and second order effects. Hence avoid potential pitfalls in the device operation in a practical environment. The goal of this research is to determine via FEA the life expectancy for a corrugated circular diaphragm made out of an aluminum alloy. The geometry of the diaphragm is given below being generated within SolidWorks 2010, all the calculations were made using Ansys 13TM . The sound design of a micropump is heavily depending on the lifetime expectancy of the working part of the device which is the diaphragm. This will be subjected on cyclic loading and the fatigue will limit the life of this part. Once the diaphragm is breaking, the micropump is no more able to fulfill its scope. Any micropump manufacturer will then be very concerned on the life expectancy from the fatigue point of view of the diaphragms. The diaphragm circular and corrugated and made of Al alloy, showed a very good behavior from the fatigue point of view, the maximum life expectancy being 1.9 years of continuous functioning with 100 cycles per second. This work showed an simple and forward application of FEA analysis methods in order to estimate the fatigue behavior of corrugated circular microdiaphragms.

  3. [Live longer, suffer more? Trends in life expectancy and health].

    PubMed

    Doblhammer, G; Kreft, D

    2011-08-01

    During the 20th century, life expectancy has been continuously increasing with the majority of the additional years resulting from decreasing mortality among the old and oldest old in the last few decades. Two phases of convergence and divergence in European mortality have been identified, with a possible new phase of divergence taking place among the oldest old. Over this period, women have always been living longer than men. Explanations for this phenomenon include not only biological factors and differences in lifestyle and health care utilization, but also differences in reporting patterns. Trends in health do not follow a clear direction. Reasons are the different dimensions of health as well as inadequate data. In general, the prevalence of morbidity has been increasing, while functional limitations and ADL disabilities have been decreasing. Due to a lack of data, no information exists for trends among the oldest old at age 80 and above. In absolute terms, the number of healthy years has been increasing with increasing life expectancy. In relative terms, they have been stable, probably slightly increasing in some countries. These trends suggest that increasing life expectancy does not result in an increase in morbidity.

  4. Life expectancy with chronic kidney disease: an educational review.

    PubMed

    Neild, Guy H

    2017-02-01

    Can renal prognosis and life expectancy be accurately predicted? Increasingly, the answer is yes. The natural history of different forms of renal disease is becoming clearer; the degree of reduction in glomerular filtration rate (GFR) and the magnitude of proteinuria are strong predictors of renal outcome. Actuarial data on life expectancy from the start of renal replacement therapy are available from renal registries such as the U.S. Renal Data System (USRDS), and the UK Renal Registry. Recently, similar data have become available for patients with chronic kidney disease. Data collected from a large population-based registry in Alberta, Canada and stratified for different levels of estimated GFR (eGFR) have shown that the reduction in life expectancy with kidney failure is not a uremic event associated with starting dialysis but a continuous process that is evident from an eGFR of ≤60 ml/min. Nevertheless, despite the poor prognosis of the last stages of renal failure, progress in the treatment and management of these patients and, in particular, of their cardiovascular risk factors continues to improve long-term outcome.

  5. Political and social determinants of life expectancy in less developed countries: a longitudinal study

    PubMed Central

    2012-01-01

    Background This study aimed to examine the longitudinal contributions of four political and socioeconomic factors to the increase in life expectancy in less developed countries (LDCs) between 1970 and 2004. Methods We collected 35 years of annual data for 119 LDCs on life expectancy at birth and on four key socioeconomic indicators: economy, measured by log10 gross domestic product per capita at purchasing power parity; educational environment, measured by the literacy rate of the adult population aged 15 years and over; nutritional status, measured by the proportion of undernourished people in the population; and political regime, measured by the regime score from the Polity IV database. Using linear mixed models, we analyzed the longitudinal effects of these multiple factors on life expectancy at birth with a lag of 0-10 years, adjusting for both time and regional correlations. Results The LDCs' increases in life expectancy over time were associated with all four factors. Political regime had the least influence on increased life expectancy to begin with, but became significant starting in the 3rd year and continued to increase, while the impact of the other socioeconomic factors began strong but continually decreased over time. The combined effects of these four socioeconomic and political determinants contributed 54.74% - 98.16% of the life expectancy gains throughout the lag periods of 0-10 years. Conclusions Though the effect of democratic politics on increasing life expectancy was relatively small in the short term when compared to the effects of the other socioeconomic factors, the long-term impact of democracy should not be underestimated. PMID:22280469

  6. What happened to life expectancy in Spain in the 1980s?

    PubMed Central

    Chenet, L; McKee, M; Otero, A; Ausin, I

    1997-01-01

    BACKGROUND: Life expectancy at birth in Spain improved between 1972 and 1982, by 2.5 years for males and 3.2 years for females. This slowed considerably in the following decade, with increases of only 0.5 and 1.7 years respectively. OBJECTIVE: To determine the causes of death that have been responsible for the failure by Spain to maintain in the 1980s and 1990s the rate of improvement in life expectancy seen during the 1970s. DESIGN: Data from WHO mortality tapes grouped in a series of clinically meaningful categories were used to calculate the contribution of each category, in five year age groups, to the changing life expectancy at birth in the two periods. SETTING: Spain. RESULTS: The trend in life expectancy at birth in Spain over this 20 year period can be considered to have two components, both with important consequences for public health policy. Underlying trends include a steady negative contribution from respiratory cancer in men and a reduction in cardiovascular disease. More recent trends include a considerable deterioration in deaths among young adults, most notably from accidents and, possibly, AIDS. CONCLUSION: The failure to maintain the rate of earlier gains in life expectancy in Spain can be attributed largely to a few conditions, although these may indicate less obvious underlying problems. These findings have important consequences for prioritising public health policies. PMID:9425460

  7. Life expectancy of the 20th century Venda: a compilation of skeletal and cemetery data.

    PubMed

    L'Abbé, E N; Steyn, M; Loots, M

    2008-01-01

    Little information is available on the 20th century mortality rates of rural black South African groups, such as the Venda. The purpose of this study was to apply abridged life tables in order to estimate life expectancy from both skeletal remains and death registry information of modern South African communities. Comparisons were also made with prehistoric and contemporary groups as a means to better evaluate life expectancy for this time period. The sample consisted of 160 skeletons of known Venda origin and burial registry information for 1364 black South Africans from the Rebecca Street and Mamelodi Cemeteries in Pretoria, South Africa. Standard anthropological techniques were applied to determine sex and estimate age from the skeletal remains. The stationary and non-stationary life table models were used to analyse the data. A high rate of child mortality, low juvenile and adult mortality with a steady increase in mortality after the age of 30 years was observed for both the Venda and the cemetery samples. Throughout the 20th century, life expectancy was shown to increase for black South Africans. However, due to the widespread HIV infection/AIDS of the 21st century, infant and young adult mortality rates continue to rise at such a speed that the decline in mortality seen for South Africans in the last 50 years will most likely to be lost in the next decade due to this disease.

  8. Bayesian Probabilistic Projections of Life Expectancy for All Countries

    PubMed Central

    Raftery, Adrian E.; Chunn, Jennifer L.; Gerland, Patrick; Ševčíková, Hana

    2014-01-01

    We propose a Bayesian hierarchical model for producing probabilistic forecasts of male period life expectancy at birth for all the countries of the world from the present 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 did 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 ten years. The ten-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. PMID:23494599

  9. Bayesian probabilistic projections of life expectancy for all countries.

    PubMed

    Raftery, Adrian E; Chunn, Jennifer L; Gerland, Patrick; Sevčíková, Hana

    2013-06-01

    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.

  10. Mobility, continence, and life expectancy in persons with Asia Impairment Scale Grade D spinal cord injuries.

    PubMed

    Shavelle, Robert M; Paculdo, David R; Tran, Linh M; Strauss, David J; Brooks, Jordan C; DeVivo, Michael J

    2015-03-01

    Previous research on the life expectancy of persons with American Spinal Injury Association (ASIA) Impairment Scale Grade D spinal cord injury has considered them as a large homogenous group, making no functional or medical distinctions. This study sought to (1) determine how survival in this group depends on ambulatory function and the extent of bowel or bladder dysfunction, (2) compute life expectancies for various subgroups, and (3) examine whether survival has improved over time. Data were from 8,206 adults with ASIA Impairment Scale Grade D spinal cord injury in the Spinal Cord Injury Model Systems database who were not ventilator dependent and who survived more than 1 yr after injury. There were a total of 114,739 person-years of follow-up and 1,730 deaths during the 1970-2011 study period. Empirical age- and sex-specific mortality rates were computed. Regression analysis of survival data with time-dependent covariates was used to determine the effect of risk factors, to test for a time trend, and to estimate mortality rates for subgroups. Life expectancies were obtained from life tables constructed for each subgroup. The ability to walk, whether independently or with an assistive device, was associated with longer survival than wheelchair dependence. The need for an indwelling catheter, and to a lesser extent intermittent catheterization, was associated with increased mortality risk. Persons who walked unaided and who did not require catheterization had life expectancies roughly 90% of normal. Those who required a wheelchair for locomotion had life expectancies comparable with that in paraplegia, less than 75% of normal. No time trend in survival was found. Life expectancy of persons with ASIA Impairment Scale D spinal cord injury depends strongly on the ability to walk and the need for catheterization.

  11. Estimation of life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for schizophrenia in Taiwan.

    PubMed

    Lêng, Chhian Hūi; Chou, Ming Hui; Lin, Sheng-Hsiang; Yang, Yen Kuang; Wang, Jung-Der

    2016-03-01

    By employing a novel semi-parametric extrapolation method, the life expectancies after the first hospitalization for schizophrenia and the associated lifetime healthcare expenditures were both estimated. Based on the linkage between the National Health Insurance Research Database and the National Mortality Registry of Taiwan, we have established a schizophrenic cohort for 2000-2010 and followed up to 2011. Survival function was estimated through Kaplan-Meier's method and extrapolated throughout life. We applied a simple linear regression to the logit-transformed survival ratio between the schizophrenic cohort and the sex-, age-matched referents via Monte Carlo simulation from the national life table. The monthly survival probability was multiplied by the average healthcare expenditures and summed throughout life to estimate the lifelong cost reimbursed by the National Health Insurance. The results showed that patients diagnosed at age 20-29 had the highest expected years of life lost (EYLL), 15 and 9years, in men and women, respectively, with corresponding lifetime healthcare expenditures of USD 48,000 and 53,000. Males generally had higher health cost per life-year than their female counterparts across their lifespan. We applied the same method to the first 6years of the cohort and extrapolated to 12years, which showed that the relative biases for different age strata were less than 5%. We thus concluded that the semi-parametric extrapolation method might provide a timely estimation of lifetime outcomes for health care planning of schizophrenia. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  12. Predicting Life Expectancy for Pirfenidone in Idiopathic Pulmonary Fibrosis.

    PubMed

    Fisher, Mark; Nathan, Steven D; Hill, Christian; Marshall, Jade; Dejonckheere, Fred; Thuresson, Per-Olof; Maher, Toby M

    2017-03-01

    Conducting an adequately powered survival study in idiopathic pulmonary fibrosis (IPF) is challenging due to the rare nature of the disease and the need for extended follow-up. Consequently, registration trials of IPF treatments have not been designed to estimate long-term survival. To predict life expectancy for patients with IPF receiving pirfenidone versus best supportive care (BSC) in a population that met the inclusion criteria of patients enrolled in the ASCEND and CAPACITY trials. Kaplan-Meier survival data for pirfenidone and BSC were obtained from randomized controlled clinical studies (CAPACITY, ASCEND), an open-label extension study (RECAP), and the Inova Fairfax Hospital database. Data from the Inova registry were matched to the inclusion criteria of the CAPACITY and ASCEND trials. Life expectancy was estimated by the area under the curve of parametric survival distributions fit to the Kaplan-Meier data. Mean (95% confidence interval) life expectancy was calculated as 8.72 (7.65-10.15) years with pirfenidone and 6.24 (5.38-7.18) years with BSC. Therefore, pirfenidone improved life expectancy by 2.47 (1.26-4.17) years compared with BSC. In addition, treatment with pirfenidone recuperated 25% of the expected years of life lost due to IPF. Sensitivity analyses found that results were sensitive to the choice of parametric survival distribution, and alternative piecewise and parametric approaches. This analysis suggests that this population of patients with IPF has an improved life expectancy if treated with pirfenidone compared with BSC. This study was funded by InterMune International AG, a wholly owned Roche subsidiary since 2014. Fisher was previously employed by InterMune UK, a wholly owned Roche subsidiary, until July 2015. He is currently employed by FIECON, which has received funding from F. Hoffmann-La Roche for consulting services. Nathan has received consulting fees from Roche-Genentech and Boehringer Ingelheim. He is also on the speakers' bureau

  13. Life Expectancy and its Socioeconomic Determinants in Iran

    PubMed Central

    Delavari, Somayeh; Zandian, Hamed; Rezaei, Satar; Moradinazar, Mehdi; Delavari, Sajad; Saber, Ali; Fallah, Razieh

    2016-01-01

    Introduction Life expectancy at birth (LEB) is closely associated with the degree of economic and social development in developed and developing countries. This study aimed to examine the socioeconomic factors affecting LEB in Iran from 1985 to 2013. Methods Time series analysis was used to examine the effects of key explanatory factors (GDP per capita, number of doctors per 10,000 population, degree of urbanization, food availability, CO2 emission, total fertility rate, inflation rate, and literacy rate) on LEB in Iran from 1985 to 2013. Study data were retrieved from the Central Bank of Iran (CBI), Iranian Statistical Center (ISC), and World Bank. Augmented Dickey Fuller (ADF) and Banergy, Dolado, and Master (BDM) tests, Engle Granger approach, and an ordinary least-square (OLS) model were used to achieve the aim of the study. Data analysis was performed by Stata V.12 software. Results Our findings indicated that GDP per capita (p=0.003), number of doctors per 10,000 population (p=0.036), literacy rate (p=0.0001), and food availability (p=0.0001) have a positive and significant statistically effect on LEB. The relationship between total fertility rate and LEB was negative and significant (p=0.023). In addition, the effect of degree urbanization (p=0.811), CO2 emission (p=0.185), and inflation rate (p=0.579) on LEB were not significant. Conclusion GDP per capita, number of doctors per 10,000 population, food availability, literacy rate, and total fertility were identified as the main factors affecting life expectancy in Iran. The study, however, suggests that life expectancy in Iran could be improved if attention is given to factors that reside outside of the health sector. PMID:27957304

  14. Prediction of life expectancy in patients with spinal epidural metastasis

    PubMed Central

    Bartels, Ronald H.M.A.; de Ruiter, Godard; Feuth, Ton; Arts, Mark P.

    2016-01-01

    Background The treatment of spinal epidural metastasis is multidisciplinary and usually involves a team of medical oncologists, radiologists, radiotherapists, and spinal surgeons. Life expectancy is one of the factors considered when deciding whether surgery is warranted. Because expert estimates of life expectancy are generally not reliable, a prediction model is needed. Here, we temporally validated a model that was previously validated geographically. Methods The records of 110 consecutive patients who were referred with a spinal epidural metastasis were collected prospectively from 2009 to 2013 in order to validate the model, which was published in 2011. The actual and estimated life expectancies were represented graphically, and calibration and discrimination were determined. The calibration slope, Harrell's c-index, D, and RD2 were calculated. Hazard ratios in the derivation set of 2011 were compared with the validation set. Misspecification was determined using the joint test for β*. Results The calibration slope was 0.64 ± 0.15 (95% CI: 0.34–0.94), Harrell's c-index was 0.72, D was 1.08, and RD2 was 0.22, indicating slightly worse discrimination in the derivation set. The joint test for β* = 0 was statistically significant and indicated misspecification; however, this misspecification was attributed entirely to the surgical group. Conclusions We validated a prediction model for surgical decision making, showing that the model's overall performance is good. Based on these results, this model will help clinicians to decide whether to offer surgery to patients with spinal epidural metastasis. PMID:26254478

  15. Life Expectancy and its Socioeconomic Determinants in Iran.

    PubMed

    Delavari, Somayeh; Zandian, Hamed; Rezaei, Satar; Moradinazar, Mehdi; Delavari, Sajad; Saber, Ali; Fallah, Razieh

    2016-10-01

    Life expectancy at birth (LEB) is closely associated with the degree of economic and social development in developed and developing countries. This study aimed to examine the socioeconomic factors affecting LEB in Iran from 1985 to 2013. Time series analysis was used to examine the effects of key explanatory factors (GDP per capita, number of doctors per 10,000 population, degree of urbanization, food availability, CO2 emission, total fertility rate, inflation rate, and literacy rate) on LEB in Iran from 1985 to 2013. Study data were retrieved from the Central Bank of Iran (CBI), Iranian Statistical Center (ISC), and World Bank. Augmented Dickey Fuller (ADF) and Banergy, Dolado, and Master (BDM) tests, Engle Granger approach, and an ordinary least-square (OLS) model were used to achieve the aim of the study. Data analysis was performed by Stata V.12 software. Our findings indicated that GDP per capita (p=0.003), number of doctors per 10,000 population (p=0.036), literacy rate (p=0.0001), and food availability (p=0.0001) have a positive and significant statistically effect on LEB. The relationship between total fertility rate and LEB was negative and significant (p=0.023). In addition, the effect of degree urbanization (p=0.811), CO2 emission (p=0.185), and inflation rate (p=0.579) on LEB were not significant. GDP per capita, number of doctors per 10,000 population, food availability, literacy rate, and total fertility were identified as the main factors affecting life expectancy in Iran. The study, however, suggests that life expectancy in Iran could be improved if attention is given to factors that reside outside of the health sector.

  16. A Unifying Framework for Assessing Changes in Life Expectancy Associated with Changes in Mortality: The Case of Violent Deaths*

    PubMed Central

    Beltrán-Sánchez, Hiram; Soneji, Samir

    2011-01-01

    For over forty years, demographers have worked intensely to develop methods that assess the gain in life expectancy from a reduction in mortality, either hypothetical or observed. This considerable body of research was motivated by assessing the gains in life expectancy when mortality declined in a particular manner and determining the contribution of a cause of death in observed changes in life expectancy over time. As yet, there has been no framework unifying this important demographic work. In this paper, we provide a unifying framework for assessing the change in life expectancy given a change in age and cause-specific mortality. We consider both conceptualizations of mortality change–counterfactual assessment of a hypothetical change and a retrospective assessment of an observed change. We apply our methodology to violent deaths, the leading cause of death among young adults, and show that realistic targeted reductions could have important impacts on life expectancy. PMID:21609727

  17. [Live longer and better? Estimates of healthy life expectancy in the Brazilian population].

    PubMed

    Camargos, Mirela Castro Santos; Gonzaga, Marcos Roberto

    2015-07-01

    This study analyzed differences in healthy life expectancy in the elderly based on three health dimensions in Brazil from 1998 to 2008: disability-free life expectancy, healthy life expectancy based on self-rated health, and chronic disease-free life expectancy. The Sullivan method was used, combining life tables from the Brazilian Institute of Geography and Statistics (IBGE) and interval estimates of the prevalence of functional disability, self-rated health, and chronic diseases according to the Brazilian National Household Sample Survey (PNAD, 1998 and 2008). Besides the increase in life expectancy, the study showed significant and similar increases in disability-free life expectancy and healthy life expectancy based on self-rated health at almost all ages. Women had higher life expectancies than men, but expected to live longer with poor health, regardless of the indicator used to measure health. Although the studies measured health differently (making comparisons difficult), women showed a consistent disadvantage in healthy life expectancy.

  18. The influence of intellectual disability on life expectancy.

    PubMed

    Bittles, A H; Petterson, B A; Sullivan, S G; Hussain, R; Glasson, E J; Montgomery, P D

    2002-07-01

    To date, relatively few representative data have been available to health planners and advocacy groups on the life expectancy of people with intellectual disability. A study of trends in the survival profiles of people with intellectual disability was undertaken to assist in the planning of appropriate medical and support services. Since 1953, the Disability Services Commission of Western Australia has maintained a database of persons diagnosed with intellectual disability. The database was used to calculate survival probabilities on a total of 8724 individuals, 7562 of whom were still alive at the time of sampling in December 2000. Kaplan-Meier survival plots showed a strong negative association between severity of intellectual disability and survival, with median life expectancies of 74.0, 67.6, and 58.6 years for people with mild, moderate, and severe levels of handicap. Significant negative associations also were observed with male gender, Indigenous Australian parentage, and individuals diagnosed with a specific genetic disorder. The findings indicate a major and expanding increase in the service requirements of this aging, intellectually disabled population during the past two generations.

  19. The Exceptionally High Life Expectancy of Costa Rican Nonagenarians

    PubMed Central

    ROSERO-BIXBY, LUIS

    2008-01-01

    Robust data from a voter registry show that Costa Rican nonagenarians have an exceptionally high live expectancy. Mortality at age 90 in Costa Rica is at least 14% lower than an average of 13 high-income countries. This advantage increases with age by 1% per year. Males have an additional 12% advantage. Age-90 life expectancy for males is 4.4 years, one-half year more than any other country in the world. These estimates do not use problematic data on reported ages, but ages are computed from birth dates in the Costa Rican birth-registration ledgers. Census data confirm the exceptionally high survival of elderly Costa Ricans, especially males. Comparisons with the United States and Sweden show that the Costa Rican advantage comes mostly from reduced incidence of cardiovascular diseases, coupled with a low prevalence of obesity, as the only available explanatory risk factor. Costa Rican nonagenarians are survivors of cohorts that underwent extremely harsh health conditions when young, and their advantage might be just a heterogeneity in frailty effect that might disappear in more recent cohorts. The availability of reliable estimates for the oldest-old in low-income populations is extremely rare. These results may enlighten the debate over how harsh early-life health conditions affect older-age mortality. PMID:18939667

  20. Decreases in diabetes-free life expectancy in the U.S. and the role of obesity.

    PubMed

    Cunningham, Solveig A; Riosmena, Fernando; Wang, Jing; Boyle, James P; Rolka, Deborah B; Geiss, Linda S

    2011-10-01

    With increasing life expectancy in the U.S., it is important to know whether a longer life expectancy means a longer healthy life span or a prolonged period of later-life morbidity. This study examines changes in lifetime without diabetes, a leading cause of morbidity in later life. Using demographic methods and nationally representative data, we estimated changes in diabetes-free life expectancy between 1980-1989 and 2000-2004 for adult men and women in the U.S., estimated the contribution of changes in age-specific diabetes rates, and examined the changing effects of weight status on diabetes risks. While life expectancy at age 18 for men and women increased between the 1980s and the 2000s, diabetes-free life expectancy at age 18 decreased by 1.7 years for men and 1.5 years for women. The proportion of 18-year-olds who would develop diabetes in their lifetimes increased by almost 50% among women and almost doubled among men. Obese individuals experienced the greatest losses in diabetes-free life expectancy during this period, estimated at 5.6 years for men and 2.5 years for women. Diabetes-free life expectancy decreased for both men and women between 1980-1989 and 2000-2004, and these decreases are almost entirely attributable to large increases in diabetes incidence among obese individuals.

  1. Gender differences in life expectancy among kibbutz members.

    PubMed

    Leviatan, U; Cohen, J

    1985-01-01

    A literature review of findings reveals that the life expectancy (LE) of females is longer than that of males and that a strong relationship exists between LE and gender differences in LE. The arguments of biological vs societal reasons for such gender differences are presented and the kibbutz society is offered as a setting to test the rivaling hypotheses. It is argued that the kibbutz society offers more similar roles for both genders than outside the kibbutz and therefore the gender differences in LE should be reduced in comparison to what is expected, given the very high LE of kibbutz members. Statistical data of the kibbutz population between the years 1975-1980 are analyzed and the results support the following conclusions: female members have higher LE but the difference is much less than expected on the basis of a regression analysis of data from 73 societies; the difference is smaller due to the relatively higher gain in LE by males; the gender differences are even smaller at age 50 compared to LE differences at birth. The Discussion section dwells upon interpretations of the findings and argues against alternative interpretations that assume selection processes for the kibbutz population. Suggestions for further studies are also made.

  2. Persistent social inequality in life expectancy and disability-free life expectancy: Outlook for a differential pension age in Denmark?

    PubMed

    Brønnum-Hansen, Henrik; Eriksen, Mette Lindholm; Andersen-Ranberg, Karen; Jeune, Bernard

    2017-06-01

    The state old-age pension in Denmark increases to keep pace with the projected increase in average life expectancy (LE) without any regard to the social gap in LE and expected lifetime in good health. The purpose of this study was to compare changes in LE and disability-free life expectancy (DFLE) between groups of Danes with high, medium and low levels of education. Nationwide register data on education and mortality were combined with data from the Surveys of Health, Ageing and Retirement in Europe (SHARE) surveys in 2006-2007, 2010-2011 and 2013-2014 and the DFLE by educational level was estimated by Sullivan's method for each of these three time points. Between 2006-2007 and 2013-2014, LE among 65-year-old men and women with a low educational level increased by 1.3 and 1.0 years, respectively, and by 1.4 and 1.3 years for highly educated men and women. The gap in LE between people with high and low levels of education remained more than 2 years. In 2006-2007, 65-year-old men with a high level of education could expect 3.2 more years without disability than men of the same age with a low level of education. In 2013-2014, the difference was 2.9 years. For women, the results were 3.7 and 3.4 years, respectively. With the persistent social inequality in LE of more than 2 years and the continuous gap between high and low educational groups in DFLE of about 3 years, a differential pension age is recommended.

  3. Care provision expectations of remote adult children of ageing parents.

    PubMed

    Veil, Klaus D; Soar, Jeffrey; Su, Ying

    2013-01-01

    The expectations of adult children about their elderly parents regarding their care provision was surveyed. We found that the needs and expectations regarding their elderly parents included better information on entitlements of their parents, how to access relevant aged care services, the challenges of remotely dealing with dementia and depression of their parents, accessing medical and non-medical services and access to respite care. The aim was to identify needs that ICTs could potential to assist with. While the majority of respondents (67.2%) stated that they were satisfied or very satisfied with the frequency of contact with their elderly parent(s), they also cited logistical/transport difficulties, lack of time and stress as potential barriers in being in regular contact with their parents. The responses also indicated a high level of interest in a service that could act as a case manager to assist the adult child in discharging their responsibilities, manage access to services and to monitor the well-being of the parent. There is a need for further research to explore how this might be accomplished, whether such a service was viable and what funding models could be applied.

  4. Resolving the life cycle alters expected impacts of climate change.

    PubMed

    Levy, Ofir; Buckley, Lauren B; Keitt, Timothy H; Smith, Colton D; Boateng, Kwasi O; Kumar, Davina S; Angilletta, Michael J

    2015-08-22

    Recent models predict contrasting impacts of climate change on tropical and temperate species, but these models ignore how environmental stress and organismal tolerance change during the life cycle. For example, geographical ranges and extinction risks have been inferred from thermal constraints on activity during the adult stage. Yet, most animals pass through a sessile embryonic stage before reaching adulthood, making them more susceptible to warming climates than current models would suggest. By projecting microclimates at high spatio-temporal resolution and measuring thermal tolerances of embryos, we developed a life cycle model of population dynamics for North American lizards. Our analyses show that previous models dramatically underestimate the demographic impacts of climate change. A predicted loss of fitness in 2% of the USA by 2100 became 35% when considering embryonic performance in response to hourly fluctuations in soil temperature. Most lethal events would have been overlooked if we had ignored thermal stress during embryonic development or had averaged temperatures over time. Therefore, accurate forecasts require detailed knowledge of environmental conditions and thermal tolerances throughout the life cycle.

  5. Increased Life Expectancy in New York City, 2001-2010: An Exploration by Cause of Death and Demographic Characteristics.

    PubMed

    Li, Wenhui; Maduro, Gil A; Begier, Elizabeth M

    2016-01-01

    New York City's (NYC's) life expectancy gains have been greater than those seen nationally. We examined life-expectancy changes over the past decade in selected NYC subpopulations and explored which age groups and causes of death contributed most to the increases. We calculated life expectancy with 95% confidence intervals (CIs) for 2001-2010 by sex and race/ethnicity. Life expectancy was decomposed by age group and cause of death. Logistic regressions were conducted to reinforce the results from decomposition by controlling confounders. Overall, NYC residents' life expectancy at birth increased from 77.9 years (95% CI, 77.8-78.0) in 2001 to 80.9 years (95% CI, 80.8-81.0) in 2010. Decreases in deaths from heart disease, cancer, and HIV disease accounted for 50%, 16%, and 11%, respectively, of the gains. Decreased mortality in older age groups (≥65 years) accounted for 45.6% of the overall change. Life expectancy increased for both sexes, across all racial/ethnic groups, and for both the US-born and the foreign-born. Disparities in life expectancy decreased as overall life expectancy increased. Decreased mortality among older adults and from heart disease, cancer, and HIV infection accounted for most of the increases.

  6. Comparative study of disability-free life expectancy across six low- and middle-income countries.

    PubMed

    Chirinda, Witness; Chen, He

    2017-04-01

    There is a knowledge gap about the disability-free life expectancy (DFLE) in low- and middle-income countries. The present study aimed to compute and compare DFLE in six such countries, and examine sex differences in DFLE in each country. Based on data from the World Health Organization Study on Global Aging and Adult Health wave 1 survey, we used the Sullivan method to estimate DFLE among persons aged years 50 years and older. Disability was divided into moderate disability and severe disability during the calculation. Of the six countries, China had the highest DFLE and lowest expected average lifetime with disability. India had the lowest DFLE and highest life years with moderate and severe disability. In each country, women live longer than men, but with more disabilities in both absolute and proportional terms. The huge sex difference in Russia requires special attention. In addition, most of the life expectancy lived with disability was spent with severe disability, rather than moderate disability. The study has shed some light on the disparities across the six countries with regard to DFLE at old ages. The low percentage of DFLE in life expectancy in some countries, such as India, calls for effective policies on healthy aging. The "sex disability-survival paradox" in DFLE is supported by our results. To differentiate the severity of disability should be routine in calculating DFLE. Geriatr Gerontol Int 2017; 17: 637-644. © 2016 Japan Geriatrics Society.

  7. Life expectancy and life expectancy with disability of normal weight, overweight, and obese smokers and nonsmokers in Europe.

    PubMed

    Majer, Istvan M; Nusselder, Wilma J; Mackenbach, Johan P; Kunst, Anton E

    2011-07-01

    The goal of this study was to estimate life expectancy (LE) and LE with disability (LwD) among normal weight, overweight, and obese smokers and nonsmokers in Western Europe. Data from four waves (1998-2001) of the European Community Household Panel (ECHP) were used; a standardized multipurpose annual longitudinal survey. Self-reported health and socioeconomic information was collected repeatedly using uniform questionnaires for 66,331 individuals in nine countries. Health status was measured in terms of disability in daily activities. Multistate Markov (MSM) models were applied to obtain hazard ratios (HRs) and age-specific transition rates according to BMI and smoking status. Multistate life tables were computed using the predicted transition probabilities to estimate LE and LwD. Significant associations were observed between disability incidence and BMI (HR = 1.15 for overweight, HR = 1.64 for obese, compared to normal weight). The risk of mortality was negatively associated with overweight status among disabled (HR = 0.77). Overweight people had higher LE than people with normal-weight and obesity. Among women, overweight and obese nonsmokers expect 3.6 and 6.1 more years of LwD than normal weight persons, respectively. In contrast, daily smokers expect lower LE but a similar LwD. The same patterns were observed among people with high education and those with low education. To conclude, daily smoking is associated with mortality more than with disability, whereas obesity is associated with disability more than with mortality. The findings suggest that further tobacco control would contribute to increasing LE, while tackling the obesity epidemic is necessary to prevent an expansion of disability.

  8. Adolescent expectations of early death predict adult risk behaviors.

    PubMed

    Nguyen, Quynh C; Villaveces, Andres; Marshall, Stephen W; Hussey, Jon M; Halpern, Carolyn T; Poole, Charles

    2012-01-01

    Only a handful of public health studies have investigated expectations of early death among adolescents. Associations have been found between these expectations and risk behaviors in adolescence. However, these beliefs may not only predict worse adolescent outcomes, but worse trajectories in health with ties to negative outcomes that endure into young adulthood. The objectives of this study were to investigate perceived chances of living to age 35 (Perceived Survival Expectations, PSE) as a predictor of suicidal ideation, suicide attempt and substance use in young adulthood. We examined the predictive capacity of PSE on future suicidal ideation/attempt after accounting for sociodemographics, depressive symptoms, and history of suicide among family and friends to more fully assess its unique contribution to suicide risk. We investigated the influence of PSE on legal and illegal substance use and varying levels of substance use. We utilized the National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994-95 among 20,745 adolescents in grades 7-12 with follow-up interviews in 1996 (Wave II), 2001-02 (Wave III) and 2008 (Wave IV; ages 24-32). Compared to those who were almost certain of living to age 35, perceiving a 50-50 or less chance of living to age 35 at Waves I or III predicted suicide attempt and ideation as well as regular substance use (i.e., exceeding daily limits for moderate drinking; smoking ≥ a pack/day; and using illicit substances other than marijuana at least weekly) at Wave IV. Associations between PSE and detrimental adult outcomes were particularly strong for those reporting persistently low PSE at both Waves I and III. Low PSE at Wave I or Wave III was also related to a doubling and tripling, respectively, of death rates in young adulthood. Long-term and wide-ranging ties between PSE and detrimental outcomes suggest these expectations may contribute to identifying at-risk youth.

  9. Adolescent Expectations of Early Death Predict Adult Risk Behaviors

    PubMed Central

    Nguyen, Quynh C.; Villaveces, Andres; Marshall, Stephen W.; Hussey, Jon M.; Halpern, Carolyn T.; Poole, Charles

    2012-01-01

    Only a handful of public health studies have investigated expectations of early death among adolescents. Associations have been found between these expectations and risk behaviors in adolescence. However, these beliefs may not only predict worse adolescent outcomes, but worse trajectories in health with ties to negative outcomes that endure into young adulthood. The objectives of this study were to investigate perceived chances of living to age 35 (Perceived Survival Expectations, PSE) as a predictor of suicidal ideation, suicide attempt and substance use in young adulthood. We examined the predictive capacity of PSE on future suicidal ideation/attempt after accounting for sociodemographics, depressive symptoms, and history of suicide among family and friends to more fully assess its unique contribution to suicide risk. We investigated the influence of PSE on legal and illegal substance use and varying levels of substance use. We utilized the National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994–95 among 20,745 adolescents in grades 7–12 with follow-up interviews in 1996 (Wave II), 2001–02 (Wave III) and 2008 (Wave IV; ages 24–32). Compared to those who were almost certain of living to age 35, perceiving a 50–50 or less chance of living to age 35 at Waves I or III predicted suicide attempt and ideation as well as regular substance use (i.e., exceeding daily limits for moderate drinking; smoking ≥ a pack/day; and using illicit substances other than marijuana at least weekly) at Wave IV. Associations between PSE and detrimental adult outcomes were particularly strong for those reporting persistently low PSE at both Waves I and III. Low PSE at Wave I or Wave III was also related to a doubling and tripling, respectively, of death rates in young adulthood. Long-term and wide-ranging ties between PSE and detrimental outcomes suggest these expectations may contribute to identifying at-risk youth. PMID:22870260

  10. How slowing senescence translates into longer life expectancy.

    PubMed

    Goldstein, Joshua R; Cassidy, Thomas

    2012-03-01

    Mortality decline has historically been largely a result of reductions in the level of mortality at all ages. A number of leading researchers on ageing, however, suggest that the next revolution of longevity increase will be the result of slowing down the rate of ageing. In this paper, we show mathematically how varying the pace of senescence influences life expectancy. We provide a formula that holds for any baseline hazard function. Our result is analogous to Keyfitz's 'entropy' relationship for changing the level of mortality. Interestingly, the influence of the shape of the baseline schedule on the effect of senescence changes is the complement of that found for level changes. We also provide a generalized formulation that mixes level and slope effects. We illustrate the applicability of these models using recent mortality decline in Japan and the problem of period to cohort translation.

  11. Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy

    PubMed Central

    Stewart, Susan T.; Cutler, David M.; Rosen, Allison B.

    2015-01-01

    Background Although increases in obesity over the past 30 years have adversely affected the health of the U.S. population, there have been concomitant improvements in health because of reductions in smoking. Having a better understanding of the joint effects of these trends on longevity and quality of life will facilitate more efficient targeting of health care resources. Methods For each year from 2005 through 2020, we forecasted life expectancy and quality-adjusted life expectancy for a representative 18-year-old, assuming a continuation of past trends in smoking (based on data from the National Health Interview Survey for 1978 through 1979, 1990 through 1991, 1999 through 2001, and 2004 through 2006) and past trends in body-mass index (BMI) (based on data from the National Health and Nutrition Examination Survey for 1971 through 1975, 1988 through 1994, 1999 through 2002, and 2003 through 2006). The 2003 Medical Expenditure Panel Survey was used to examine the effects of smoking and BMI on health-related quality of life. Results The negative effects of increasing BMI overwhelmed the positive effects of declines in smoking in multiple scenarios. In the base case, increases in the remaining life expectancy of a typical 18-year-old are held back by 0.71 years or 0.91 quality-adjusted years between 2005 and 2020. If all U.S. adults became nonsmokers of normal weight by 2020, we forecast that the life expectancy of an 18-year-old would increase by 3.76 life-years or 5.16 quality-adjusted years. Conclusions If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates. Failure to address continued increases in obesity could result in an erosion of the pattern of steady gains in health observed since early in the 20th century. PMID:19955525

  12. Inequalities in healthy life expectancy by Federated States.

    PubMed

    Szwarcwald, Célia Landmann; Montilla, Dália Elena Romero; Marques, Aline Pinto; Damacena, Giseli Nogueira; Almeida, Wanessa da Silva de; Malta, Deborah Carvalho

    2017-06-01

    To estimate the healthy life expectancy at 60 years by sex and Federated States and to investigate geographical inequalities by socioeconomic status. Healthy life expectancy was estimated by the Sullivan method, based on the information of the National Survey on Health, 2013. Three criteria were adopted for the definition of "unhealthy state": self-assessment of bad health, functionality for performing the activities of daily living, and the presence of noncommunicable disease with intense degree of limitation. The indicator of socioeconomic status was built based on the number of goods at household and educational level of the head of household. To analyze the geographical inequalities and socioeconomic level, inequality measures were calculated, such as the ratio, the difference, and the angular coefficient. Healthy life expectancy among men ranged from 13.8 (Alagoas) to 20.9 (Espírito Santo) for the self-assessment criterion of bad health. Among women, the corresponding estimates were always higher and ranged from 14.9 (Maranhão) to 22.2 (São Paulo). As to the ratio of inequality by Federated State, the medians were always higher for healthy life expectancy than for life expectancy, regardless of the definition adopted for healthy state. Regarding the differences per Federated State, the healthy life expectancy was seven years higher in one state than in another. By socioeconomic status, differences of three and four years were found, approximately, between the last and first fifth, for men and women, respectively. Despite the association of the mortality indicators with living conditions, the inequalities are even more pronounced when the welfare and the limitations in usual activities are considered, showing the necessity to promote actions and programs to reduce the socio-spatial gradient. Estimar a esperança de vida saudável aos 60 anos por sexo e Unidade da Federação e investigar as desigualdades geográficas e por nível socioeconômico. A esperan

  13. Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada

    PubMed Central

    Samji, Hasina; Cescon, Angela; Hogg, Robert S.; Modur, Sharada P.; Althoff, Keri N.; Buchacz, Kate; Burchell, Ann N.; Cohen, Mardge; Gebo, Kelly A.; Gill, M. John; Justice, Amy; Kirk, Gregory; Klein, Marina B.; Korthuis, P. Todd; Martin, Jeff; Napravnik, Sonia; Rourke, Sean B.; Sterling, Timothy R.; Silverberg, Michael J.; Deeks, Stephen; Jacobson, Lisa P.; Bosch, Ronald J.; Kitahata, Mari M.; Goedert, James J.; Moore, Richard; Gange, Stephen J.

    2013-01-01

    Background Combination antiretroviral therapy (ART) has significantly increased survival among HIV-positive adults in the United States (U.S.) and Canada, but gains in life expectancy for this region have not been well characterized. We aim to estimate temporal changes in life expectancy among HIV-positive adults on ART from 2000–2007 in the U.S. and Canada. Methods Participants were from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), aged ≥20 years and on ART. Mortality rates were calculated using participants' person-time from January 1, 2000 or ART initiation until death, loss to follow-up, or administrative censoring December 31, 2007. Life expectancy at age 20, defined as the average number of additional years that a person of a specific age will live, provided the current age-specific mortality rates remain constant, was estimated using abridged life tables. Results The crude mortality rate was 19.8/1,000 person-years, among 22,937 individuals contributing 82,022 person-years and 1,622 deaths. Life expectancy increased from 36.1 [standard error (SE) 0.5] to 51.4 [SE 0.5] years from 2000–2002 to 2006–2007. Men and women had comparable life expectancies in all periods except the last (2006–2007). Life expectancy was lower for individuals with a history of injection drug use, non-whites, and in patients with baseline CD4 counts <350 cells/mm3. Conclusions A 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70 s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain. PMID:24367482

  14. Heart Rate, Life Expectancy and the Cardiovascular System: Therapeutic Considerations.

    PubMed

    Boudoulas, Konstantinos Dean; Borer, Jeffrey S; Boudoulas, Harisios

    2015-01-01

    It has long been known that life span is inversely related to resting heart rate in most organisms. This association between heart rate and survival has been attributed to the metabolic rate, which is greater in smaller animals and is directly associated with heart rate. Studies have shown that heart rate is related to survival in apparently healthy individuals and in patients with different underlying cardiovascular diseases. A decrease in heart rate due to therapeutic interventions may result in an increase in survival. However, there are many factors regulating heart rate, and it is quite plausible that these may independently affect life expectancy. Nonetheless, a fast heart rate itself affects the cardiovascular system in multiple ways (it increases ventricular work, myocardial oxygen consumption, endothelial stress, aortic/arterial stiffness, decreases myocardial oxygen supply, other) which, in turn, may affect survival. In this brief review, the effects of heart rate on the heart, arterial system and survival will be discussed. © 2015 S. Karger AG, Basel.

  15. The New Demographic Transition: Most Gains in Life Expectancy Now Realized Late in Life

    PubMed Central

    Eggleston, Karen N.; Fuchs, Victor R.

    2013-01-01

    The share of increases in life expectancy realized after age 65 was only about 20 percent at the beginning of the 20th century for the US and 16 other countries at comparable stages of development; but that share was close to 80 percent by the dawn of the 21st century, and is almost certainly approaching 100 percent asymptotically. This new demographic transition portends a diminished survival effect on working life. For high-income countries at the forefront of the longevity transition, expected lifetime labor force participation as a percent of life expectancy is declining. Innovative policies are needed if societies wish to preserve a positive relationship running from increasing longevity to greater prosperity. PMID:25076810

  16. Accuracy of advanced cancer patients' life expectancy estimates: The role of race and source of life expectancy information.

    PubMed

    Trevino, Kelly M; Zhang, Baohui; Shen, Megan J; Prigerson, Holly G

    2016-06-15

    The objective of this study was to examine the source of advanced cancer patients' information about their prognosis and determine whether this source of information could explain racial disparities in the accuracy of patients' life expectancy estimates (LEEs). Coping With Cancer was a prospective, longitudinal, multisite study of terminally ill cancer patients followed until death. In structured interviews, patients reported their LEEs and the sources of these estimates (ie, medical providers, personal beliefs, religious beliefs, and other). The accuracy of LEEs was calculated through a comparison of patients' self-reported LEEs with their actual survival. The sample for this analysis included 229 patients: 31 black patients and 198 white patients. Only 39.30% of the patients estimated their life expectancy within 12 months of their actual survival. Black patients were more likely to have an inaccurate LEE than white patients. A minority of the sample (18.3%) reported that a medical provider was the source of their LEEs; none of the black patients (0%) based their LEEs on a medical provider. Black race remained a significant predictor of an inaccurate LEE, even after the analysis had been controlled for sociodemographic characteristics and the source of LEEs. The majority of advanced cancer patients have an inaccurate understanding of their life expectancy. Black patients with advanced cancer are more likely to have an inaccurate LEE than white patients. Medical providers are not the source of information for LEEs for most advanced cancer patients and especially for black patients. The source of LEEs does not explain racial differences in LEE accuracy. Additional research into the mechanisms underlying racial differences in prognostic understanding is needed. Cancer 2016;122:1905-12. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons

  17. The Impact of Improved Population Life Expectancy in Survival Trend Analyses of Specific Diseases.

    PubMed

    van Walraven, Carl

    2016-08-01

    Survival trend analyses examine mortality outcomes over time. The impact of conducting survival trend analyses without accounting for improved population survival has not been systematically studied. The 1-year risk of death in the 100 most common hospital admissions for Ontario adults in 1994, 1999, 2004, and 2009 was determined. Generalized linear models were used to determine if adjusted death risk changed significantly over time with and without accounting for population survival. The statistical significance of temporal trends in survival changed after accounting for population life expectancy in 16 diagnoses (16 percent) (in 13 of 55 diagnoses, statistically significant decreasing mortality trends became insignificant; in 3 of 15 diagnoses, insignificant trends changed to a significant increase in mortality risk over time). These results highlight the importance of accounting for population life-expectancy changes in survival trend analyses. © Health Research and Educational Trust.

  18. Gender differences in disability-free life expectancy at old ages in Bangladesh.

    PubMed

    Tareque, Md Ismail; Begum, Sharifa; Saito, Yasuhiko

    2013-12-01

    We examined gender differences in the prevalence of disability and Disability-free Life Expectancy (DFLE) for Bangladeshi older adults. We used data representing 4,189 elderly subjects aged 60 years and over from a nationally representative survey (Bangladesh's Household Income and Expenditure Survey-2010). The Sullivan method was used to compute DFLE. Eyesight disability is prevalent among 28.94 and 36.47 men and women, respectively, and is the most prevalent type of disability in Bangladesh. Women have each disability and at least one disability in significantly higher percentages than men. At all ages, and in both numbers and proportion, women have longer life expectancy but shorter DFLE than men. Attention should be given to the elderly, with special care devoted to elderly women. The findings of the current study have important implications for risk of disability and the need for, and use of, long-term care services.

  19. [Disability-free life expectancy among 60-year-olds in Denmark].

    PubMed

    Brønnum-Hansen, Henrik; Davidsen, Michael; Kjøller, Mette

    2003-06-02

    Life expectancy can be expressed as average expected lifetime in different health states. The purpose of the study was to estimate disability-free life expectancy, i.e. average lifetime without disabilities, in Denmark and in the counties of Denmark and evaluate the relation between life expectancy and the proportion of disability-free life expectancy. Prevalence rates of disability (in terms of walking, walking on stairs, carrying 5 kg, reading, hearing and speaking) derived from the Danish Health Interview Survey 2000 were combined with life-table data and disability-free life expectancy was calculated by Sullivan's method. In 2000 expected lifetime of 60-year-old men and women was 18.8 years and 22.0 years respectively and disability-free life expectancy was 14.7 years for both sexes corresponding to 78.4% and 66.6% of the remaining lifetime for men and women respectively. Differences in disability-free life expectancy between counties ranged from zero to three years. In counties with the highest life expectancy among women they tended to have a higher proportion of life years with disabilities, but there was no correlation between life expectancy and the proportion of disability-free life expectancy for men. The results may illustrate theories about the relation between increased lifetime and quality of life in terms of health. Increased total lifetime for women prolongs the proportion of expected lifetime with disability ("expansion of morbidity"), whereas for men no correlation was found ("dynamic equilibrium").

  20. Age of Migration Differentials in Life Expectancy with Cognitive Impairment: 20-Year Findings From the Hispanic-EPESE.

    PubMed

    Garcia, Marc A; Saenz, Joseph L; Downer, Brian; Chiu, Chi-Tsun; Rote, Sunshine; Wong, Rebeca

    2017-05-09

    To examine differences in life expectancy with cognitive impairment among older Mexican adults according to nativity (U.S.-born/foreign-born) and among immigrants, age of migration to the United States. This study employs 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to estimate the proportion of life spent cognitively healthy and cognitively impaired prior to death among older Mexican adults residing in the southwestern United States. We combine age-specific mortality rates with age-specific prevalence of cognitive impairment, defined as a Mini-Mental Status Exam score of less than 21 points to calculate Sullivan-based life table models with and without cognitive impairment in later life. Foreign-born Mexican immigrants have longer total life expectancy and comparable cognitive healthy life expectancy regardless of gender compared to U.S.-born Mexican-Americans. However, the foreign-born spend a greater number of years after age 65 with cognitive impairment relative to their U.S.-born counterparts. Furthermore, we document an advantage in life expectancy with cognitive impairment and proportion of years after age 65 cognitively healthy among mid-life immigrant men and women relative to early- and late-life migrants. The relationship between nativity, age of migration, and life expectancy with cognitive impairment means that the foreign-born are in more need of support and time-intensive care in late life. This issue merits special attention to develop appropriate and targeted screening efforts that reduce cognitive decline for diverse subgroups of older Mexican-origin adults as they age.

  1. Educational and Sex Differentials in Life Expectancies and Disability-Free Life Expectancies in São Paulo, Brazil, and Urban Areas in Mexico

    PubMed Central

    Andrade, Flávia Cristina Drumond

    2013-01-01

    Objectives To estimate transition probabilities between disability states, total life expectancy, and the latter’s decomposition into years spent disabled and disability-free by age, sex and education among older adults in São Paulo, Brazil, and urban areas in Mexico. Methods Applied a micro-simulation method (Interpolative Markov Chains) using longitudinal data. Results We found large between-country educational differences in incidence of and recovery from disability with higher rates in Mexico than in São Paulo, but no differences in mortality. Older adults in Mexico spent longer time being disability-free than in São Paulo for both levels of education. Males and females in São Paulo spent a larger fraction of their remaining life disabled at every age than their counterparts in urban areas in Mexico. Discussion There were educational differences in the prevalence of disability in São Paulo and urban areas in Mexico, and significant educational differences in disability incidence and recovery across sites. PMID:23781016

  2. Educational and sex differentials in life expectancies and disability-free life expectancies in São Paulo, Brazil, and urban areas in Mexico.

    PubMed

    Beltrán-Sánchez, Hiram; Andrade, Flávia Cristina Drumond

    2013-08-01

    To estimate transition probabilities between disability states, total life expectancy, and the latter's decomposition into years spent disabled and disability-free by age, sex, and education among older adults in São Paulo, Brazil, and urban areas in Mexico. Applied a micro-simulation method (Interpolative Markov Chains) using longitudinal data. We found large between-country educational differences in incidence of and recovery from disability with higher rates in Mexico than in São Paulo, but no differences in mortality. Older adults in Mexico spent longer time being disability-free than in São Paulo for both levels of education. Males and females in São Paulo spent a larger fraction of their remaining life disabled at every age than their counterparts in urban areas in Mexico. There were educational differences in the prevalence of disability in São Paulo and urban areas in Mexico, and significant educational differences in disability incidence and recovery across sites.

  3. Remaining Life Expectancy Measurement and PSA Screening of Older Men.

    PubMed

    Kotwal, Ashwin A; Mohile, Supriya G; Dale, William

    2012-07-01

    BACKGROUND: Guidelines recommend informed decision-making regarding prostate specific antigen (PSA) screening for men with at least 10 years of remaining life expectancy (RLE). Comorbidity measures have been used to judge RLE in previous studies, but assessments based on other common RLE measures are unknown. We assessed whether screening rates varied based on four clinically relevant RLE measures, including comorbidities, in a nationally-representative, community-based sample. METHODS: Using the National Social Life, Health and Aging Project (NSHAP), we selected men over 65 without prostate cancer (n=709). They were stratified into three RLE categories (0-7 years, 8-12 years, and 13+ years) based on validated measures of comorbidities, self-rated health status, functional status, and physical performance. The independent relationship of each RLE measure and a combined measure to screening was determined using multivariable logistic regressions. RESULTS: Self-rated health (OR = 6.82; p < 0.01) most closely correlated with RLE-based screening, while the comorbidity index correlated the least (OR = 1.50; p = 0.09). The relationship of RLE to PSA screening significantly strengthened when controlling for the number of doctor visits, particularly for comorbidities (OR= 43.6; p < 0.001). Men who had consistent estimates of less than 7 years RLE by all four measures had an adjusted PSA screening rate of 43.3%. CONCLUSIONS: Regardless of the RLE measure used, men who were estimated to have limited RLE had significant PSA screening rates. However, different RLE measures have different correlations with PSA screening. Specific estimates of over-screening should therefore carefully consider the RLE measure used.

  4. Does pain deteriorate working life expectancy in aging workers?

    PubMed

    Lee, Wanhyung; Hong, Kwanyoung; Lim, Sung-Shil; Yoon, Jin-Ha

    2016-11-29

    Many aging workers wish to continue working as long as they can for a better life in the future. However, symptoms of pain are a key obstacle in the continuation of work among older workers. The impact of pain on work is understudied. Thus, we investigated the relationship between pain characteristics (total site and severity) and aging workers' working life expectancy scale (WoLES) in Korea. We included 1,979 participants (1,175 men and 804 women) from a well-established survey of a nationally representative population: the Korean Longitudinal Study of Ageing. A self-questionnaire was used to assess pain characteristics and WoLES. Odds ratios (ORs) and 95% confidence intervals (CIs) for the lower-WoLES group were calculated using multiple logistic regression models. Compared with the absence of pain, ORs and 95% CIs of the lower-WoLES group were increased, as follows: 1 pain site, 1.75 (1.20-2.55); 2 pain sites, 1.99 (1.32-3.03); 3 or more pain sites, 2.28 (1.51-3.42); mild pain, 1.74 (1.32-2.61); moderate pain, 2.02 (1.28-3.22); and severe pain, 2.12 (1.46-3.08). The statistical trend was significant in both total sites and severity of pain (p<0.001). There was a significant association between WoLES and both total pain sites and severity of pain, even after adjusting for potential confounding factors.

  5. Examination of correlation between medical expenses with average life expectancy according to municipality and gender.

    PubMed

    Nakajima, Hisato; Yano, Kouya; Nagasawa, Kaoko; Kobayashi, Eiji; Uetake, Shinichirou; Takagi, Ichirou; Yokota, Kuninobu

    2014-01-01

    To determine the influence of medical expenses on life expectancy. The expenses of 1,718 municipalities were divided into total expenses, hospitalization expenses and expenses other than hospitalization and dental expenses. 1) The correlation of life expectancy with sex was considered. 2) The correlation between expenses and life expectancy was considered. 3) The correlation of life expectancy or expenses with the numbers of doctors, dentists, facilities and beds was considered. 4) Using the Mahalanobis-Taguchi method, a unit space was formed by 10 municipalities with a high life expectancy, and D(2) was calculated. When D(2) was outside the unit space, the expenses were not as much as those of the 10 municipalities with a high life expectancy. 1) Life expectancy showed a positive correlation with gender. 2) Male life expectancy showed a negative correlation with total and hospitalization expenses, and a positive correlation with dental expenses. A positive correlation was found between each of expenses and female life expectancy. Total expenses, hospitalization expenses and expenses other than those on hospitalization showed a negative correlations with life expectancy in Hokkaido. Dental expenses showed a negative correlation with life expectancy in Chubu, hospitalization expenses showed a negative correlation with life expectancy in Kyushu. Total, hospitalization and dental expenses showed positive correlations with life expectancy in Tohoku, and dental expenses showed a positive correlation with life expectancy in Kanto and Chubu. 3) Total expenses, hospitalization expenses and expenses other than those on hospitalization were found to correlate with the number of doctors. Dental expenses were found to correlate with the numbers of doctors, facilities, and beds. 4) The difference in among estranged municipalities was considered. Life expectancy was significantly short in estranged municipalities, and the total expenses and hospitalization expenses were large

  6. Gender gaps--Life expectancy and proportion of life in poor health.

    PubMed

    Luy, Marc; Minagawa, Yuka

    2014-12-01

    The literature suggests that women report worse health but live longer than men--a phenomenon known as the gender paradox in health and mortality. Although studies examining the paradox abound, relatively little is known about mechanisms underlying the gap. With data on healthy life expectancy from the Global Burden of Disease Study 2010, this article analyses the relationship between length of life and health among men and women in 45 more-developed countries. The proportion of life spent in poor health is used as an indicator of health. This approach accounts for gender differences in longevity and illustrates the female health disadvantage pattern more clearly. Life expectancy at birth and the proportion of life in poor health are closely related for both genders. Furthermore, the larger the female excess in longevity, the larger the female excess in the proportion of life in poor health. By focusing on the proportion of life in poor health, this analysis suggests that women's longevity advantage translates into a health disadvantages relative to men. The results indicate that women suffer from poor health not in spite of living longer, but because they live longer.

  7. Impact of smoking on mortality and life expectancy in Japanese smokers: a prospective cohort study

    PubMed Central

    Sakata, R; McGale, P; Grant, E J; Ozasa, K; Peto, R

    2012-01-01

    Objective To investigate the impact of smoking on overall mortality and life expectancy in a large Japanese population, including some who smoked throughout adult life. Design The Life Span Study, a population-based prospective study, initiated in 1950. Setting Hiroshima and Nagasaki, Japan. Participants Smoking status for 27 311 men and 40 662 women was obtained during 1963-92. Mortality from one year after first ascertainment of smoking status until 1 January 2008 has been analysed. Main outcome measures Mortality from all causes in current, former, and never smokers. Results Smokers born in later decades tended to smoke more cigarettes per day than those born earlier, and to have started smoking at a younger age. Among those born during 1920-45 (median 1933) and who started smoking before age 20 years, men smoked on average 23 cigarettes/day, while women smoked 17 cigarettes/day, and, for those who continued smoking, overall mortality was more than doubled in both sexes (rate ratios versus never smokers: men 2.21 (95% confidence interval 1.97 to 2.48), women 2.61 (1.98 to 3.44)) and life expectancy was reduced by almost a decade (8 years for men, 10 years for women). Those who stopped smoking before age 35 avoided almost all of the excess risk among continuing smokers, while those who stopped smoking before age 45 avoided most of it. Conclusions The lower smoking related hazards reported previously in Japan may have been due to earlier birth cohorts starting to smoke when older and smoking fewer cigarettes per day. In Japan, as elsewhere, those who start smoking in early adult life and continue smoking lose on average about a decade of life. Much of the risk can, however, be avoided by giving up smoking before age 35, and preferably well before age 35. PMID:23100333

  8. The aging process and potential interventions to extend life expectancy.

    PubMed

    Tosato, Matteo; Zamboni, Valentina; Ferrini, Alessandro; Cesari, Matteo

    2007-01-01

    Aging is commonly defined as the accumulation of diverse deleterious changes occurring in cells and tissues with advancing age that are responsible for the increased risk of disease and death. The major theories of aging are all specific of a particular cause of aging, providing useful and important insights for the understanding of age-related physiological changes. However, a global view of them is needed when debating of a process which is still obscure in some of its aspects. In this context, the search for a single cause of aging has recently been replaced by the view of aging as an extremely complex, multifactorial process. Therefore, the different theories of aging should not be considered as mutually exclusive, but complementary of others in the explanation of some or all the features of the normal aging process. To date, no convincing evidence showing the administration of existing "anti-aging" remedies can slow aging or increase longevity in humans is available. Nevertheless, several studies on animal models have shown that aging rates and life expectancy can be modified. The present review provides an overlook of the most commonly accepted theories of aging, providing current evidence of those interventions aimed at modifying the aging process.

  9. Gender, educational and ethnic differences in active life expectancy among older Singaporeans.

    PubMed

    Chan, Angelique; Malhotra, Rahul; Matchar, David B; Ma, Stefan; Saito, Yasuhiko

    2016-04-01

    The aim of the present study was to compute total life expectancy (TLE), active life expectancy (ALE) and inactive life expectancy among older Singaporeans by gender, education and ethnicity. Data from a longitudinal survey of older Singaporeans were used. No difficulty in carrying out activities of daily living or instrumental activities of daily living was considered as "active." Transition probabilities across health states (active/inactive/dead) were assessed to develop multistate life tables, which estimated TLE, ALE and inactive life expectancy. At age 60 years, women, versus men, had significantly higher TLE (25.9, 95% confidence interval [CI] 24.0-27.8 vs 21.6, 95% CI 20.1-23.1), but similar ALE (18.1, 95% CI 17.0-19.2 vs 18.9, 95% CI 17.7-20.2). Those with high (secondary or higher), versus low (primary or less), education had significantly higher TLE (28.5, 95% CI 25.0-32.0 vs 22.5, 95% CI 21.1-23.9) and ALE (23.5, 95% CI 21.2-25.7 vs 17.1, 95% CI 16.1-18.0) at age 60 years. Those of Chinese, versus non-Chinese, ethnicity had significantly higher ALE at age 60 years (19.4, 95% CI 18.4-20.3 vs 15.0, 95% CI 13.4-16.7). Unlike Western nations, there was no gender difference in ALE among older adults in Singapore. However, difference in ALE by education among older Singaporeans was similar to that observed in Western societies. Policies focusing specifically on improving women's health at all ages, in addition to policies that increase population education levels, are promising approaches to improving ALE. Recognizing ethnic differences in ALE will help target policies that increase ALE in multicultural societies. © 2015 Japan Geriatrics Society.

  10. Work, Love, and Learning in Adult Life.

    ERIC Educational Resources Information Center

    Merriam, Sharan B.; Clark, M. Carolyn

    To understand how work, love, and learning are interrelated in adults' lives, data were collected in two ways: through a life-history type instrument and through in-depth interviews with 19 men and women. A life event framework was chosen to illustrate the broad constructs of work and love. Respondents identified in two columns major life events…

  11. Evaluating natural resource amenities in a human life expectancy production function

    Treesearch

    Neelam C. Poudyal; Donald G. Hodges; J.M. Bowker; H.K. Cordell

    2009-01-01

    This study examined the effect of natural resource amenities on human life expectancy. Extending theexisting model of the life expectancy production function, and correcting for spatial dependence, weevaluated the determinants of life expectancy using county level data. Results indicate that after controlling

  12. Evaluating natural resource amenities in a human life expectancy production function

    Treesearch

    Neelam C. Poudyal; Donald G. Hodges; J.M. Bowker; H.K. Cordell

    2009-01-01

    This study examined the effect of natural resource amenities on human life expectancy. Extending the existing model of the life expectancy production function, and correcting for spatial dependence, we evaluated the determinants of life expectancy using county level data. Results indicate that after controlling for socio-demographic and economic factors, medical...

  13. Adding years to life: effect of avoidable mortality on life expectancy at birth.

    PubMed Central

    Benavides, F G; Orts, R; Pérez, S

    1992-01-01

    STUDY OBJECTIVE--The aim was to determine the number of years that could be gained by preventing avoidable deaths. DESIGN--The study arose from the concept of avoidable causes of death and life expectancy at birth. Four abbreviated life tables were computed. The first included all causes of death; the second excluded all avoidable causes of death; the third and fourth excluded respectively primary and secondary avoidable causes of death. SETTING--Mortality and population data were taken from Mortality Statistics Offices in Valencia Region, Spain. MAIN RESULTS--Life expectancy at birth (LEB) was 75.7 years. After removing all avoidable deaths, LEB increased by 1.74 years. This improvement is attributed to avoidable deaths by primary prevention (1.09 years) and avoidable death by secondary prevention (0.37 year). CONCLUSIONS--According to these results the greatest improvement in LEB would be gained by primary prevention. PMID:1431715

  14. Facts of life for adults.

    PubMed

    Paxman, J M

    1991-04-01

    The editorial commentary reflects the desire for openness in providing contraceptive services for adolescents, rather than pretending that the emperor has new clothes. The simile is used to expose the coverup intended by adults who desire adolescent sexual behavior that does not exist. Examples of 4 European countries, (Sweden, Netherlands, France, and England and Wales) who support contraceptive use for teenagers are given. Lessons can be learned from these countries which have a 3 times lower teenage pregnancy rate than the US. In the Netherlands contraceptives are used by 90% of sexually active teenagers. The birth rate of 14/1000 and the abortion rate of 10/1000 is the lowest of the 4 countries. Swedish contraceptive, birth, and abortion rates are similar, but the age of the 1st sexual experience is the earliest. England and Wales has a similar contraception rate but the birth rate is also 45/1000 and the abortion rate is slightly higher. All countries provide teenage contraceptive services free or at low cost as well as sex education. The debate over contraception in other countries links access to sexual activity, when the facts of life are that teenagers become sexually active before contraception. In Sweden to curb abortions, contraception was increased between 1974-1981 with a concomitant decline of 27% in the abortion rate. In the US, it rose 59%. The experience of all 4 countries has been to reduce abortion, but still provide access to abortion services. The formula for successful management of teenage sexuality such as sex education, low cost contraceptive services, and access to early safe abortion services may not meet the needs of the AIDS pandemic. Many questions arise and Europe may provide the answers.

  15. Years off your life? The effects of homicide on life expectancy by neighborhood and race/ethnicity in Los Angeles county.

    PubMed

    Redelings, Matthew; Lieb, Loren; Sorvillo, Frank

    2010-07-01

    Homicide is one of the leading causes of death in Los Angeles County and is known to be elevated in low-income urban neighborhoods and in black males. However, because homicide occurs primarily among young adults, mortality rate statistics may underrepresent its importance. We estimated the impact of homicide on life expectancy by demographic group and geographic area in Los Angeles County, 2001-2006. Life expectancy estimates were calculated using mortality records and population estimates for Los Angeles County. Cause elimination techniques were used to estimate the impact of homicide on life expectancy. Homicide was estimated to reduce life expectancy by 0.4 years for Los Angeles County residents and by 2.1 years for black males. The impact of homicide on life expectancy was higher in low-income neighborhoods. In some low-income urban neighborhoods, homicide was estimated to decrease life expectancy in black males by nearly 5 years. Homicide causes substantial reductions in life expectancy in Los Angeles County. Its impact is magnified among black males and in low-income urban areas, underscoring the need for homicide reduction in urban centers.

  16. Years off Your Life? The Effects of Homicide on Life Expectancy by Neighborhood and Race/Ethnicity in Los Angeles County

    PubMed Central

    Lieb, Loren; Sorvillo, Frank

    2010-01-01

    Homicide is one of the leading causes of death in Los Angeles County and is known to be elevated in low-income urban neighborhoods and in black males. However, because homicide occurs primarily among young adults, mortality rate statistics may underrepresent its importance. We estimated the impact of homicide on life expectancy by demographic group and geographic area in Los Angeles County, 2001–2006. Life expectancy estimates were calculated using mortality records and population estimates for Los Angeles County. Cause elimination techniques were used to estimate the impact of homicide on life expectancy. Homicide was estimated to reduce life expectancy by 0.4 years for Los Angeles County residents and by 2.1 years for black males. The impact of homicide on life expectancy was higher in low-income neighborhoods. In some low-income urban neighborhoods, homicide was estimated to decrease life expectancy in black males by nearly 5 years. Homicide causes substantial reductions in life expectancy in Los Angeles County. Its impact is magnified among black males and in low-income urban areas, underscoring the need for homicide reduction in urban centers. PMID:20556528

  17. Quality-adjusted life expectancy (QALE) loss due to smoking in the United States.

    PubMed

    Jia, Haomiao; Zack, Matthew M; Thompson, William W; Dube, Shanta R

    2013-02-01

    Estimate quality-adjusted life expectancy (QALE) loss due to smoking and examine trends and state differences in smoking-related QALE loss in the U.S. Population health-related quality of life (HRQOL) scores were estimated from the Behavioral Risk Factor Surveillance System. This study constructed life tables based on U.S. mortality files and the mortality linked National Health Interview Survey and calculated QALE for smokers, non-smokers, and the total population. In 2009, an 18-year-old smoker was expected to have 43.5 (SE = 0.2) more years of QALE, and a non-smoker of the same age was expected to have 54.6 (SE = 0.2) more years of QALE. Therefore, smoking contributed 11.0 (SE = 0.2) years of QALE loss for smokers and 4.1 years (37%) of this loss resulted from reductions in HRQOL alone. At the population level, smoking was associated with 1.9 fewer years of QALE for U.S. adults throughout their lifetime, starting at age 18. This study demonstrates an application of a recently developed QALE estimation methodology. The analyses show good precision and relatively small bias in estimating QALE--especially at the individual level. Although smokers may live longer today than before, they still have a high disease burden due to morbidities associated with poor HRQOL.

  18. Life Satisfaction in Adult Survivors of Childhood Brain Tumors

    PubMed Central

    Crom, Deborah B.; Li, Zhenghong; Brinkman, Tara M.; Hudson, Melissa M.; Armstrong, Gregory T.; Neglia, Joseph; Ness, Kirsten K.

    2014-01-01

    Adult survivors of childhood brain tumors experience multiple, significant, life-long deficits as a consequence of their malignancy and therapy. Current survivorship literature documents the substantial impact such impairments have on survivors’ physical health and quality of life. Psychosocial reports detail educational, cognitive, and emotional limitations characterizing survivors as especially fragile, often incompetent, and unreliable in evaluating their circumstances. Anecdotal data suggests some survivors report life experiences similar to those of healthy controls. The aim of our investigation was to determine whether life satisfaction in adult survivors of childhood brain tumors differs from that of healthy controls and to identify potential predictors of life satisfaction in survivors. This cross-sectional study compared 78 brain tumor survivors with population–based matched controls. Chi-square tests, t-tests, and linear regression models were used to investigate patterns of life satisfaction and identify potential correlates. Results indicated life satisfaction of adult survivors of childhood brain tumors was similar to that of healthy controls. Survivors’ general health expectations emerged as the primary correlate of life satisfaction. Understanding life satisfaction as an important variable will optimize the design of strategies to enhance participation in follow-up care, reduce suffering, and optimize quality of life in this vulnerable population. PMID:25027187

  19. Long life expectancy of alkaline fuel cells in hybrid vehicles

    SciTech Connect

    Kordesch, K.; Gsellmann, J.; Aronson, R.R.

    1998-07-01

    The alkaline Hydrogen-Air fuel cell system with circulating KOH-electrolyte and low-cost catalyzed carbon electrodes has a simple design and a good efficiency (high voltage). With new electrodes current densities of 200 to 300 mA/cm 2 are expected with air operation at 80 o C. The Austin A-40 City Car Hybrid vehicle which K. Kordesch operated on public roads for 3 years, demonstrated already in the early 1970s that the useful life of the alkaline system with circulating electrolyte can be increased by completely shutting down the fuel cell part of an AFC-lead-acid battery hybrid system. In this way, only the operating hours during driving time of the vehicle are counting and the electrode deterioration processes going on at open circuit (e.g. carbon oxidation, deep wetting of the electrode interface, parasitic current phenomena, etc.) are reduced. Like with a combustion engine, 3000--4000 actual operating hours are what are required for 200.000 km driving. The stacks, which use low-cost modular cell units, could be replaced after that. Another objective is to lower the fuel cell system cost on a mass production scale to the range of $ 100 to 150 per kW, which is then competitive with car engines, which cost only $ 50 to 75 per kW. No other fuel cell system could even approach such cost estimates. For reasons demanded by space requirements the historic development of AFC's shifted to matrix AFC systems. However, for terrestrial applications the use of circulation systems is more advantageous for thermal and water management. Jet pumps are usable for providing a load-dependent gas circulation. The exchangeability of the KOH makes it possible to operate on air with a less than complete removal of the CO{sub 2}. Cell reversal of series-connected cells, a frequent failure mode during shut-down and starting, is one of the main causes for the short life of electrodes in a high voltage stack. It can be prevented by a parallel, potential providing circuit.

  20. Inequalities in US Life Expectancy by Area Unemployment Level, 1990–2010

    PubMed Central

    Singh, Gopal K.; Siahpush, Mohammad

    2016-01-01

    This study examined the association between unemployment and life expectancy in the United States during 1990–2010. Census-based unemployment rates were linked to US county-level mortality data. Life expectancies were calculated by age, sex, race, and unemployment level during 1990–2010. Differences in life expectancy were decomposed by age and cause of death. Life expectancy was consistently lower in areas with higher unemployment rates. In 2006–2010, those in areas with high unemployment rates (≥9%) had a life expectancy of 76.9 years, compared with 80.7 years for those in areas with low unemployment rates (<3%). The association between unemployment and life expectancy was stronger for men than for women. Life expectancy ranged from 69.9 years among black men in high unemployment areas to 90.0 years among Asian/Pacific Islander women in low unemployment areas. Disparities persisted over time. In 1990–1992, life expectancy was 4.7 years shorter in high unemployment than in low unemployment areas. In 2006–2010, the life expectancy difference between the lowest and highest unemployment areas decreased to 3.8 years. Heart disease, cancer, homicide, unintentional injuries, diabetes, HIV/AIDS, and liver cirrhosis contributed most to the lower life expectancy in high unemployment areas. High unemployment areas recorded larger gains in life expectancy than low unemployment areas, contributing to the narrowing gap during 1990–2010. PMID:27073716

  1. Inequalities in US Life Expectancy by Area Unemployment Level, 1990-2010.

    PubMed

    Singh, Gopal K; Siahpush, Mohammad

    2016-01-01

    This study examined the association between unemployment and life expectancy in the United States during 1990-2010. Census-based unemployment rates were linked to US county-level mortality data. Life expectancies were calculated by age, sex, race, and unemployment level during 1990-2010. Differences in life expectancy were decomposed by age and cause of death. Life expectancy was consistently lower in areas with higher unemployment rates. In 2006-2010, those in areas with high unemployment rates (≥9%) had a life expectancy of 76.9 years, compared with 80.7 years for those in areas with low unemployment rates (<3%). The association between unemployment and life expectancy was stronger for men than for women. Life expectancy ranged from 69.9 years among black men in high unemployment areas to 90.0 years among Asian/Pacific Islander women in low unemployment areas. Disparities persisted over time. In 1990-1992, life expectancy was 4.7 years shorter in high unemployment than in low unemployment areas. In 2006-2010, the life expectancy difference between the lowest and highest unemployment areas decreased to 3.8 years. Heart disease, cancer, homicide, unintentional injuries, diabetes, HIV/AIDS, and liver cirrhosis contributed most to the lower life expectancy in high unemployment areas. High unemployment areas recorded larger gains in life expectancy than low unemployment areas, contributing to the narrowing gap during 1990-2010.

  2. Work-Life Balance and Ideal Worker Expectations for Administrators

    ERIC Educational Resources Information Center

    Wilk, Kelly E.

    2016-01-01

    This chapter explores the work-life experiences of administrators as well as whether and how the ideal worker model affects those experiences. Departmental and supervisory differences and technology complicate administrators' work-life experiences.

  3. Work-Life Balance and Ideal Worker Expectations for Administrators

    ERIC Educational Resources Information Center

    Wilk, Kelly E.

    2016-01-01

    This chapter explores the work-life experiences of administrators as well as whether and how the ideal worker model affects those experiences. Departmental and supervisory differences and technology complicate administrators' work-life experiences.

  4. Life expectancy and longevity of varanid lizards (Reptilia:Squamata:Varanidae) in North American zoos.

    PubMed

    Mendyk, Robert W

    2015-01-01

    In zoos, life expectancy-the average lifespan of individuals within a population, and longevity-the maximum lifespan within a population, can be useful parameters for evaluating captive husbandry and animal welfare. Using life history and demographic data derived from regional studbooks, this study examined life expectancy and longevity in a total of 782 wild-caught (WC) and captive-bred (CB) varanid lizards of seven species maintained in North American zoos since 1926. The average lifespans for WC and CB animals were 6.3 ± 0.3 and 9.3 ± 0.4 years, respectively, with CB males living significantly longer than females (P = 0.009). A total of 26.4% of WC and 22.5% of CB animals experienced mortality during their first 2 years in captivity, with mortality during this period greatest among Varanus rudicollis and V. prasinus. A positive correlation was observed between life expectancy and adult body mass in captive-bred individuals (r = 0.981; P = 0.002). Wild-caught females with a history of successful reproduction had a significantly greater average lifespan than non-reproducing females (P < 0.0001). Results from this study suggest that varanids have not been reaching their lifespan capacities in North American zoos. In light of these findings, several husbandry-related factors which may be affecting the welfare and lifespans of varanids in zoos are identified and discussed. This study also highlights the utility of demographic and life history data in captive animal management, and offers a general framework for future herpetological studies of a similar nature. © 2014 Wiley Periodicals, Inc.

  5. Life satisfaction in adult survivors of childhood brain tumors.

    PubMed

    Crom, Deborah B; Li, Zhenghong; Brinkman, Tara M; Hudson, Melissa M; Armstrong, Gregory T; Neglia, Joseph; Ness, Kirsten K

    2014-01-01

    Adult survivors of childhood brain tumors experience multiple, significant, lifelong deficits as a consequence of their malignancy and therapy. Current survivorship literature documents the substantial impact such impairments have on survivors' physical health and quality of life. Psychosocial reports detail educational, cognitive, and emotional limitations characterizing survivors as especially fragile, often incompetent, and unreliable in evaluating their circumstances. Anecdotal data suggest some survivors report life experiences similar to those of healthy controls. The aim of our investigation was to determine whether life satisfaction in adult survivors of childhood brain tumors differs from that of healthy controls and to identify potential predictors of life satisfaction in survivors. This cross-sectional study compared 78 brain tumor survivors with population-based matched controls. Chi-square tests, t tests, and linear regression models were used to investigate patterns of life satisfaction and identify potential correlates. Results indicated that life satisfaction of adult survivors of childhood brain tumors was similar to that of healthy controls. Survivors' general health expectations emerged as the primary correlate of life satisfaction. Understanding life satisfaction as an important variable will optimize the design of strategies to enhance participation in follow-up care, reduce suffering, and optimize quality of life in this vulnerable population.

  6. Andragogical Characteristics and Expectations of University of Hawai'i Adult Learners in a 3D Multi-User Virtual Environment

    ERIC Educational Resources Information Center

    Meeder, Rebecca L.

    2012-01-01

    The purpose of this study was to discover which andragogical characteristics and expectations of adult learners manifested themselves in the three-dimensional, multi-user virtual environment known as Second Life. This digital ethnographic study focused specifically on adult students within the University of Hawai'i Second Life group and their…

  7. Andragogical Characteristics and Expectations of University of Hawai'i Adult Learners in a 3D Multi-User Virtual Environment

    ERIC Educational Resources Information Center

    Meeder, Rebecca L.

    2012-01-01

    The purpose of this study was to discover which andragogical characteristics and expectations of adult learners manifested themselves in the three-dimensional, multi-user virtual environment known as Second Life. This digital ethnographic study focused specifically on adult students within the University of Hawai'i Second Life group and their…

  8. Alcohol Expectancies in Young Adult Sons of Alcoholics and Controls.

    ERIC Educational Resources Information Center

    Brown, Sandra A.; And Others

    Adolescent offspring of alcoholics have been found to have higher alcohol reinforcement expectancies than do teenagers from nonalcoholic families. In particular, those with a positive family history of alcoholism expect more cognitive and motor enhancement with alcohol consumption. This study examined the alcohol expectancies of 58 matched pairs…

  9. Social inequalities in life expectancy and mortality during the transition period of economic crisis (1993–2010) in Korea

    PubMed Central

    2012-01-01

    Backgrounds This study examines social inequalities in life expectancy and mortality during the transition period of the Korean economic crisis (1993–2010) among Korean adults aged 40 and over. Methods Data from the census and the national death file from the Statistics Korea are employed to calculate life expectancy and age-specific-death-rates (ASDR) by age, gender, and educational attainment for five years: 1993, 1995, 2000, 2005, and 2010. Absolute and relative differences in life expectancy and Age-Specific Death Rates by educational attainment were utilized as proxy measures of social inequality. Results Clear educational gradient of life expectancy was observed at age 40 by both sexes and across five time periods (1993, 1995, 2000, 2005, and 2010). The gradient became notably worse in females between 1993 and 2010 compared to the trend in males. The educational gradient was also found for ASDR in all five years, but it was more pronounced in working age groups (40s and 50s) than in elderly groups. The relative disadvantage of ASDR among working age Korean adults, both males and females, became substantially worse over time. Conclusions Social inequalities in life expectancy and ASDR of the working age group across socioeconomic status over time were closely related to the widening of the social difference created by the macroeconomic crisis and the expansion of neo-liberalism in Korea. PMID:23171369

  10. Reduced tobacco consumption, improved diet and life expectancy for 1988-1998: analysis of New Zealand and OECD data.

    PubMed

    Laugesen, Murray; Grace, Randolph C

    2017-06-02

    We compared changes in tobacco consumption and diet in relation to changes in life expectancy in 1988-1998 in 22 OECD (Organisation for Economic Cooperation and Development) countries. Between 1985 and 1995 using regression analysis we estimated differences in tobacco consumption per adult and the differences in the sum of atherogenic and thrombogenic indices against life expectancy. Each index was derived from the various fats per gram of food from standard texts, and from the annual measurements of fat in the food balance sheets of each country. In 1985-1995, New Zealand showed the largest decrease in tobacco consumption per adult (41%) and the greatest decrease (except for Switzerland) in the sum of atherogenic and thrombogenic indices (17%) as a measure of diet. New Zealand ranked first for life expectancy increases from 1988-1998 for men (3.2 years), women (2.8 years) and both sexes combined. Regression analyses revealed that increases in life expectancy across the OECD for males, but not females, were strongly associated with decreases in tobacco consumption, with a weaker effect of diet improvement. These results suggest that reduced tobacco consumption in 1985-1995 likely contributed to New Zealand's gains in life expectancy from 1988-1998.

  11. [Life expectancy at birth in Colombia, 2000-2009: inequalities by region and gender].

    PubMed

    Eslava-Schmalbach, Javier H; Rincón, Carlos Javier; Guarnizo-Herreño, Carol Cristina

    2013-01-01

    Life expectancy is one of the measurements that have been used to monitor socioeconomic development within and among countries. During the last 30 years, life expectancy has increased worldwide mainly due to medical and technological developments. However, access to health care, new technologies and social determinants remain unevenly distributed among regions and countries in the world. To assess inequalities in life expectancy by gender and regions (departments) in Colombia between 2000 and 2009. Ecological study. Life expectancy was estimated for each Colombian department using yearly life tables from 2000 to 2009. We used data from the death registries and the estimated population series, provided by the Departamento Administrativo Nacional de Estadística (DANE). For the study period, estimates of life expectancy by departments were compared with those from Japan for the years 2000, 2006 and 2009, which is the country with the highest life expectancy in the world, and with the Colombian department with the highest life expectancy from 2000 to 2009. Compared with the highest life expectancy in the world, Colombian departments showed differences ranged between 5.7 and 21 years. We found significant differences between departments, with the largest difference being 15.3 years. Additionally, in some departments life expectancy decreased during the analyzed period. This study identified differences in life expectancy in Colombian departments suggesting inequalities in health and living conditions among them. These differences increased in some departments during the period 2000-2009.

  12. [Women's empowerment and life expectancy at birth in Mexico].

    PubMed

    Idrovo, Alvaro J; Casique, Irene

    2006-07-01

    To assess the effect of women's empowerment (WE) on life expectancy at birth (LEB) in the federative states of Mexico and to compare the results of measuring WE with various compound indicators that reflect, to a greater or lesser degree, an individual or population focus. This was an ecological study conducted in Mexico's 32 federative states. We estimated the correlations between overall and sex-specific LEB on the one hand, and a measure of gender empowerment (MGE), the index of women's ability to make decisions within the household (WADH), the index of women's autonomy (IWA), income inequality, certain aspects of the physical environment, the proportion of the population who spoke an indigenous language, and the net migratory rate on the other. By using robust regressions, we studied the effect on LEB of MGE, IWA, and WADH, after mutually adjusting for other independent variables. A very strong inverse correlation (-0.93) was found between overall LEB and factors of the physical environment linked to population vulnerability and biodiversity. Significant direct and inverse correlations were also found between LEB on the one hand and WADH, IWA, net migratory rate, the percentage of the population that spoke an indigenous language, and the Gini coefficient on the other. Multiple robust regressions showed inverse associations between MGE and LEB in women (beta: -1.44; 95% confidence interval [95% CI]: -2.71 to -0.17). WAI was positively associated with LEB in men (beta: 0.88; 95% CI: 0.01 to 1.75) and women (beta: 0.66; 95% CI: 0.03 to 1.30). The use of MGE as a surrogate for WE failed to reveal a positive effect of WE on LEB in Mexico. It is necessary to review the components that make up MGE and the relevance of using such a measure in different contexts. WAI showed a greater association with LEB and its effect was greater among men. This indicator made it possible to measure WE in Mexico and its use is recommended, as long as there are no other indicators

  13. Life Expectancies in Hawai‘i: A Multi-ethnic Analysis of 2010 Life Tables

    PubMed Central

    Braun, Kathryn; Onaka, Alvin T; Horiuchi, Brian Y; Tottori, Caryn J; Wilkens, Lynne

    2017-01-01

    The objective of this study is to examine longevity disparities in Hawai‘i by race/ethnicity and gender based on age-specific death rates in 2010. Abridged life tables for Chinese, Japanese, Filipino, Hawaiians, and Caucasians in Hawai‘i are presented for the age groups: <1, 1–4, every 5-year interval from 5–84, and 85+ years for the year of 2010. Death data were provided by the Hawai‘i Department of Health Office of Health Status Monitoring, and population data were based on 2010 Census modified based on ethnicity estimates from the Hawai‘i Health Survey. Life expectancy at birth in Hawai‘i has increased consistently from 69.5 years in 1950 to 82.4 years in 2010. Longevity disparities seen in past decades continue to persist between the longest-living groups, Japanese and Chinese, and the shortest-living group, Native Hawaiians, with a gap of approximately 10 years. In addition, females lived 6 years longer than males on average. Racial/ethnic disparities in longevity can be partially explained by differences in socioeconomic status, health behaviors, health care access, and racism. Native Hawaiians continue to have the shortest life expectancy of the ethnic groups examined, requiring expanded efforts to address Native Hawaiian health across the life course. Our findings also support more ethnic-specific research to understand the health care needs and utilization patterns of each group. PMID:28090398

  14. Effects of smoking and smoking cessation on life expectancy in an elderly population in Beijing, China, 1992-2000: an 8-year follow-up study.

    PubMed

    Tian, Xiaobing; Tang, Zhe; Jiang, Jingmei; Fang, Xianghua; Wu, Xiaoguang; Han, Wei; Guan, Shaochen; Liu, Hongjun; Diao, Lijun; Sun, Fei

    2011-01-01

    We assessed the effects of smoking and smoking cessation on life expectancy and active life expectancy among persons aged 55 years or older in Beijing. This study included 1593 men and 1664 women who participated in the Beijing Longitudinal Study of Aging, which commenced in 1992 and had 4 survey waves up to year 2000. An abridged life table was used to estimate life expectancy, in which age-specific mortality and age-specific disability rates were adjusted by using a discrete-time hazard model to control confounders. The mean ages (SD) for men and women were 70.1 (9.25) and 70.2 (8.72) years, respectively; mortality and disability rates during follow-up were 34.7% and 8.0%, respectively. In both sexes, never smokers had the highest life expectancy and active life expectancy across ages, as compared with current and former smokers. Current heavy smokers had a shorter life expectancy and a shorter active life expectancy than light smokers. Among former smokers, male long-term quitters had a longer life expectancy and longer active life expectancy than short-term quitters, but this was not the case in women. Older adults remain at higher risk of mortality and morbidity from smoking and can expect to live a longer and healthier life after smoking cessation.

  15. Effects of Smoking and Smoking Cessation on Life Expectancy in an Elderly Population in Beijing, China, 1992–2000: An 8-Year Follow-up Study

    PubMed Central

    Tian, Xiaobing; Tang, Zhe; Jiang, Jingmei; Fang, Xianghua; Wu, Xiaoguang; Han, Wei; Guan, Shaochen; Liu, Hongjun; Diao, Lijun; Sun, Fei

    2011-01-01

    Background We assessed the effects of smoking and smoking cessation on life expectancy and active life expectancy among persons aged 55 years or older in Beijing. Methods This study included 1593 men and 1664 women who participated in the Beijing Longitudinal Study of Aging, which commenced in 1992 and had 4 survey waves up to year 2000. An abridged life table was used to estimate life expectancy, in which age-specific mortality and age-specific disability rates were adjusted by using a discrete-time hazard model to control confounders. Results The mean ages (SD) for men and women were 70.1 (9.25) and 70.2 (8.72) years, respectively; mortality and disability rates during follow-up were 34.7% and 8.0%, respectively. In both sexes, never smokers had the highest life expectancy and active life expectancy across ages, as compared with current and former smokers. Current heavy smokers had a shorter life expectancy and a shorter active life expectancy than light smokers. Among former smokers, male long-term quitters had a longer life expectancy and longer active life expectancy than short-term quitters, but this was not the case in women. Conclusions Older adults remain at higher risk of mortality and morbidity from smoking and can expect to live a longer and healthier life after smoking cessation. PMID:21747208

  16. The long arm of expectancies: adolescent alcohol expectancies predict adult alcohol use.

    PubMed

    Patrick, Megan E; Wray-Lake, Laura; Finlay, Andrea K; Maggs, Jennifer L

    2010-01-01

    Alcohol expectancies are strong concurrent predictors of alcohol use and problems, but the current study addressed their unique power to predict from adolescence to midlife. Long-term longitudinal data from the national British Cohort Study 1970 (N = 2146, 59.8% female) were used to predict alcohol use and misuse in the mid-30s by alcohol expectancies reported in adolescence. Cohort members with more positive alcohol expectancies at age 16 reported greater alcohol quantity concurrently, increases in alcohol quantity relative to their peers between ages 16 and 35, and a higher likelihood of lifetime and previous year alcohol misuse at age 35, independent of gender, social class in family of origin, age of alcohol use onset, adolescent delinquent behavior and age 16 exam scores. Alcohol expectancies were strong proximal predictors of alcohol use and predicted relative change in alcohol use and misuse across two decades into middle adulthood.

  17. [150 years of geriatric medicine: from improving life expectation to better quality of life for the very old ].

    PubMed

    Federspiel C; Keipes M

    2014-01-01

    With the world further aging, geriatric medicine clearly became a necessity: in the 21th century many more people reach older ages by means of continued medical success in expanding lifespan. 150 years ago life expectancy was between 30 to 40 years, but today close to 800 million people are 60 yeas old or more. During the last century aging has been associated with decline and decay, but gradually more people lived ably and healthily in older ages. The expansion in life expectancy has become a synchronism of quality of life: the average 65 year old today is much healthier, physically and mentally fitter, than the average 50 year old 150 years ago, when Alois Alzheimer war born, a period when most nowadays existing geriatric institutions were envisioned and progressively realized over time. Today we strongly believe that a healthy life and, equally, the quality of life of the very old people can be extended with presently existing medical knowledge, based on research, environmental and behavioural changes, by postponing the onset and progression of fatal and disabling diseases and disorders. But very soon ethical considerations concerning all kinds of medical and technological solutions available to maintain or even improve the mental and physical functioning of dependant elderly people will engage our society when deciding how and at what moment in time to make the best decisions and allocate resources. Geriatric medicine will be further challenged by competing and demanding medical and economic needs, when marshalling resources to meet the growing demands of our society for improving care for the very old and often demented adult.

  18. Adult education and the quality of life

    NASA Astrophysics Data System (ADS)

    Tuijnman, Albert

    1990-09-01

    The purpose of this study is to investigate the complementary role of adult education in influencing people's objective and subjective quality of life. The analytical strategy used to achieve this end is to estimate parameters in a path model which includes both objective indicators such as occupational status and earned income, and subjective indicators such as job satisfaction and perceived personal wellbeing. The investigation builds on Swedish data and employs the LISREL method in the fitting of the model to the data. The results indicate that adult education positively influences objective indicators of the quality of life. Even though adult education is found to relate to measures of perceived personal wellbeing, the hypothesis that it also influences the way men assess their life situation and evaluate their subjective quality of life cannot be confirmed.

  19. Change in Disability-Free Life Expectancy for Americans 70 Years Old and Older

    PubMed Central

    CRIMMINS, EILEEN M.; HAYWARD, MARK D.; HAGEDORN, AARON; SAITO, YASUHIKO; BROUARD, NICOLAS

    2009-01-01

    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. PMID:19771948

  20. Relationships between the Active Aging Index and Disability-Free Life Expectancy: A Case Study in the Rajshahi District of Bangladesh.

    PubMed

    Tareque, Md Ismail; Hoque, Nazrul; Islam, Towfiqua Mahfuza; Kawahara, Kazuo; Sugawa, Makiko

    2013-12-01

    Life expectancy has increased considerably throughout the world. In Bangladesh, life expectancy has increased from about 53 years in 1975 to 69 years in 2010. However, it is unknown whether the increase in life expectancy is simultaneously accompanied by an increase in disability-free life expectancy (DFLE). The purpose of the study described in this article was to explore the relationship between life expectancy and DFLE in the Rajshahi District of Bangladesh by examining the relationships between the Active Aging Index (AAI) and DFLE. The study fi ndings suggest that urban, more-educated, elderly males are more active in all aspects of life and have longer DFLE. Females are found to outlive males but are more likely to live a greater part of their remaining life with disability. Positive correlations between the AAI and DFLE suggest that older adults could enjoy more DFLE by involving themselves in active aging activities.

  1. When things do not go as expected: scenario life savers.

    PubMed

    Dieckmann, Peter; Lippert, Anne; Glavin, Ronnie; Rall, Marcus

    2010-08-01

    In this paper we discuss scenario life savers - interventions before and during simulation scenarios that allow to create and use relevant learning opportunities, even if unexpected events happen during the conduction of the scenario. Scenario life savers are needed, when the comprehension or acceptance of the scenario by the participants is at stake, thus compromising learning opportunities. Scenario life savers can principally work by bringing participants back on track of the planned scenario or by adapting the conduction to their actions on the fly. Interventions can be within the logic of the scenario or from the "outside," not being part of the scenario itself. Scenario life savers should be anticipated during the design of scenarios and used carefully during their conduction, aiming to maximize the learning for participants.

  2. Remaining Life Expectancy With and Without Polypharmacy: A Register-Based Study of Swedes Aged 65 Years and Older.

    PubMed

    Wastesson, Jonas W; Canudas-Romo, Vladimir; Lindahl-Jacobsen, Rune; Johnell, Kristina

    2016-01-01

    To investigate the remaining life expectancy with and without polypharmacy for Swedish women and men aged 65 years and older. Age-specific prevalence of polypharmacy from the nationwide Swedish Prescribed Drug Register (SPDR) combined with life tables from Statistics Sweden was used to calculate the survival function and remaining life expectancy with and without polypharmacy according to the Sullivan method. Nationwide register-based study. A total of 1,347,564 individuals aged 65 years and older who had been prescribed and dispensed a drug from July 1 to September 30, 2008. Polypharmacy was defined as the concurrent use of 5 or more drugs. At age 65 years, approximately 8 years of the 20 remaining years of life (41%) can be expected to be lived with polypharmacy. More than half of the remaining life expectancy will be spent with polypharmacy after the age of 75 years. Women had a longer life expectancy, but also lived more years with polypharmacy than men. Older women and men spend a considerable proportion of their lives with polypharmacy. Given the negative health outcomes associated with polypharmacy, efforts should be made to reduce the number of years older adults spend with polypharmacy to minimize the risk of unwanted consequences. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  3. The Contribution of Drug Overdose to Educational Gradients in Life Expectancy in the United States, 1992-2011.

    PubMed

    Ho, Jessica Y

    2017-06-01

    Since the mid-1990s, the United States has witnessed a dramatic rise in drug overdose mortality. Educational gradients in life expectancy widened over the same period, and drug overdose likely plays a role in this widening, particularly for non-Hispanic whites. The contemporary drug epidemic is distinctive in terms of its scope, the nature of the substances involved, and its geographic patterning, which influence how it impacts different education groups. I use vital statistics and National Health Interview Survey data to examine the contribution of drug overdose to educational gradients in life expectancy from 1992-2011. I find that over this period, years of life lost due to drug overdose increased for all education groups and for both males and females. The contribution of drug overdose to educational gradients in life expectancy has increased over time and is greater for non-Hispanic whites than for the population as a whole. Drug overdose accounts for a sizable proportion of the increases in educational gradients in life expectancy, particularly at the prime adult ages (ages 30-60), where it accounts for 25 % to 100 % of the widening in educational gradients between 1992 and 2011. Drug overdose mortality has increased more rapidly for females than for males, leading to a gender convergence. These findings shed light on the processes driving recent changes in educational gradients in life expectancy and suggest that effective measures to address the drug overdose epidemic should take into account its differential burden across education groups.

  4. Life expectancy in four U.S. racial/ethnic populations: 1990.

    PubMed

    Hahn, R A; Eberhardt, S

    1995-07-01

    Previous estimates of life expectancy in the United States have not corrected for biases in population and mortality data, and no study has examined life expectancy in U.S. Asian/Pacific Islander and American Indian populations. We used information on population undercounts by race/ethnicity in the census and on misclassification of race/ethnicity on death certificates to calculate life expectancy for black, white, American Indian, and Asian men and women in the United States in 1990. Correction for undercount and misclassification had little effect on life expectancy estimates for whites, but it substantially decreased estimates for American Indians and Asians. Asian men had life expectancies of 82.0 years and Asian women 85.8 years--the highest life expectancies reported for any population in the world and beyond the limit predicted by some current theories.

  5. Unemployment, disability and life expectancy in the United States: A life course study.

    PubMed

    Laditka, James N; Laditka, Sarah B

    2016-01-01

    Unemployment may be associated with health through factors including stress, depression, unhealthy behaviors, reduced health care, and loss of social networks. Little is known about associations of total lifetime unemployment with disability and life expectancy. People with high unemployment (≥the median) will live shorter lives with more disability than those with less unemployment. Data were nationally representative of African Americans and non-Hispanic whites, from the Panel Study of Income Dynamics (37 waves 1968-2011, n = 7,970, mean work years = 24.7). Seven waves (1999-2011, 58,268 person-years) measured disability in activities of daily living. We estimated monthly probabilities of disability and death associated with unemployment using multinomial logistic Markov models adjusted for age, sex, race/ethnicity, education, health status at baseline and throughout work life, and social support. We used the probabilities to create large populations with microsimulation, each individual having known monthly disability status, age 40 to death. We analyzed the populations to measure outcomes. Respectively for African American and white women and African American and white men, life expectancies (with 95% confidence intervals) from age 40 with low unemployment were ages: 77.1 (75.0-78.3), 80.6 (78.4-81.4), 71.4 (69.6-72.5), and 76.9 (74.9-77.9). Corresponding high unemployment results were: 73.7 (71.7-75.0), 77.5 (75.1-78.0), 68.4 (66.8-69.0), and 73.7 (71.5-74.3). The percentage of life disabled from age 40 was greater with high unemployment for the same groups, by 23.9%, 21.0%, 21.3%, and 21.1% (all p < 0.01). High lifetime unemployment may be associated with a larger proportion of later life with disability and lower life expectancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Mass HIV Treatment and Sex Disparities in Life Expectancy: Demographic Surveillance in Rural South Africa

    PubMed Central

    Bor, Jacob; Rosen, Sydney; Chimbindi, Natsayi; Haber, Noah; Herbst, Kobus; Mutevedzi, Tinofa; Tanser, Frank; Pillay, Deenan; Bärnighausen, Till

    2015-01-01

    Background Women have better patient outcomes in HIV care and treatment than men in sub-Saharan Africa. We assessed—at the population level—whether and to what extent mass HIV treatment is associated with changes in sex disparities in adult life expectancy, a summary metric of survival capturing mortality across the full cascade of HIV care. We also determined sex-specific trends in HIV mortality and the distribution of HIV-related deaths in men and women prior to and at each stage of the clinical cascade. Methods and Findings Data were collected on all deaths occurring from 2001 to 2011 in a large population-based surveillance cohort (52,964 women and 45,688 men, ages 15 y and older) in rural KwaZulu-Natal, South Africa. Cause of death was ascertained by verbal autopsy (93% response rate). Demographic data were linked at the individual level to clinical records from the public sector HIV treatment and care program that serves the region. Annual rates of HIV-related mortality were assessed for men and women separately, and female-to-male rate ratios were estimated in exponential hazard models. Sex-specific trends in adult life expectancy and HIV-cause-deleted adult life expectancy were calculated. The proportions of HIV deaths that accrued to men and women at different stages in the HIV cascade of care were estimated annually. Following the beginning of HIV treatment scale-up in 2004, HIV mortality declined among both men and women. Female adult life expectancy increased from 51.3 y (95% CI 49.7, 52.8) in 2003 to 64.5 y (95% CI 62.7, 66.4) in 2011, a gain of 13.2 y. Male adult life expectancy increased from 46.9 y (95% CI 45.6, 48.2) in 2003 to 55.9 y (95% CI 54.3, 57.5) in 2011, a gain of 9.0 y. The gap between female and male adult life expectancy doubled, from 4.4 y in 2003 to 8.6 y in 2011, a difference of 4.3 y (95% CI 0.9, 7.6). For women, HIV mortality declined from 1.60 deaths per 100 person-years (95% CI 1.46, 1.75) in 2003 to 0.56 per 100 person

  7. Characterization of Dementia and Alzheimer’s Disease in an Older Population: Updated Incidence and Life Expectancy With and Without Dementia

    PubMed Central

    Tom, Sarah E.; Hubbard, Rebecca A.; Crane, Paul K.; Haneuse, Sebastien J.; Bowen, James; McCormick, Wayne C.; McCurry, Susan; Larson, Eric B.

    2015-01-01

    Objectives. We estimated dementia incidence rates, life expectancies with and without dementia, and percentage of total life expectancy without dementia. Methods. We studied 3605 members of Group Health (Seattle, WA) aged 65 years or older who did not have dementia at enrollment to the Adult Changes in Thought study between 1994 and 2008. We estimated incidence rates of Alzheimer’s disease and dementia, as well as life expectancies with and without dementia, defined as the average number of years one is expected to live with and without dementia, and percentage of total life expectancy without dementia. Results. Dementia incidence increased through ages 85 to 89 years (74.2 cases per 1000 person-years) and 90 years or older (105 cases per 1000 person-years). Life expectancy without dementia and percentage of total life expectancy without dementia decreased with age. Life expectancy with dementia was longer in women and people with at least a college degree. Percentage of total life expectancy without dementia was greater in younger age groups, men, and those with more education. Conclusions. Efforts to delay onset of dementia, if successful, would likely benefit older adults of all ages. PMID:25033130

  8. An economic analysis of life expectancy by gender with application to the United States.

    PubMed

    Leung, Michael C M; Zhang, Jie; Zhang, Junsen

    2004-07-01

    This paper presents an economic model to explain the behavior of life expectancy of both sexes. It explicitly examines the relationship between the gender gap in life expectancy and the gender gap in pay. It shows that as the latter narrows over the course of economic development, the former may initially expand but will eventually shrink. Simulation results from our model accord with the behavior of life expectancy for both sexes since the 1940s in the United States.

  9. A Second Look at "School-Life Expectancy"

    ERIC Educational Resources Information Center

    Barakat, Bilal Fouad

    2012-01-01

    The number of years a child of school-entry age can expect to remain in school is of great interest both as a measure of individual human capital and of the performance of an education system. An approximate indicator of this concept is the sum of age-specific enrolment rates. The relatively low data demands of this indicator that are feasible to…

  10. Anxiety-Linked Expectancy Bias across the Adult Lifespan

    PubMed Central

    Steinman, Shari A.; Smyth, Frederick L.; Bucks, Romola S.; MacLeod, Colin; Teachman, Bethany A.

    2012-01-01

    Anxiety is characterized by a negative expectancy bias, such that anxious individuals report negatively distorted expectations about the future. Contrary to anxiety, aging is characterized by a positivity effect, such that aging is associated with a tendency to attend to and remember positive information, relative to negative information. The current study integrates these literatures to examine anxiety- and age-linked biases when thinking about the future. Participants (N=1109) completed a procedure that involved reading valenced scenarios (positive, negative, or ambiguous) and then rating the likelihood of future valenced events occurring. Results suggest that aging and anxiety have independent and opposing effects. Heightened anxiety was associated with a reduced expectancy for positive events, regardless of the scenarios’ current emotional valence, whereas increased age was associated with an inflated expectancy for positive events, which was strongest when individuals were processing socially-relevant or negative scenarios. PMID:22861128

  11. The impact of peptic ulcer disease and infection with Helicobacter pylori on life expectancy.

    PubMed

    Inadomi, J M; Sonnenberg, A

    1998-08-01

    Knowledge about the influence of H. pylori-related disease on life expectancy might affect physician behavior in dealing with such disease. The aim of this study was to assess how life expectancy is influenced by H. pylori infection and peptic ulcer disease. The declining exponential approximation of life expectancy was used to model the effects of H. pylori and various peptic ulcer disease conditions on life expectancy. Deaths from peptic ulcer and gastric cancer were determined from the Vital Statistics of the United States. H. pylori prevalence rates were derived from the existing literature. Cure of active peptic ulcer increases life expectancy by 2.3 yr in persons aged 40-44 yr and 121 days in persons aged 70-74 yr. More substantial impact occurs in complicated ulcer, with increases in life expectancy ranging between 26.1 and 6.3 yr. Primary prevention of H. pylori could increase life expectancy by 190 days in those aged 40-44 yr and 26 days in 70-74-yr-old subjects. The benefit of ulcer cure or H. pylori prevention diminishes as age advances. Cure of ulcers in young patients or in those who have sustained complications results in an appreciable increase in life expectancy. Successful primary prevention of H. pylori in selected populations could substantially increase life expectancy.

  12. The gap gets bigger: changes in mortality and life expectancy, by education, 1981-2000.

    PubMed

    Meara, Ellen R; Richards, Seth; Cutler, David M

    2008-01-01

    In this paper we examine educational disparities in mortality and life expectancy among non-Hispanic blacks and whites in the 1980s and 1990s. Despite increased attention and substantial dollars directed to groups with low socioeconomic status, within race and gender groups, the educational gap in life expectancy is rising, mainly because of rising differentials among the elderly. With the exception of black males, all recent gains in life expectancy at age twenty-five have occurred among better-educated groups, raising educational differentials in life expectancy by 30 percent. Differential trends in smoking-related diseases explain at least 20 percent of this trend.

  13. The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening.

    PubMed

    Gross, Cary P; McAvay, Gail J; Krumholz, Harlan M; Paltiel, A David; Bhasin, Devina; Tinetti, Mary E

    2006-11-07

    Older adults with shorter life expectancies may receive less benefit from colorectal cancer screening than younger, healthier patients. To determine the degree to which life expectancy after diagnosis of an early-stage cancer varies according to age or coexisting chronic illness. Retrospective cohort study. Population-based cancer registry with linked administrative claims data. Patients 67 years of age or older who received a diagnosis of colorectal cancer from 1993 through 1999. Chronic conditions were identified by searching Medicare claims. Using a life-table approach, the authors quantified the degree to which life expectancy associated with each cancer stage at diagnosis varied with patient age, sex, and burden of chronic conditions. The final study sample consisted of 35 755 patients. After accounting for cancer stage at diagnosis, the authors found that life expectancy was strongly related to both age and the burden of chronic illness. Among men who received a diagnosis of stage I cancer at 67 years of age, life expectancy decreased from 19.1 years (95% CI, 17.8 to 20.5 years) for patients with no chronic conditions to 12.4 years (CI, 11.4 to 13.5 years) for those with 1 or 2 conditions and 7.6 years (CI, 6.1 to 9.4 years) for those with 3 or more conditions. A similar trend was noted among female counterparts, with life expectancy decreasing from approximately 23 years to 16 years and 7 years for the 3 chronic condition groups, respectively. For men and women 81 years of age with no chronic illnesses, life expectancy after stage I cancer diagnosis was 10.3 years (CI, 9.2 to 11.9 years) and 13.8 years (CI, 12.3 to 15.3 years), respectively. Administrative claims may not identify all chronic conditions. Life expectancy estimates at the population level are averages and, therefore, may not accurately predict the life expectancy of individual patients. Coexisting chronic illness is associated with a substantial reduction in life expectancy after diagnosis of

  14. Trends Over 4 Decades in Disability-Free Life Expectancy in the United States

    PubMed Central

    Zhang, Yuan; Saito, Yasuhiko

    2016-01-01

    Objectives. To examine changes over 40 years (1970–2010) in life expectancy, life expectancy with disability, and disability-free life expectancy for American men and women of all ages. Methods. We used mortality rates from US Vital Statistics and data on disability prevalence in the community-dwelling population from the National Health Interview Survey; for the institutional population, we computed disability prevalence from the US Census. We used the Sullivan method to estimate disabled and disability-free life expectancy for 1970, 1980, 1990, 2000, and 2010. Results. Over the 40 years, there was a steady increase in both disability-free life expectancy and disabled life expectancy. At birth, increases in disabled life and nondisabled life were equal for men (4.5 years); for women, at birth the increase in life with disability (3.6 years) exceeded the increase in life free of disability (2.7 years). At age 65 years, the increase in disability-free life was greater than the increase in disabled life. Conclusions. Across the life cycle, there was no compression of morbidity, but at age 65 years some compression occurred. PMID:27077352

  15. Racial Disparities in Life Expectancy in Brazil: Challenges From a Multiracial Society

    PubMed Central

    Chiavegatto Filho, Alexandre Dias Porto; Beltrán-Sánchez, Hiram; Kawachi, Ichiro

    2014-01-01

    Objectives. We calculated life expectancy at birth for Whites, Blacks, and mixed races in Brazil, and decomposed the differences by causes of death. Methods. We used Ministry of Health death records and 2010 Census population data (190 755 799 residents and 1 136 947 deaths). We applied the Arriaga methodology to calculate decomposition of life expectancy by cause of death. We performed sensitivity analyses for underreporting of deaths, missing data, and numerator–denominator bias. Results. Using standard life table methods, female life expectancy was highest for mixed races (78.80 years), followed by Whites (77.54 years), then Blacks (76.32 years). Male life expectancy was highest for Whites (71.10 years) followed closely by mixed races (71.08 years), and lower for Blacks (70.11 years). Homicides contributed the most to the relative life expectancy increase for Whites, and cancer decreased the gap. After adjustment for underreporting, missing data, and numerator–denominator bias, life expectancy was higher for Whites than for Blacks and mixed races. Conclusions. Despite wide socioeconomic differences between Whites and mixed races, standard life table methods showed that mixed races had higher life expectancy than Whites for women, and similar for men. With the increase of multiracial populations, measuring racial disparities in life expectancy will be a fast-growing challenge. PMID:24432884

  16. Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the National Health Survey, 2013.

    PubMed

    Szwarcwald, Célia Landmann; Souza Júnior, Paulo Roberto Borges de; Marques, Aline Pinto; Almeida, Wanessa da Silva de; Montilla, Dalia Elena Romero

    2016-11-17

    The demographic shift and epidemiologic transition in Brazil have drawn attention to ways of measuring population health that complement studies of mortality. In this paper, we investigate regional differences in healthy life expectancy based on information from the National Health Survey (PNS), 2013. In the survey, a three-stage cluster sampling (census tracts, households and individuals) with stratification of the primary sampling units and random selection in all stages was used to select 60,202 Brazilian adults (18 years and over). Healthy life expectancies (HLE) were estimated by Sullivan's method according to sex, age and geographic region, using poor self-rated health for defining unhealthy status. Logistic regression models were used to investigate socioeconomic and regional inequalities in poor self-rated health, after controlling by sex and age. Wide disparities by geographic region were found with the worst indicators in the North and Northeast regions, whether considering educational attainment, material deprivation, or health care utilization. Life expectancy at birth for women and men living in the richest regions was 5 years longer than for those living in the less wealthy regions. Modeling the variation across regions for poor self-rated health, statistically significant effects (p < 0.001) were found for the North and Northeast when compared to the Southeast, even after controlling for age, sex, diagnosis of at least one non-communicable chronic disease, and schooling or socioeconomic class. Marked regional inequalities in HLE were found, with the loss of healthy life much higher among residents of the poorest regions, especially among the elderly. By combining data on self-rated health status and mortality in a single indicator, Healthy Life Expectancy, this study demonstrated the excess burden of poor health experienced by populations in the less wealthy regions of Brazil. To mitigate the effects of social exclusion, the development of strategies

  17. Widening rural-urban disparities in life expectancy, U.S., 1969-2009.

    PubMed

    Singh, Gopal K; Siahpush, Mohammad

    2014-02-01

    There is limited research on rural-urban disparities in U.S. life expectancy. This study examined trends in rural-urban disparities in life expectancy at birth in the U.S. between 1969 and 2009. The 1969-2009 U.S. county-level mortality data linked to a rural-urban continuum measure were analyzed. Life expectancies were calculated by age, gender, and race for 3-year time periods between 1969 and 2004 and for 2005-2009 using standard life-table methodology. Differences in life expectancy were decomposed by age and cause of death. Life expectancy was inversely related to levels of rurality. In 2005-2009, those in large metropolitan areas had a life expectancy of 79.1 years, compared with 76.9 years in small urban towns and 76.7 years in rural areas. When stratified by gender, race, and income, life expectancy ranged from 67.7 years among poor black men in nonmetropolitan areas to 89.6 among poor Asian/Pacific Islander women in metropolitan areas. Rural-urban disparities widened over time. In 1969-1971, life expectancy was 0.4 years longer in metropolitan than in nonmetropolitan areas (70.9 vs 70.5 years). By 2005-2009, the life expectancy difference had increased to 2.0 years (78.8 vs 76.8 years). The rural poor and rural blacks currently experience survival probabilities that urban rich and urban whites enjoyed 4 decades earlier. Causes of death contributing most to the increasing rural-urban disparity and lower life expectancy in rural areas include heart disease, unintentional injuries, COPD, lung cancer, stroke, suicide, and diabetes. Between 1969 and 2009, residents in metropolitan areas experienced larger gains in life expectancy than those in nonmetropolitan areas, contributing to the widening gap. Published by American Journal of Preventive Medicine on behalf of American Journal of Preventive Medicine.

  18. Use of Surveillance Mammography Among Older Breast Cancer Survivors by Life Expectancy.

    PubMed

    Freedman, Rachel A; Keating, Nancy L; Pace, Lydia E; Lii, Joyce; McCarthy, Ellen P; Schonberg, Mara A

    2017-09-20

    Purpose The benefits of annual surveillance mammography in older breast cancer survivors with limited life expectancy are not known, and there are important risks; however, little is known about mammography use among these women. Materials and Methods We used National Health Interview Study data from 2000, 2005, 2008, 2010, 2013, and 2015 to examine surveillance mammography use among women age ≥ 65 years who reported a history of breast cancer. Using multivariable logistic regression, we assessed the probability of mammography within the last 12 months by 5- and 10-year life expectancy (using the validated Schonberg index), adjusting for survey year, region, age, marital status, insurance, educational attainment, and indicators of access to care. Results Of 1,040 respondents, 33.7% were age ≥ 80 years and 88.6% were white. Approximately 8.6% and 35.1% had an estimated life expectancy of ≤ 5 and ≤ 10 years, respectively. Overall, 78.9% reported having routine surveillance mammography in the last 12 months. Receipt of mammography decreased with decreasing life expectancy ( P < .001), although 56.7% and 65.9% of those with estimated ≤ 5-year and ≤ 10-year life expectancy, respectively, reported mammography in the last year. Conversely, 14.1% of those with life expectancy > 10 years did not report mammography. In adjusted analyses, lower ( v higher) life expectancy was significantly associated with lower odds of mammography (odds ratio, 0.4; 95% CI, 0.3 to 0.8 for ≤ 5-year life expectancy and OR, 0.4; 95% CI, 0.3 to 0.6 for ≤ 10-year life expectancy). Conclusion Many (57%) older breast cancer survivors with an estimated short life expectancy (< 5 years) receive annual surveillance mammography despite unknown benefits, whereas 14% with estimated life expectancy > 10 years did not report mammography. Practice guidelines are needed to optimize and tailor follow-up care for older patients.

  19. Seasonal life history trade-offs in two leafwing butterflies: Delaying reproductive development increases life expectancy.

    PubMed

    McElderry, Robert M

    2016-04-01

    Surviving inhospitable periods or seasons may greatly affect fitness. Evidence of this exists in the prevalence of dormant stages in the life cycles of most insects. Here I focused on butterflies with distinct seasonal morphological types (not a genetic polymorphism) in which one morphological type, or form, delays reproduction until favorable conditions return, while the other form develops in an environment that favors direct reproduction. For two butterflies, Anaea aidea and A. andria, I tested the hypothesis that the development of each seasonal form involves a differential allocation of resources to survival at eclosion. I assayed differences in adult longevity among summer and winter forms in either a warm, active environment or a cool, calm environment. Winter form adults lived 40 times longer than summer form but only in calm, cool conditions. The magnitude of this difference provided compelling evidence that the winter form body plan and metabolic strategy (i.e. resource conservatism) favor long term survival. This research suggests that winter form adults maintain lowered metabolic rate, a common feature of diapause, to conserve resources and delay senescence while overwintering. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. New methodology for shaft design based on life expectancy

    NASA Technical Reports Server (NTRS)

    Loewenthal, S. H.

    1986-01-01

    The design of power transmission shafting for reliability has not historically received a great deal of attention. However, weight sensitive aerospace and vehicle applications and those where the penalties of shaft failure are great, require greater confidence in shaft design than earlier methods provided. This report summarizes a fatigue strength-based, design method for sizing shafts under variable amplitude loading histories for limited or nonlimited service life. Moreover, applications factors such as press-fitted collars, shaft size, residual stresses from shot peening or plating, corrosive environments can be readily accommodated into the framework of the analysis. Examples are given which illustrate the use of the method, pointing out the large life penalties due to occasional cyclic overloads.

  1. Differences in life expectancy due to race and educational differences are widening, and many may not catch up.

    PubMed

    Olshansky, S Jay; Antonucci, Toni; Berkman, Lisa; Binstock, Robert H; Boersch-Supan, Axel; Cacioppo, John T; Carnes, Bruce A; Carstensen, Laura L; Fried, Linda P; Goldman, Dana P; Jackson, James; Kohli, Martin; Rother, John; Zheng, Yuhui; Rowe, John

    2012-08-01

    It has long been known that despite well-documented improvements in longevity for most Americans, alarming disparities persist among racial groups and between the well-educated and those with less education. In this article we update estimates of the impact of race and education on past and present life expectancy, examine trends in disparities from 1990 through 2008, and place observed disparities in the context of a rapidly aging society that is emerging at a time of optimism about the next revolution in longevity. We found that in 2008 US adult men and women with fewer than twelve years of education had life expectancies not much better than those of all adults in the 1950s and 1960s. When race and education are combined, the disparity is even more striking. In 2008 white US men and women with 16 years or more of schooling had life expectancies far greater than black Americans with fewer than 12 years of education-14.2 years more for white men than black men, and 10.3 years more for white women than black women. These gaps have widened over time and have led to at least two "Americas," if not multiple others, in terms of life expectancy, demarcated by level of education and racial-group membership. The message for policy makers is clear: implement educational enhancements at young, middle, and older ages for people of all races, to reduce the large gap in health and longevity that persists today.

  2. Life Expectancy With and Without Pain in the U.S. Elderly Population

    PubMed Central

    Rubin, Sara

    2016-01-01

    Background: This study contributes to dialogue on quality versus quantity of life by examining years older persons can expect to live in various states of pain. Methods: Data from seven waves of the Health and Retirement Study; N = 26,896; age 55+. Estimations using the Interpolative Markov Chain approach apply probability transitions to multistate life table functions. Two estimates are interpreted: (i) population-based, which provide population averages aggregated across baseline states and (ii) status-based, which provide independent estimates by baseline state. Age- and sex-specific years with no pain, milder nonlimiting, and severe or limiting pain are reported as is percent of life in states of pain. Results: Females have higher life expectancy than males but similar expectations of pain-free life. Total life expectancy varies only slightly by baseline pain states but pain-free life expectancy varies greatly. For example, an 85-year-old female pain-free at baseline expects 7.04 more years, 5.28 being pain-free. An 85-year-old female with severe pain at baseline expects 6.42 years with only 2.66 pain-free. Percent of life with pain decreases by age for those pain-free at baseline and increases for those with pain at baseline. Conclusion: Pain is moderately associated with quantity of or total life but substantially and importantly associated with quality of or pain-free life. PMID:26988661

  3. Reduction of social inequalities in life expectancy in a city of Southeastern Brazil

    PubMed Central

    2011-01-01

    Background Around the world the life expectancy at birth has risen steadily over time. However, this increase in life years is not equally distributed among different social segments of the population. Studies have demonstrated that social groups living in deprived areas have a shorter life expectancy at birth in comparison to affluent ones. The aim of this study was to evaluate inequalities in life expectancy by socioeconomic strata in a city with one million inhabitants in Southeastern Brazil, in 2000 and 2005. Methods Through an ecological approach, the 49 areas of health care units of the city were classified into three socioeconomic strata, defined according to variables of income and educational level of the heads of household obtained from the 2000 Census. Life tables were constructed by sex for each of the three socioeconomic strata in 2000 and 2005. Results The life expectancy at birth for men and women living in poor areas was 6.9 and 5.5 years lower in comparison to the affluent ones in 2000. Between 2000 and 2005, these social inequalities in life expectancy at birth reduced, since the groups with lower socioeconomic level had gained more life years. The increase in life expectancy at birth experienced by areas with worse living conditions was 3 times higher than the increment estimated for prosperous areas for both sexes. Males had the greatest gain in life years, leading to a narrowing of gender differentials in life expectancy between 2000 and 2005. Conclusions The reduction of social inequalities in life expectancy suggests that living and health conditions have improved over time, due to social and health policies. The expansion of both health care coverage and cash transfer policies could have had positive effects on mortality reduction and on the consequent increase in the life expectancy, especially for the poor population. PMID:21871100

  4. Expectancies for Success as a Multidimensional Construct among Employed Adults.

    ERIC Educational Resources Information Center

    Ward, Edward A.

    2001-01-01

    Administered the Generalized Expectancy for Success-Revised (GESS-R) scale (B. Fibel and W. Hale, 1978) to 547 full-time employees in the United States. Exploratory factor analysis found four distinct factors, and scores on these four subscales were minimally related to the demographics of the subjects and had adequate internal consistency.…

  5. Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble.

    PubMed

    Kontis, Vasilis; Bennett, James E; Mathers, Colin D; Li, Guangquan; Foreman, Kyle; Ezzati, Majid

    2017-04-01

    Projections of future mortality and life expectancy are needed to plan for health and social services and pensions. Our aim was to forecast national age-specific mortality and life expectancy using an approach that takes into account the uncertainty related to the choice of forecasting model. We developed an ensemble of 21 forecasting models, all of which probabilistically contributed towards the final projections. We applied this approach to project age-specific mortality to 2030 in 35 industrialised countries with high-quality vital statistics data. We used age-specific death rates to calculate life expectancy at birth and at age 65 years, and probability of dying before age 70 years, with life table methods. Life expectancy is projected to increase in all 35 countries with a probability of at least 65% for women and 85% for men. There is a 90% probability that life expectancy at birth among South Korean women in 2030 will be higher than 86·7 years, the same as the highest worldwide life expectancy in 2012, and a 57% probability that it will be higher than 90 years. Projected female life expectancy in South Korea is followed by those in France, Spain, and Japan. There is a greater than 95% probability that life expectancy at birth among men in South Korea, Australia, and Switzerland will surpass 80 years in 2030, and a greater than 27% probability that it will surpass 85 years. Of the countries studied, the USA, Japan, Sweden, Greece, Macedonia, and Serbia have some of the lowest projected life expectancy gains for both men and women. The female life expectancy advantage over men is likely to shrink by 2030 in every country except Mexico, where female life expectancy is predicted to increase more than male life expectancy, and in Chile, France, and Greece where the two sexes will see similar gains. More than half of the projected gains in life expectancy at birth in women will be due to enhanced longevity above age 65 years. There is more than a 50% probability

  6. Living longer, working longer? The impact of subjective life expectancy on retirement intentions and behaviour.

    PubMed

    van Solinge, Hanna; Henkens, Kène

    2010-02-01

    Virtually all Western countries are seeking to bring retirement ages more in line with increases in longevity. The central question in this article is whether individuals choose a retirement age that fits their life expectancy. This would be ideal from a public policy perspective. The present study aims to test empirically whether retirement planning varies with expectations of survival among a sample of older employees in the Netherlands. Two questions are addressed: (i) what are older employees' expectations of their remaining lifetime, and what factors influence this subjective life expectancy? (ii) Are individuals who perceive longer life horizons (high subjective life expectancy) more inclined to retire later than people who expect to live shorter? Using data from a panel study on retirement behaviour in the Netherlands (N = 1621 older employees aged 50-60 years), regression and survival models are estimated to examine the effect of subjective life expectancy on retirement planning and behaviour. The results indicate that subjective life expectancy is a factor that is taken into account in retirement decision making, at least as far as retirement intentions are concerned. Older employees with longer time horizons have a preference for later retirement. When it comes to actual behaviour, however, time horizon does not appear to play a role. The results suggest that particularly employees with a high perceived life expectancy and an intention to work longer do not succeed in carrying their intentions into effect.

  7. [Living longer, working longer? The impact of subjective life expectancy on retirement intentions and behavior].

    PubMed

    van Solinge, H; Henkens, K

    2010-10-01

    Virtually all Western countries are seeking to bring retirement ages more in line with increases in longevity. The central question in this paper is whether individuals choose a retirement age that fits their life expectancy. This would be ideal from a public policy perspective. The present study aims to test empirically whether retirement planning varies with expectations of survival among a sample of older employees in the Netherlands. Two questions are addressed: (1) What are older employees' expectations of their remaining lifetime, and what factors influence this subjective life expectancy? (2) Are individuals who perceive longer life horizons (high subjective life expectancy) more inclined to retire later than people who expect to live shorter? Using data from a panel study on retirement behaviour in the Netherlands (N=1621 older employees aged 50-60), regression and survival models are estimated to examine the effect of subjective life expectancy on retirement planning and behaviour. The results indicate that subjective life expectancy is a factor that is taken into account in retirement decision making, at least as far as retirement intentions are concerned. Older employees with longer time horizons have a preference for later retirement. When it comes to actual behaviour, however, time horizon does not appear to play a role. The results suggest that particularly employees with a high perceived life expectancy and an intention to work longer do not succeed in carrying their intentions into effect.

  8. Mortality ratios and life expectancy in X chromatin positive males.

    PubMed Central

    Price, W H; Clayton, J F; Collyer, S; de Mey, R

    1985-01-01

    In a prospective study of 466 X chromatin positive males an increase in mortality of about 50% has been observed. The increase is associated with a loss of about five years in life span. There is no convincing evidence that the increase is concentrated at any particular age group but this possibility could not be excluded. No effect of mode of ascertainment could be demonstrated. From this study we conclude that it is likely that the mortality experienced by chromatin positive males in general is at least 115% of that experienced by normal men and could be more than 200%. PMID:4039353

  9. Effects of Premature Parental Death on Subjective Life Expectancy, Death Anxiety, and Health Behavior.

    ERIC Educational Resources Information Center

    Denes-Raj, Veronika; Ehrlichman, Howard

    1991-01-01

    Subjective life expectancy, death anxiety, and health behavior were assessed in college students (n=36) with at least one parent who died prematurely of illness (PD group) and students (n=36) with both parents alive (PA group). PD group estimated their life expectancy to be shorter than the PA; subgroup of PD reported poorer diet. (Author/ABL)

  10. Life Expectancy and Human Capital Investments: Evidence from Maternal Mortality Declines. NBER Working Paper No. 13947

    ERIC Educational Resources Information Center

    Jayachandran, Seema; Lleras-Muney, Adriana

    2008-01-01

    Longer life expectancy should encourage human capital accumulation, since a longer time horizon increases the value of investments that pay out over time. Previous work has been unable to determine the empirical importance of this life-expectancy effect due to the difficulty of isolating it from other effects of health on education. We examine a…

  11. Life Expectancy Varies in Local Communities in Chicago: Racial and Spatial Disparities and Correlates.

    PubMed

    Hunt, Bijou R; Tran, Gary; Whitman, Steven

    2015-12-01

    Life expectancy in the USA reached a record high of 78.7 years in 2010. However, the racial gap in life expectancy persists. National data, which are readily available, provide averages which mask important local-level differences. Local data are needed to identify the worst off groups, key to reducing disparities and pursuing health equity. Using vital records data, we calculated life expectancy for the USA and Chicago by race/ethnicity and gender and for Chicago's 77 community areas. We also examined the correlation between life expectancy and (1) racial/ethnic composition of a community area and (2) median household income. In Chicago, the highest life expectancy was observed among Hispanics at 84.6 and the lowest life expectancy was observed among Blacks at 71.7-a difference of about 13 years. Life expectancy varied substantially across the 77 community areas of Chicago, from a low of 68.2 to a high of 83.3-a difference of 15 years. There were strong correlations between life expectancy and the racial, ethnic, and socioeconomic distributions among the community areas. The examination of data at the local level provides invaluable insight into which communities are facing the greatest burden in terms of health and well-being. It is only through the examination of local-level data that we can understand the unique needs of these communities and begin to address them.

  12. People with Intellectual Disability: What Do We Know about Adulthood and Life Expectancy?

    ERIC Educational Resources Information Center

    Coppus, A. M. W.

    2013-01-01

    Increases in the life expectancy of people with Intellectual Disability have followed similar trends to those found in the general population. With the exception of people with severe and multiple disabilities or Down syndrome, the life expectancy of this group now closely approximates with that of the general population. Middle and old age, which…

  13. Ethnic and gender specific life expectancies of the Singapore population, 1965 to 2009 - converging, or diverging?

    PubMed

    Lim, Raymond Boon Tar; Zheng, Huili; Yang, Qian; Cook, Alex Richard; Chia, Kee Seng; Lim, Wei Yen

    2013-10-26

    The increase in life expectancy and the persistence of expectancy gaps between different social groups in the 20th century are well-described in Western developed countries, but less well documented in the newly industrialised countries of Asia. Singapore, a multiethnic island-state, has undergone a demographic and epidemiologic transition concomitant with economic development. We evaluate secular trends and differences in life expectancy by ethnicity and gender in Singapore, from independence to the present. Period abridged life tables were constructed to derive the life expectancy of the Singapore population from 1965 to 2009 using data from the Department of Statistics and the Registry of Births and Deaths, Singapore. All 3 of Singapore's main ethnic groups, and both genders, experienced an increase in life expectancy at birth and at 65 years from 1965 to 2009, though at substantially different rates. Although there has been a convergence in life expectancy between Indians and Chinese, the (substantial) gap between Malays and the other two ethnic groups has remained. Females continued to have a higher life expectancy at birth and at 65 years than males throughout this period, with no evidence of convergence. Ethnic and gender differences in life expectancy persist in Singapore despite its rapid economic development. Targeted chronic disease prevention measures and health promotion activities focusing on people of Malay ethnicity and the male community may be needed to remedy this inequality.

  14. A Comparative Study of Handicap-Free Life Expectancy of China in 1987 and 2006

    ERIC Educational Resources Information Center

    Lai, Dejian

    2009-01-01

    After the first large scale national sampling survey on handicapped persons in 1987, China conducted its second national sampling survey in 2006. Using the data from these two surveys and the national life tables, we computed and compared the expected years of life free of handicapped condition by the Sullivan method. The expected years of life…

  15. People with Intellectual Disability: What Do We Know about Adulthood and Life Expectancy?

    ERIC Educational Resources Information Center

    Coppus, A. M. W.

    2013-01-01

    Increases in the life expectancy of people with Intellectual Disability have followed similar trends to those found in the general population. With the exception of people with severe and multiple disabilities or Down syndrome, the life expectancy of this group now closely approximates with that of the general population. Middle and old age, which…

  16. Life Expectancy and Human Capital Investments: Evidence from Maternal Mortality Declines. NBER Working Paper No. 13947

    ERIC Educational Resources Information Center

    Jayachandran, Seema; Lleras-Muney, Adriana

    2008-01-01

    Longer life expectancy should encourage human capital accumulation, since a longer time horizon increases the value of investments that pay out over time. Previous work has been unable to determine the empirical importance of this life-expectancy effect due to the difficulty of isolating it from other effects of health on education. We examine a…

  17. Left behind: widening disparities for males and females in US county life expectancy, 1985–2010

    PubMed Central

    2013-01-01

    Background The United States spends more than any other country on health care. The poor relative performance of the US compared to other high-income countries has attracted attention and raised questions about the performance of the US health system. An important dimension to poor national performance is the large disparities in life expectancy. Methods We applied a mixed effects Poisson statistical model and Gaussian Process Regression to estimate age-specific mortality rates for US counties from 1985 to 2010. We generated uncertainty distributions for life expectancy at each age using standard simulation methods. Results Female life expectancy in the United States increased from 78.0 years in 1985 to 80.9 years in 2010, while male life expectancy increased from 71.0 years in 1985 to 76.3 years in 2010. The gap between female and male life expectancy in the United States was 7.0 years in 1985, narrowing to 4.6 years in 2010. For males at the county level, the highest life expectancy steadily increased from 75.5 in 1985 to 81.7 in 2010, while the lowest life expectancy remained under 65. For females at the county level, the highest life expectancy increased from 81.1 to 85.0, and the lowest life expectancy remained around 73. For male life expectancy at the county level, there have been three phases in the evolution of inequality: a period of rising inequality from 1985 to 1993, a period of stable inequality from 1993 to 2002, and rising inequality from 2002 to 2010. For females, in contrast, inequality has steadily increased during the 25-year period. Compared to only 154 counties where male life expectancy remained stagnant or declined, 1,405 out of 3,143 counties (45%) have seen no significant change or a significant decline in female life expectancy from 1985 to 2010. In all time periods, the lowest county-level life expectancies are seen in the South, the Mississippi basin, West Virginia, Kentucky, and selected counties with large Native American populations

  18. Developing Community Expectations: The Critical Role of Adult Educators

    ERIC Educational Resources Information Center

    Deggs, David; Miller, Michael

    2011-01-01

    The quality of life in a community is directly tied to the capital available to its citizenry. The idea of capital refers to the resources related to the population--the wealth, the open-minded nature of individuals, the potential for jobs, and putting skills and talents to use to earn a living. There have been a wide range of studies and efforts…

  19. The Promise of Prevention: The Effects of Four Preventable Risk Factors on National Life Expectancy and Life Expectancy Disparities by Race and County in the United States

    PubMed Central

    Danaei, Goodarz; Rimm, Eric B.; Oza, Shefali; Kulkarni, Sandeep C.; Murray, Christopher J. L.; Ezzati, Majid

    2010-01-01

    Background There has been substantial research on psychosocial and health care determinants of health disparities in the United States (US) but less on the role of modifiable risk factors. We estimated the effects of smoking, high blood pressure, elevated blood glucose, and adiposity on national life expectancy and on disparities in life expectancy and disease-specific mortality among eight subgroups of the US population (the “Eight Americas”) defined on the basis of race and the location and socioeconomic characteristics of county of residence, in 2005. Methods and Findings We combined data from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System to estimate unbiased risk factor levels for the Eight Americas. We used data from the National Center for Health Statistics to estimate age–sex–disease-specific number of deaths in 2005. We used systematic reviews and meta-analyses of epidemiologic studies to obtain risk factor effect sizes for disease-specific mortality. We used epidemiologic methods for multiple risk factors to estimate the effects of current exposure to these risk factors on death rates, and life table methods to estimate effects on life expectancy. Asians had the lowest mean body mass index, fasting plasma glucose, and smoking; whites had the lowest systolic blood pressure (SBP). SBP was highest in blacks, especially in the rural South—5–7 mmHg higher than whites. The other three risk factors were highest in Western Native Americans, Southern low-income rural blacks, and/or low-income whites in Appalachia and the Mississippi Valley. Nationally, these four risk factors reduced life expectancy at birth in 2005 by an estimated 4.9 y in men and 4.1 y in women. Life expectancy effects were smallest in Asians (M, 4.1 y; F, 3.6 y) and largest in Southern rural blacks (M, 6.7 y; F, 5.7 y). Standard deviation of life expectancies in the Eight Americas would decline by 0.50 y (18%) in men and 0

  20. Spatial Abilities across the Adult Life Span

    ERIC Educational Resources Information Center

    Borella, Erika; Meneghetti, Chiara; Ronconi, Lucia; De Beni, Rossana

    2014-01-01

    The study investigates age-related effects across the adult life span on spatial abilities (testing subabilities based on a distinction between spatial visualization, mental rotation, and perspective taking) and spatial self-assessments. The sample consisted of 454 participants (223 women and 231 men) from 20 to 91 years of age. Results showed…

  1. Spatial Abilities across the Adult Life Span

    ERIC Educational Resources Information Center

    Borella, Erika; Meneghetti, Chiara; Ronconi, Lucia; De Beni, Rossana

    2014-01-01

    The study investigates age-related effects across the adult life span on spatial abilities (testing subabilities based on a distinction between spatial visualization, mental rotation, and perspective taking) and spatial self-assessments. The sample consisted of 454 participants (223 women and 231 men) from 20 to 91 years of age. Results showed…

  2. Marital and Life Satisfaction among Gifted Adults

    ERIC Educational Resources Information Center

    Perrone-McGovern, Kristin M.; Boo, Jenelle N.; Vannatter, Aarika

    2012-01-01

    Spousal giftedness, dual-career status, and gender were studied in relation to marital and life satisfaction among gifted adults. The data for the present study were collected twice over a 5-year period in order to examine the stability of the findings over time. Results indicated that marital satisfaction was significantly related to life…

  3. Quality of Life in Adults Who Stutter

    ERIC Educational Resources Information Center

    Koedoot, Caroline; Bouwmans, Clazien; Franken, Marie-Christine; Stolk, Elly

    2011-01-01

    Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In…

  4. Quality of Life in Adults Who Stutter

    ERIC Educational Resources Information Center

    Koedoot, Caroline; Bouwmans, Clazien; Franken, Marie-Christine; Stolk, Elly

    2011-01-01

    Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In…

  5. Marital and Life Satisfaction among Gifted Adults

    ERIC Educational Resources Information Center

    Perrone-McGovern, Kristin M.; Boo, Jenelle N.; Vannatter, Aarika

    2012-01-01

    Spousal giftedness, dual-career status, and gender were studied in relation to marital and life satisfaction among gifted adults. The data for the present study were collected twice over a 5-year period in order to examine the stability of the findings over time. Results indicated that marital satisfaction was significantly related to life…

  6. Social Rank, Stress, Fitness, and Life Expectancy in Wild Rabbits

    NASA Astrophysics Data System (ADS)

    von Holst, Dietrich; Hutzelmeyer, Hans; Kaetzke, Paul; Khaschei, Martin; Schönheiter, Ronald

    Wild rabbits of the two sexes have separate linear rank orders, which are established and maintained by intensive fights. The social rank of individuals strongly influence their fitness: males and females that gain a high social rank, at least at the outset of their second breeding season, have a much higher lifetime fitness than subordinate individuals. This is because of two separate factors: a much higher fecundity and annual reproductive success and a 50% longer reproductive life span. These results are in contrast to the view in evolutionary biology that current reproduction can be increased only at the expense of future survival and/or fecundity. These concepts entail higher physiological costs in high-ranking mammals, which is not supported by our data: In wild rabbits the physiological costs of social positions are caused predominantly by differential psychosocial stress responses that are much lower in high-ranking than in low-ranking individuals.

  7. National independence, women's political participation, and life expectancy in Norway.

    PubMed

    Nobles, Jenna; Brown, Ryan; Catalano, Ralph

    2010-05-01

    This study investigates the role of national independence and women's political participation on population health using historical lifespan data from Norway. We use time-series methods to analyze data measuring the actual length of time lived by Norwegian birth cohorts spanning a 61 year period surrounding the political emancipation of Norway from Sweden in 1905 and the establishment of a Norwegian monarchy in 1906. The use of a discrete, historical event improves our ability to interpret the population health effects of national independence and women's political participation as causal. We find a large and significant positive effect on the lifespan of Norwegian females born in the 1906 cohort. Interestingly, the effect does not extend to all living females during the Norwegian drive toward sovereignty. We conclude that the beneficial effects were likely conferred through intrauterine biological transfers and/or neonatal investments specific to the first year of life. Copyright 2010 Elsevier Ltd. All rights reserved.

  8. Limited life expectancy among a subgroup of medicare beneficiaries receiving screening colonoscopies.

    PubMed

    Mittal, Sahil; Lin, Yu-Li; Tan, Alai; Kuo, Yong-Fang; El-Serag, Hashem B; Goodwin, James S

    2014-03-01

    Life expectancy is an important consideration when assessing appropriateness of preventive programs for older individuals. Most studies on this subject have used age cutoffs as a proxy for life expectancy. We analyzed patterns of utilization of screening colonoscopy in Medicare enrollees by using estimated life expectancy. We used a 5% random national sample of Medicare claims data to identify average-risk patients who underwent screening colonoscopies from 2008 to 2010. Colonoscopies were considered to be screening colonoscopies in the absence of diagnoses for nonscreening indications, which were based on either colonoscopies or any claims in the preceding 3 months. We estimated life expectancies by using a model that combined age, sex, and comorbidity. Among patients who underwent screening colonoscopies, we calculated the percentage of those with life expectancies <10 years. Among the 57,597 Medicare beneficiaries 66 years old or older who received at least 1 screening colonoscopy, 24.8% had an estimated life expectancy of <10 years. There was a significant positive association between total Medicare per capita costs in hospital referral regions and the proportion of patients with limited life expectancies (<10 years) at the time of screening colonoscopy (R = 0.25; P < .001, Pearson correlation test). In a multivariable analysis, men were substantially more likely than women to have limited life expectancy at the time of screening colonoscopy (odds ratio, 2.25; 95% confidence interval, 2.16-2.34). Nearly 25% of Medicare beneficiaries, especially men, had life expectancies <10 years at the time of screening colonoscopies. Life expectancy should therefore be incorporated in decision-making for preventive services. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  9. Educational differences in life expectancy over five decades among the oldest old in Norway.

    PubMed

    Kinge, Jonas Minet; Steingrímsdóttir, Ólöf Anna; Moe, Joakim Oliu; Skirbekk, Vegard; Næss, Øyvind; Strand, Bjørn Heine

    2015-11-01

    Socioeconomic inequalities in life expectancy have been shown among the middle aged and the youngest of the old individuals, but the situation in the oldest old is less clear. The aim of this study was to investigate trends in life expectancy at ages 85, 90 and 95 years by education in Norway in the period 1961-2009. This was a register-based population study including all residents in Norway aged 85 and over. Individual-level data were provided by the Central Population Register and the National Education Database. For each decade during 1961-2009, death rates by 1-year age groups were calculated separately for each sex and three educational categories. Annual life tables were used to calculate life expectancy at ages 85 (e85), 90 (e90) and 95 (e95). Educational differentials in life expectancy at each age were non-significant in the early decades, but became significant over time. For example, for the decade 2000-9, a man aged 90 years with primary education had a life expectancy of 3.4 years, while a man with tertiary education could expect to live for 3.8 years. Similar numbers in women were 4.1 and 4.5 years, respectively. Even among 95-year-old men, statistically significant differences in life expectancy were found by education in the two last decades. Education matters regarding remaining life expectancy also for the oldest old in Norway. Life expectancy at these ages is low, so a growth of 0.5 years in the life expectancy differential is sizeable. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Comorbidity-adjusted life expectancy: a new tool to inform recommendations for optimal screening strategies.

    PubMed

    Cho, Hyunsoon; Klabunde, Carrie N; Yabroff, K Robin; Wang, Zhuoqiao; Meekins, Angela; Lansdorp-Vogelaar, Iris; Mariotto, Angela B

    2013-11-19

    Many guidelines recommend considering health status and life expectancy when making cancer screening decisions for elderly persons. To estimate life expectancy for elderly persons without a history of cancer, taking into account comorbid conditions. Population-based cohort study. A 5% sample of Medicare beneficiaries in selected geographic areas, including their claims and vital status information. Medicare beneficiaries aged 66 years or older between 1992 and 2005 without a history of cancer (n = 407 749). Medicare claims were used to identify comorbid conditions included in the Charlson index. Survival probabilities were estimated by comorbidity group (no, low/medium, and high) and for the 3 most prevalent conditions (diabetes, chronic obstructive pulmonary disease, and congestive heart failure) by using the Cox proportional hazards model. Comorbidity-adjusted life expectancy was calculated based on comparisons of survival models with U.S. life tables. Survival probabilities from the U.S. life tables providing the most similar survival experience to the cohort of interest were used. Persons with higher levels of comorbidity had shorter life expectancies, whereas those with no comorbid conditions, including very elderly persons, had favorable life expectancies relative to an average person of the same chronological age. The estimated life expectancy at age 75 years was approximately 3 years longer for persons with no comorbid conditions and approximately 3 years shorter for those with high comorbidity relative to the average U.S. population. The cohort was limited to Medicare fee-for-service beneficiaries aged 66 years or older living in selected geographic areas. Data from the Surveillance, Epidemiology, and End Results cancer registry and Medicare claims lack information on functional status and severity of comorbidity, which might influence life expectancy in elderly persons. Life expectancy varies considerably by comorbidity status in elderly persons

  11. Population-Based Estimates of Life Expectancy After HIV Diagnosis. United States 2008 – 2011

    PubMed Central

    Siddiqi, Azfar-e-Alam; Irene Hall, H.; Hu, Xiaohong; Song, Ruiguang

    2016-01-01

    Introduction Using National HIV surveillance system data we estimated life expectancy and average years of life lost among person diagnosed with HIV infection during 2008–2011. Methods Population-based surveillance data, restricted to persons with diagnosed HIV infection age 13 years or older, from all 50 states and D.C. were used to estimate life expectancy after HIV diagnosis using the life table method. Generated estimates were compared with life expectancy in the general population in the same calendar year to calculate average years of life lost (AYLL). Life expectancy and average years of life lost were also estimated for subgroups by age, sex and race/ethnicity. Results The overall life expectancy after HIV diagnosis in the United States, increased 3.43 years from 25.43 (95% Confidence interval (CI) 25.37–25.49) in 2008, to 28.86 (95% CI 28.80–28.92) in 2011. Improvements were observed irrespective of sex, race/ethnicity, transmission category and stage of disease at diagnosis, though the extent of improvement varied by different characteristics. Based on the life expectancy in the general population, in 2010 the AYLL, were 12.8 years for males and 16.5 years for females. By race/ethnicity, on average blacks (13.3 years) and whites (13.4 years) had fewer AYLL than Hispanic/Latinos (14.7). Conclusions Despite improvements in life expectancy among people diagnosed with an HIV infection during 2008–2011, disparities by sex and by race/ethnicity persist. Targeted efforts should continue to further reduce disparities and improve life expectancy after HIV diagnosis. PMID:26890283

  12. Longevity in Slovenia: Past and potential gains in life expectancy by age and causes of death.

    PubMed

    Lotrič Dolinar, Aleša; Došenović Bonča, Petra; Sambt, Jože

    2017-06-01

    In Slovenia, longevity is increasing rapidly. From 1997 to 2014, life expectancy at birth increased by 7 and 5 years for men and women, respectively. This paper explores how this gain in life expectancy at birth can be attributed to reduced mortality from five major groups of causes of death by 5-year age groups. It also estimates potential future gains in life expectancy at birth. The importance of the five major causes of death was analysed by cause-elimination life tables. The total elimination of individual causes of death and a partial hypothetical adjustment of mortality to Spanish levels were analysed, along with age and cause decomposition (Pollard). During the 1997-2014 period, the increase in life expectancy at birth was due to lower mortality from circulatory diseases (ages above 60, both genders), as well as from lower mortality from neoplasms (ages above 50 years) and external causes (between 20 and 50 years) for men. However, considering the potential future gains in life expectancy at birth, by far the strongest effect can be attributed to lower mortality due to circulatory diseases for both genders. If Spanish mortality rates were reached, life expectancy at birth would increase by more than 2 years, again mainly because of lower mortality from circulatory diseases in very old ages. Life expectancy analyses can improve evidence-based decision-making and allocation of resources among different prevention programmes and measures for more effective disease management that can also reduce the economic burden of chronic diseases.

  13. Life Expectancy Estimates in the Life Care Plan: Accounting for Economic Factors.

    PubMed

    Krause, James S; Saunders, Lee L

    2010-06-01

    The purpose of this study was to summarize the existing scientific literature on the relationship between economic factors and life expectancy (LE) after spinal cord injury (SCI), present new data on the relationship between household income and LE, and present a revised theoretical risk model to account for the observed relationships. Data were from a prospective cohort study of 1386 participants with SCI which began in 1997. Mortality status was determined 10 years later. Person year logistic regression was used to evaluate predictors of mortality and to generate LE estimates, as each year of follow-up was treated as a separate observation (rather than a single observation per person). Results indicated significant relationships between age, injury severity, household income and LE, which suggest the need for more refined models of economic factors and LE. LE estimates in life care plans need to account for economic factors in order to improve accuracy. It is important to allocate resources to meet all healthcare needs throughout the lifecycle to ensure that LE is not compromised.

  14. The impact of functional status on life expectancy in older persons.

    PubMed

    Keeler, Emmett; Guralnik, Jack M; Tian, Haijun; Wallace, Robert B; Reuben, David B

    2010-07-01

    Although life tables provide a basis for estimating remaining life by age, gender, and race, these tables do not consider clinical characteristics or functional status, which can lead to wide variations in remaining years. Inclusion of functional status may permit more precise prognostic estimates of life expectancy and proportion of time in various functional states. We used longitudinal data from the Established Populations for Epidemiologic Studies of the Elderly to determine transition probabilities between three functional states (independent in activities of daily living [ADL] and mobility, dependent in mobility but independent in ADL, and dependent in ADL) and death. These were used to estimate total life expectancy and life expectancy in each functional state. In general, the largest proportion of remaining life expectancy was spent in the persons' baseline functional status category. Persons younger than 80 years with dependencies, however, spend substantial proportions of their remaining years in a better functional status category, and mobility-disabled 70-year-old persons spend the greatest part of their life expectancy in the independent functional state. Functional status has a dramatic impact on life expectancy. For example, 75-year-old men and women without limitations have life expectancies 5 years longer than those with ADL limitation and more than 1 year longer than those limited in mobility. The life expectancy of an ADL-disabled 75-year-old is similar to that of an 85-year-old independent person; thus, the impact of the disability approximates being 10 years older with much more of the remaining life spent disabled. Both ADL and mobility disability result in diminished survival and more of that survival period spent in disabled states.

  15. Effects of context expectation on prospective memory performance among older and younger adults.

    PubMed

    Kominsky, Terrence K; Reese-Melancon, Celinda

    2017-01-01

    This experiment examined the impact of context expectation on prospective memory (PM) performance among older and younger adults. Participants responded to PM target words embedded in an ongoing lexical decision task (LDT). Older and younger adults performed similarly on the PM task. Regardless of age, PM was significantly better for participants in the correct context expectation condition and significantly worse in the incorrect context expectation condition relative to participants who held no expectations about the context in which targets would appear. Participants' LDT response latencies were used to assess cost of the PM task to the ongoing task. Latencies were discernibly longer in the LDT block where the PM targets were expected compared to the block where they were not expected. The findings provide new information about how context can be used to support PM aging and suggest that contextual information can be equally beneficial for older and younger adults.

  16. [Healthy life expectancy in older adults with social security].

    PubMed

    Rodríguez-Ábrego, Gabriela; Ramírez-Sánchez, Teresita Jesús; Torres-Cosme, José Luis

    2014-01-01

    INTRODUCCIÓN: El envejecimiento poblacional incrementa la prevalencia de enfermedades crónicas. Esta morbilidad incide en los niveles de mortalidad relativamente altos y tiene efectos discapacitantes. Los indicadores clásicos de salud —esperanza de vida al nacer y tasa bruta de mortalidad— se complementan con la esperanza de vida libre de discapacidad (EVLD), cuya ventaja es la estandarización de los conceptos, las fuentes de información y los métodos de cálculo. En esta investigación se estima la esperanza de vida saludable en población adulta mayor con seguridad social en México. MÉTODOS: la esperanza de vida se estimó a partir del análisis de la mortalidad y construcción de tablas de vida de la población derechohabiente del Instituto Mexicano del Seguro Social. Se utilizó el método de Chiang y se modificó la tabla de vida ajustada por la prevalencia de discapacidad mediante el método de Sullivan. Se resaltó el análisis de la esperanza de vida saludable, esperanza de vida libre de discapacidad y esperanza de vida con discapacidad en el adulto mayor.

  17. The epidemiology of driving in later life: Sociodemographic, health and functional characteristics, predictors of incident cessation, and driving expectations.

    PubMed

    Anstey, Kaarin J; Li, Xiaolan; Hosking, Diane E; Eramudugolla, Ranmalee

    2017-08-14

    To describe population-level characteristics of drivers and non-drivers in a cohort of older Australians and identify predictors of driving cessation and expectations. The sample comprised the oldest cohort of the PATH Through Life project who were assessed 4 times between 2001 and 2013. At waves 3 and 4 questions on driving were included in the study interview. Data were also collected on health, physical and cognitive function and psychosocial wellbeing. Descriptive analyses compared drivers and non-drivers on sociodemographic, health and functional variables and regression models identified predictors of cessation and driving expectations. 92.5% of the sample were current drivers. They reported better physical, mental and cognitive health than non-drivers. Drivers expected to drive for another 12.6 years, the majority drove 6+ days per week. Four percent of the sample ceased driving over the four year follow-up. Predictors of cessation were financial problems, driving expectations and driving fewer kilometres per week. Predictors of expectations were poorer self-rated health, mastery, difficulties reading maps, self-rated visual function, years of driving experience, and fewer kilometres driven per week. Driving is normative for many older Australians in their 70s. Similar factors are associated with actual cessation and expectation of driving suggesting that older adults do have a sense of their expected driving life. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. The Association Between Income and Life Expectancy in the United States, 2001–2014

    PubMed Central

    Chetty, Raj; Stepner, Michael; Abraham, Sarah; Lin, Shelby; Scuderi, Benjamin; Turner, Nicholas; Bergeron, Augustin; Cutler, David

    2016-01-01

    Importance The relationship between income and mortality is well established but remains poorly understood. Objectives To measure the level, temporal trend, and geographic variability in the association between income and life expectancy, and identify factors related to small area variation in this association. Design and Setting Income data for the US population were obtained from 1.4 billion de-identified tax records between 1999 and 2014. Mortality data were obtained from Social Security Administration death records. These data were used to estimate race- and ethnicity-adjusted life expectancy at 40 years of age by household income percentile, sex, and geographic area, and to evaluate factors associated with differences in life expectancy. Main Outcomes and Measures Relationship between income and life expectancy; trends in life expectancy by income group; geographic variation in life expectancy levels and trends by income group; and factors associated with differences in life expectancy across areas. Results The sample consisted of 1 408 287 218 person-year observations (mean age at which individuals were analyzed, 53.0 years; median household earnings among working individuals, $61 175 per year [mean, $97 725 per year]). Among those aged 40 to 76 years, there were 4 114 380 deaths among men (mortality rate, 596.3 per 100 000) and 2 694 808 deaths among women (mortality rate, 375.1 per 100 000). The analysis yielded four results. First, higher income was associated with greater longevity throughout the income distribution. The gap in life expectancy between the richest 1% and poorest 1% of individuals was 14.6 years (95% CI, 14.4 to 14.8 years) for men and 10.1 years (95% CI, 9.9 to 10.3 years) for women. Second, inequality in life expectancy increased over time. Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years for women in the top 5% of the income distribution, but increased by only 0.32 years for men and 0.04 years for

  19. A study of air pollutants influencing life expectancy and longevity from spatial perspective in China.

    PubMed

    Wang, Li; BingganWei; Li, Yonghua; Li, Hairong; Zhang, Fengying; Rosenberg, Mark; Yang, Linsheng; Huang, Jixia; Krafft, Thomas; Wang, Wuyi

    2014-07-15

    Life expectancy and longevity are influenced by air pollutants and socioeconomic status, but the extend and significance are still unclear. Better understanding how the spatial differences of life expectancy and longevity are affected by air pollutants is needed for generating public health and environmental strategies since the whole of China is now threatened by deteriorated air quality. 85 major city regions were chosen as research areas. Geographically Weighted Regression (GWR) and Stepwise Regression (SR) were used to find the spatial correlations between health indicators and air pollutants, adjusted by per capita GDP(1). The results were, regions with higher life expectancy were mainly located in the east area and areas with good air quality, a regional difference of 10 μg/m(3) in ambient air SO2(2) could cause adjusted 0.28 year's difference in life expectancy, a regional difference of 10 μg/m(3) in ambient air PM10(3) could lead to a longevity ratio difference of 2.23, and per capita GDP was positively associating with life expectancy but not longevity ratio, with a regional difference of 10,000 RMB(4) associating with adjusted 0.49 year's difference in life expectancy. This research also showed the evidences that there exist spatially differences for ambient air PM10 and SO2 influencing life expectancy and longevity in China, and this influences were clearer in south China.

  20. Life expectancy, economic inequality, homicide, and reproductive timing in Chicago neighbourhoods.

    PubMed Central

    Wilson, M.; Daly, M.

    1997-01-01

    In comparisons among Chicago neighbourhoods, homicide rates in 1988-93 varied more than 100-fold, while male life expectancy at birth ranged from 54 to 77 years, even with effects of homicide mortality removed. This "cause deleted" life expectancy was highly correlated with homicide rates; a measure of economic inequality added significant additional prediction, whereas median household income did not. Deaths from internal causes (diseases) show similar age patterns, despite different absolute levels, in the best and worst neighbourhoods, whereas deaths from external causes (homicide, accident, suicide) do not. As life expectancy declines across neighbourhoods, women reproduce earlier; by age 30, however, neighbourhood no longer affects age specific fertility. These results support the hypothesis that life expectancy itself may be a psychologically salient determinant of risk taking and the timing of life transitions. PMID:9154035

  1. Stagnating Life Expectancies and Future Prospects in an Age of Uncertainty*

    PubMed Central

    Denney, Justin T.; McNown, Robert; Rogers, Richard G.; Doubilet, Steven

    2014-01-01

    Objective This article provides a timely assessment of U.S. life expectancy given recent stalls in the growth of length of life, the continuing drop in international rankings of life expectancy for the U.S., and during a period of growing social and economic insecurity. Methods Time series analysis is used on over 70 years of data from the Human Mortality Database to forecast future life expectancy to the year 2055. Results The results show limited improvements in U.S. life expectancy at birth, less than 3 years on average, for both men and women. Conclusions Even in uncertain times, it is important to look forward in preparing for the needs of future populations. The results presented here underscore the relevance of policy and health initiatives aimed at improving the nation’s health and reveal important insight into possible limits to mortality improvement over the next five decades. PMID:25506092

  2. Contributions of various major causes of death to life expectancy in Singapore, 1980-1990.

    PubMed

    Tan, K C; Low, C K

    1996-08-01

    This paper considers the contributions by age of the various major groups of deaths to the increase in life expectancy at birth between 1980 and 1990 for both sexes in Singapore. Sixteen cause groups were used in the study. The data were analysed using LIFETIME, a personal computer package with a wide variety of methods for mortality investigations. Respiratory diseases made the largest contribution to the increase in life expectancy for both sexes. In contrast, ischaemic heart disease made a negative contribution of 1% in the gain in female life expectancy but contributed 12% improvement for males. Life tables for Singaporean males and females in the year 2000 were projected by extrapolating the mortality trends observed in earlier periods. The calculations show that the life expectancy at birth in the year 2000 to be 74.72 years for males and 79.48 years for females.

  3. Life expectancy, economic inequality, homicide, and reproductive timing in Chicago neighbourhoods.

    PubMed

    Wilson, M; Daly, M

    1997-04-26

    In comparisons among Chicago neighbourhoods, homicide rates in 1988-93 varied more than 100-fold, while male life expectancy at birth ranged from 54 to 77 years, even with effects of homicide mortality removed. This "cause deleted" life expectancy was highly correlated with homicide rates; a measure of economic inequality added significant additional prediction, whereas median household income did not. Deaths from internal causes (diseases) show similar age patterns, despite different absolute levels, in the best and worst neighbourhoods, whereas deaths from external causes (homicide, accident, suicide) do not. As life expectancy declines across neighbourhoods, women reproduce earlier; by age 30, however, neighbourhood no longer affects age specific fertility. These results support the hypothesis that life expectancy itself may be a psychologically salient determinant of risk taking and the timing of life transitions.

  4. Life Expectancy in Police Officers: A Comparison with the U.S. General Population

    PubMed Central

    Violanti, John M.; Hartley, Tara A.; Gu, Ja K.; Fekedulegn, Desta; Andrew, Michael E.; Burchfiel, Cecil M.

    2016-01-01

    Previous epidemiological research indicates that police officers have an elevated risk of death relative to the general population overall and for several specific causes. Despite the increased risk for mortality found in previous research, controversy still exists over the life expectancy of police officers. The goal of the present study was to compare life expectancy of male police officers from Buffalo New York with the U.S. general male population utilizing an abridged life table method. On average, the life expectancy of Buffalo police officers in our sample was significantly lower than the U.S. population (mean difference in life expectancy =21.9 years; 95% CI: 14.5-29.3; p<0.0001). Life expectancy of police officers was shorter and differences were more pronounced in younger age categories. Additionally, police officers had a significantly higher average probability of death than did males in the general population (mean difference= 0.40; 95% CI: 0.26,-0.54; p<0.0001). The years of potential life lost (YPLL) for police officers was 21 times larger than that of the general population (Buffalo male officers vs. U.S. males = 21.7, 95% CI: 5.8-37.7). Possible reasons for shorter life expectancy among police are discussed, including stress, shift work, obesity, and hazardous environmental work exposures. PMID:24707585

  5. Geographical variation in life expectancy at birth in England and Wales is largely explained by deprivation

    PubMed Central

    Woods, L.; Rachet, B.; Riga, M.; Stone, N.; Shah, A.; Coleman, M.

    2005-01-01

    Study objective: To describe the population mortality profile of England and Wales by deprivation and in each government office region (GOR) during 1998, and to quantify the influence of geography and deprivation in determining life expectancy. Design: Construction of life tables describing age specific mortality rates and life expectancy at birth from death registrations and estimated population counts. Life tables were created for (a) quintiles of income deprivation based on the income domain score of the index of multiple deprivation 2000, (b) each GOR and Wales, and (c) every combination of deprivation and geography. Setting: England and Wales. Patients/participants: Residents of England and Wales, 1998. Main results: Life expectancy at birth varies with deprivation quintile and is highest in the most affluent groups. The differences are mainly attributable to differences in mortality rates under 75 years of age. Regional life expectancies display a clear north-south gradient. Linear regression analysis shows that deprivation explains most of the geographical variation in life expectancy. Conclusions: Geographical patterns of life expectancy identified within these data for England and Wales in 1998 are mainly attributable to variations in deprivation status as defined by the IMD 2000 income domain score. PMID:15650142

  6. Qualitative analysis of young adult ENDS users' expectations and experiences

    PubMed Central

    Hoek, Janet; Thrul, Johannes; Ling, Pamela

    2017-01-01

    Objectives Despite extensive research into the determinants of electronic nicotine delivery system (ENDS) uptake, few studies have examined the psychosocial benefits ENDS users seek and experience. Using a consumer ritual framework, we explored how ENDS users recreated or replaced smoking practices, and considered implications for smoking cessation. Design In-depth interviews; data analysed using thematic analysis. Setting Dunedin, New Zealand. Participants 16 young adult ENDS users (age M=21.4, SD=1.9; 44% female). Results Participants reported using different ENDS to achieve varying outcomes. Some used ‘cigalikes’ to recreate a physically and visually similar experience to smoking; they privileged device appearance over nicotine delivery. In contrast, others used personally crafted mods to develop new rituals that differentiated them from smokers and showcased their technical expertise. Irrespective of the device they used, several former smokers and dual users of cigarettes and ENDS experienced strong nostalgia for smoking attributes, particularly the elemental appeal of fire and the finiteness of a cigarette. Non-smoking participants used ENDS to maintain social connections with their peers. Conclusions Participants used ENDS to construct rituals that recreated or replaced smoking attributes, and that varied in the emphasis given to device appearance, nicotine delivery, and social performance. Identifying how ENDS users create new rituals and the components they privilege within these could help promote full transition from smoking to ENDS and identify those at greatest risk of dual use or relapse to cigarette smoking. PMID:28270392

  7. Estimated Life Expectancy in a Scottish Cohort With Type 1 Diabetes, 2008-2010

    PubMed Central

    Livingstone, Shona J.; Levin, Daniel; Looker, Helen C.; Lindsay, Robert S.; Wild, Sarah H.; Joss, Nicola; Leese, Graham; Leslie, Peter; McCrimmon, Rory J.; Metcalfe, Wendy; McKnight, John A.; Morris, Andrew D.; Pearson, Donald W. M.; Petrie, John R.; Philip, Sam; Sattar, Naveed A.; Traynor, Jamie P.; Colhoun, Helen M.

    2015-01-01

    IMPORTANCE Type 1 diabetes has historically been associated with a significant reduction in life expectancy. Major advances in treatment of type 1 diabetes have occurred in the past 3 decades. Contemporary estimates of the effect of type 1 diabetes on life expectancy are needed. OBJECTIVE To examine current life expectancy in people with and without type 1 diabetes in Scotland. We also examined whether any loss of life expectancy in patients with type 1 diabetes is confined to those who develop kidney disease. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort of all individuals alive in Scotland with type 1 diabetes who were aged 20 years or older from 2008 through 2010 and were in a nationwide register (n=24 691 contributing 67 712 person-years and 1043 deaths). MAIN OUTCOMES AND MEASURES Differences in life expectancy between those with and those without type 1 diabetes and the percentage of the difference due to various causes. RESULTS Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% CI, 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 mL/min/1.73m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women) giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic heart disease (36% in men, 31% in women) but death from diabetic coma or ketoacidosis was associated with the largest percentage of the estimated loss occurring before age 50 years (29.4% in men, 21.7% in

  8. Faster Increases in Human Life Expectancy Could Lead to Slower Population Aging

    PubMed Central

    2015-01-01

    Counterintuitively, faster increases in human life expectancy could lead to slower population aging. The conventional view that faster increases in human life expectancy would lead to faster population aging is based on the assumption that people become old at a fixed chronological age. A preferable alternative is to base measures of aging on people’s time left to death, because this is more closely related to the characteristics that are associated with old age. Using this alternative interpretation, we show that faster increases in life expectancy would lead to slower population aging. Among other things, this finding affects the assessment of the speed at which countries will age. PMID:25876033

  9. Faster increases in human life expectancy could lead to slower population aging.

    PubMed

    Sanderson, Warren C; Scherbov, Sergei

    2015-01-01

    Counterintuitively, faster increases in human life expectancy could lead to slower population aging. The conventional view that faster increases in human life expectancy would lead to faster population aging is based on the assumption that people become old at a fixed chronological age. A preferable alternative is to base measures of aging on people's time left to death, because this is more closely related to the characteristics that are associated with old age. Using this alternative interpretation, we show that faster increases in life expectancy would lead to slower population aging. Among other things, this finding affects the assessment of the speed at which countries will age.

  10. 'Futureless persons': shifting life expectancies and the vicissitudes of progressive illness.

    PubMed

    Gibson, Barbara E; Zitzelsberger, Hilde; McKeever, Patricia

    2009-05-01

    Medical technological advances can have profound effects on people's lives by extending the life course and creating uncertain futures. This is the case for a number of persons with 'diseases of childhood' who can now survive well into adulthood with technological support. This paper draws on a Canadian qualitative study of young men with Duchenne muscular dystrophy (DMD)which examined the effects of a shifting life expectancy on personal identities. Engaging with Pierre Bourdieu's central concept of habitus, we discuss the temporal dimensions of social exclusion and marginalised identities. Participants' narrative accounts revealed how their dispositions were orientated to a shortened lifespan that exerted damaging effects regardless of actual lifespan. Compounding their material, social and symbolic isolation was a temporal isolation whereby the men had lived every day anticipating that it could be their last for as much as a decade. The findings suggest a need to re-orient medical and social discourses to serve and include adults with DMD and other conditions previously limited to childhood in their communities.

  11. Estimating the loss in expectation of life due to cancer using flexible parametric survival models.

    PubMed

    Andersson, Therese M-L; Dickman, Paul W; Eloranta, Sandra; Lambe, Mats; Lambert, Paul C

    2013-12-30

    A useful summary measure for survival data is the expectation of life, which is calculated by obtaining the area under a survival curve. The loss in expectation of life due to a certain type of cancer is the difference between the expectation of life in the general population and the expectation of life among the cancer patients. This measure is used little in practice as its estimation generally requires extrapolation of both the expected and observed survival. A parametric distribution can be used for extrapolation of the observed survival, but it is difficult to find a distribution that captures the underlying shape of the survival function after the end of follow-up. In this paper, we base our extrapolation on relative survival, because it is more stable and reliable. Relative survival is defined as the observed survival divided by the expected survival, and the mortality analogue is excess mortality. Approaches have been suggested for extrapolation of relative survival within life-table data, by assuming that the excess mortality has reached zero (statistical cure) or has stabilized to a constant. We propose the use of flexible parametric survival models for relative survival, which enables estimating the loss in expectation of life on individual level data by making these assumptions or by extrapolating the estimated linear trend at the end of follow-up. We have evaluated the extrapolation from this model using data on four types of cancer, and the results agree well with observed data.

  12. Spatial abilities across the adult life span.

    PubMed

    Borella, Erika; Meneghetti, Chiara; Ronconi, Lucia; De Beni, Rossana

    2014-02-01

    The study investigates age-related effects across the adult life span on spatial abilities (testing subabilities based on a distinction between spatial visualization, mental rotation, and perspective taking) and spatial self-assessments. The sample consisted of 454 participants (223 women and 231 men) from 20 to 91 years of age. Results showed nonlinear age-related effects for spatial visualization and perspective taking but linear effects for mental rotation; few or no age-related effects were found for spatial self-assessments. Working memory accounted for only a small proportion of the variance in all spatial tasks and had no effect on spatial self-assessments. Overall, our findings suggest that the influence of age on spatial skills across the adult life span is considerable, but the effects of age change as a function of the spatial task considered, and the effect on spatial self-assessment is more marginal.

  13. “Racial and social class gradients in life expectancy in contemporary California”

    PubMed Central

    Clarke, Christina A.; Miller, Tim; Chang, Ellen T; Yin, Daixin; Cockburn, Myles; Gomez, Scarlett L

    2010-01-01

    Life expectancy, or the estimated average age of death, is among the most basic measures of a population's health. However, monitoring differences in life expectancy among sociodemographically defined populations has been challenging, at least in the United States (US), because death certification does not include collection of markers of socioeconomic status (SES). In order to understand how SES and race/ethnicity independently and jointly affected overall health in a contemporary US population, we assigned a small area-based measure of SES to all 689,036 deaths occurring in California during a three-year period (1999-2001) overlapping the most recent US census. Residence at death was geocoded to the smallest census area available (block group) and assigned to a quintile of a multifactorial SES index. We constructed life tables using mortality rates calculated by age, sex, race/ethnicity and neighborhood SES quintile, and produced corresponding life expectancy estimates. We found a 19.6 (±0.6) year gap in life expectancy between the sociodemographic groups with the longest life expectancy (highest SES quintile of Asian females; 84.9 years) and the shortest (lowest SES quintile of African-American males; 65.3 years). A positive SES gradient in life expectancy was observed among whites and African-Americans but not Hispanics or Asians. Age-specific mortality disparities varied among groups. Race/ethnicity and neighborhood SES had substantial and independent influences on life expectancy, underscoring the importance of monitoring health outcomes simultaneously by these factors. African-American males living in the poorest 20% of California neighborhoods had life expectancy comparable to that reported for males living in developing countries. Neighborhood SES represents a readily available metric for ongoing surveillance of health disparities in the US. PMID:20171001

  14. Impact of Pregnancy-Related Deaths on Female Life Expectancy in Zambia: Application of Life Table Techniques to Census Data

    PubMed Central

    Banda, Richard; Sandøy, Ingvild Fossgard; Fylkesnes, Knut; Janssen, Fanny

    2015-01-01

    Introduction Since 2000, the world has been coalesced around efforts to reduce maternal mortality. However, few studies have estimated the significance of eliminating maternal deaths on female life expectancy. We estimated, based on census data, the potential gains in female life expectancy assuming complete elimination of pregnancy-related mortality in Zambia. Methods We used data on all-cause and pregnancy-related deaths of females aged 15–49 reported in the Zambia 2010 census, and evaluated, adjusted and smoothed them using existing and verified techniques. We used associated single decrement life tables, assuming complete elimination of pregnancy-related deaths to estimate the potential gains in female life expectancy at birth, at age 15, and over the ages 15–49. We compared these gains with the gains from eliminating deaths from accidents, injury, violence and suicide. Results Complete elimination of pregnancy-related deaths would extend life expectancy at birth among Zambian women by 1.35 years and life expectancy at age 15 by 1.65 years. In rural areas, this would be 1.69 years and 2.19 years, respectively, and in urban areas, 0.78 years and 0.85 years. An additional 0.72 years would be spent in the reproductive age group 15–49; 1.00 years in rural areas and 0.35 years in urban areas. Eliminating deaths from accidents, injury, suicide and violence among women aged 15–49 would cumulatively contribute 0.55 years to female life expectancy at birth. Conclusion Eliminating pregnancy-related mortality would extend female life expectancy in Zambia substantially, with more gains among adolescents and females in rural areas. The application of life table techniques to census data proved very valuable, although rigorous evaluation and adjustment of reported deaths and age was necessary to attain plausible estimates. The collection of detailed high quality cause-specific mortality data in future censuses is indispensable. PMID:26513160

  15. Impact of Pregnancy-Related Deaths on Female Life Expectancy in Zambia: Application of Life Table Techniques to Census Data.

    PubMed

    Banda, Richard; Sandøy, Ingvild Fossgard; Fylkesnes, Knut; Janssen, Fanny

    2015-01-01

    Since 2000, the world has been coalesced around efforts to reduce maternal mortality. However, few studies have estimated the significance of eliminating maternal deaths on female life expectancy. We estimated, based on census data, the potential gains in female life expectancy assuming complete elimination of pregnancy-related mortality in Zambia. We used data on all-cause and pregnancy-related deaths of females aged 15-49 reported in the Zambia 2010 census, and evaluated, adjusted and smoothed them using existing and verified techniques. We used associated single decrement life tables, assuming complete elimination of pregnancy-related deaths to estimate the potential gains in female life expectancy at birth, at age 15, and over the ages 15-49. We compared these gains with the gains from eliminating deaths from accidents, injury, violence and suicide. Complete elimination of pregnancy-related deaths would extend life expectancy at birth among Zambian women by 1.35 years and life expectancy at age 15 by 1.65 years. In rural areas, this would be 1.69 years and 2.19 years, respectively, and in urban areas, 0.78 years and 0.85 years. An additional 0.72 years would be spent in the reproductive age group 15-49; 1.00 years in rural areas and 0.35 years in urban areas. Eliminating deaths from accidents, injury, suicide and violence among women aged 15-49 would cumulatively contribute 0.55 years to female life expectancy at birth. Eliminating pregnancy-related mortality would extend female life expectancy in Zambia substantially, with more gains among adolescents and females in rural areas. The application of life table techniques to census data proved very valuable, although rigorous evaluation and adjustment of reported deaths and age was necessary to attain plausible estimates. The collection of detailed high quality cause-specific mortality data in future censuses is indispensable.

  16. Older Adults in Rural Appalachia: Preference and Expectations for Future Care.

    PubMed

    Weaver, Raven H; Roberto, Karen A; Blieszner, Rosemary

    2017-01-01

    Little is known about how rural-dwelling older adults anticipate and plan for future care needs. Using a mixed-method explanatory design, structural equation modeling ( n = 535) revealed significant associations between concerns about using services on preference for type of help; preference was associated with likelihood of using future services. Content analysis of interview data from 19 older adults who needed but were not receiving help revealed how they conceptualize their need for assistance and anticipated future care arrangements. Nine older adults were not thinking about future care needs. While most older adults articulated preferences for informal help, they indicated some openness to formal assistance. Preferences did not always align with expectations for the future. Rather, concerns about burdening family and friends outweighed concerns about community services and influenced expectations of using formal services. Understanding rural older adults' expectations for future care arrangements is necessary for advancing policy and implementing successful services options.

  17. Quality of life in short adults.

    PubMed

    Busschbach, J J; Rikken, B; Grobbee, D E; De Charro, F T; Wit, J M

    1998-01-01

    The use of (costly) growth hormone (GH) treatment in short children is often justified by the assumption that short stature considerably reduces quality of life in adults. We tested this assumption in 5 groups of short adults: 25 patients with isolated GH deficiency; 17 male patients with childhood onset renal failure; 25 women with Turner syndrome and 26 patients who were presented as a child to a paediatrician for idiopathic short stature. A group of 44 short individuals with presumably idiopathic short stature, who had not been presented to a paediatrician for short stature, was sampled from the general population ('normal shorts'). We measured quality of life in terms of socio-economic variables, the Nottingham Health Profile and time trade-off. The mean height of most groups was close to the 3rd percentile. The chance of having a partner was low for all groups, except for the normal shorts. Problems with job application were only reported in Turner syndrome. The scores on the Nottingham Health Profile were all within the normal range, but GH-deficient adults had a higher score on the domain energy than normal shorts. Women with Turner syndrome, individuals with renal failure, and those with idiopathic short stature had a wish to be taller, with an estimated reduction in quality of life of 2-4% (time trade-off). As the normal shorts did not show any sign of a reduced quality of life, we falsify the assumption of a direct relation between short stature and quality of life. The complaints of patients with idiopathic short stature around the 3rd percentile seem to be the result of unsuccessful coping strategies.

  18. The Gap Gets Bigger: Changes in Mortality and Life expectancy by Education, 1981−2000

    PubMed Central

    Meara, Ellen; Richards, Seth; Cutler, David

    2008-01-01

    Reducing health disparities in the United States has been targeted by numerous policies. We examine educational disparities in mortality and life expectancy among non-Hispanic blacks and whites in the 1980s and 1990s. Despite increased attention and substantial dollars directed to groups with low socioeconomic status, within race and sex groups, the educational gap in life expectancy is rising, mainly due to rising differentials among the elderly. With the exception of black males all recent gains in life expectancy at age 25 occurred among better educated groups, raising educational differentials in life expectancy by 30 percent. Differential trends in smoking-related diseases explain at least 20 percent of this trend. PMID:18332489

  19. Socio-economic determinants of life expectancy in Nigeria (1980 - 2011).

    PubMed

    Sede, Peter I; Ohemeng, Williams

    2015-01-01

    Attainment of 70 years life expectancy by 2020 is one of the millennium development goals in Nigeria. This study examined the socio-economic determinants of life expectancy in Nigeria using data from 1980-2011. Judging from the endogeneity feature of the variables, A VAR and VECM frameworks were employed. Socio-economic features were proxy by secondary school enrolment, government expenditure on health, per capita income, unemployment rate and the Naira foreign exchange rate. It was found that, the conventional socio-economic variables such as per capita income, education and government expenditure on health considered to be highly effective in determining life expectancy of developing countries are not significant in the case of Nigeria. The study however suggests that, life expectancy in Nigeria could be improved if attention is given to quality of government health expenditure, unemployment and measures to halt the depreciation of the Nigerian Naira against major foreign currency.

  20. Arts and ageing; life expectancy of historical artists in the Low Countries.

    PubMed

    Mirzada, Fereshta; Schimberg, Anouk S; Engelaer, Frouke M; Bijwaard, Govert E; van Bodegom, David; Westendorp, Rudi G J; van Poppel, Frans W A

    2014-01-01

    Practising arts has been linked to lowering stress, anxiety and blood pressure. These mechanisms are all known to affect the ageing process. Therefore, we examine the relation between long-term involvement in arts and life expectancy at age 50 (LE50), in a cohort of 12,159 male acoustic, literary and visual artists, who were born between 1700 and 1899 in the Low Countries. We compared the life expectancy at age 50 of the various artists with the elite and middle class of that time. In the birth cohorts before 1850, acoustic (LE50:14.5-19.5) and literary artists (LE50:17.8-20.8) had a similar life expectancy at age 50 compared to the elite (LE50:18.0-19.0). Only visual artists (LE50:15.5-17.1) had a lower life expectancy at age 50 compared to the elite at that time. For the most recent birth cohorts from 1850 through 1899, the comparison between artists and the elite reversed and acoustic and literary artist had a lower life expectancy at age 50, while visual artists enjoyed a similar life expectancy at age 50. Although artists belonged to the middle socioeconomic class and lived predominantly in urban areas with poor living conditions, they had a life expectancy similar to the elite population. This is in line with observed favourable effects of practicing arts on health in the short-term. From our historical analysis, we hypothesize several mechanisms through which artistic creativity could influence the ageing process and life expectancy. These hypotheses, however, should be formally tested before any definite conclusions on effects of arts on ageing can be drawn.

  1. Arts and Ageing; Life Expectancy of Historical Artists in the Low Countries

    PubMed Central

    Engelaer, Frouke M.; Bijwaard, Govert E.; van Bodegom, David; Westendorp, Rudi G. J.; van Poppel, Frans W. A.

    2014-01-01

    Practising arts has been linked to lowering stress, anxiety and blood pressure. These mechanisms are all known to affect the ageing process. Therefore, we examine the relation between long-term involvement in arts and life expectancy at age 50 (LE50), in a cohort of 12,159 male acoustic, literary and visual artists, who were born between 1700 and 1899 in the Low Countries. We compared the life expectancy at age 50 of the various artists with the elite and middle class of that time. In the birth cohorts before 1850, acoustic (LE50:14.5–19.5) and literary artists (LE50:17.8–20.8) had a similar life expectancy at age 50 compared to the elite (LE50:18.0–19.0). Only visual artists (LE50:15.5–17.1) had a lower life expectancy at age 50 compared to the elite at that time. For the most recent birth cohorts from 1850 through 1899, the comparison between artists and the elite reversed and acoustic and literary artist had a lower life expectancy at age 50, while visual artists enjoyed a similar life expectancy at age 50. Although artists belonged to the middle socioeconomic class and lived predominantly in urban areas with poor living conditions, they had a life expectancy similar to the elite population. This is in line with observed favourable effects of practicing arts on health in the short-term. From our historical analysis, we hypothesize several mechanisms through which artistic creativity could influence the ageing process and life expectancy. These hypotheses, however, should be formally tested before any definite conclusions on effects of arts on ageing can be drawn. PMID:24416148

  2. Impact of walking on life expectancy and lifetime medical expenditure: the Ohsaki Cohort Study.

    PubMed

    Nagai, Masato; Kuriyama, Shinichi; Kakizaki, Masako; Ohmori-Matsuda, Kaori; Sone, Toshimasa; Hozawa, Atsushi; Kawado, Miyuki; Hashimoto, Shuji; Tsuji, Ichiro

    2011-01-01

    People who spend a longer time walking have lower demands for medical care. However, in view of their longer life expectancy, it is unclear whether their lifetime medical expenditure increases or decreases. The present study examined the association between time spent walking, life expectancy and lifetime medical expenditure. The authors followed up 27,738 participants aged 40-79 years and prospectively collected data on their medical expenditure and survival covering a 13-year-period. Participants were classified into those walking <1 and ≥1 h per day. The authors constructed life tables and estimated the life expectancy and lifetime medical expenditure from 40 years of age using estimate of multiadjusted mortality and medical expenditure using a Poisson regression model and linear regression model, respectively. Participants who walked ≥1 h per day have a longer life expectancy from 40 years of age than participants who walked <1 h per day. The multiadjusted life expectancy for those who walked ≥1 h per day was 44.81 years, significantly lower by 1.38 years in men (p=0.0073) in men and 57.78 years in women, non-significantly lower by 1.16 years in women (p=0.2351). In addition to their longer life expectancy, participants who walked ≥1 h per day required a lower lifetime medical expenditure from 40 years of age than participants who walked <1 h per day. The multiadjusted lifetime medical expenditure for those who walked ≥1 h per day was £99 423.6, significantly lower by 7.6% in men (p=0.0048) and £128 161.2, non-significantly lower by 2.7% in women (p=0.2559). Increased longevity resulting from a healthier lifestyle does not necessarily translate into an increased amount of medical expenditure throughout life. Encouraging people to walk may extend life expectancy and decrease lifetime medical expenditure, especially for men.

  3. Adults' Learning Motivation: Expectancy of Success, Value, and the Role of Affective Memories

    ERIC Educational Resources Information Center

    Gorges, Julia; Kandler, Christian

    2012-01-01

    The present study tested the applicability of expectancy-value theory to adults' learning motivation. Motivation was measured as the anticipated reaction (AR) of German students (N = 300) to receiving their instructions in English as a new learning opportunity. We used structural equation modeling to test our hypotheses. Expectancies of success…

  4. Therapy Expectations: Preliminary Exploration and Measurement in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Kilbane, Amy L.; Jahoda, Andrew

    2011-01-01

    Objectives: To carry out a preliminary exploration and measurement of therapy expectancy in adults with intellectual disabilities through the development and psychometric evaluation of the therapy expectation measure (TEAM). Design: The initial scale development phase combined top-down theory-driven and bottom-up data-driven processes to identify…

  5. Adults' Learning Motivation: Expectancy of Success, Value, and the Role of Affective Memories

    ERIC Educational Resources Information Center

    Gorges, Julia; Kandler, Christian

    2012-01-01

    The present study tested the applicability of expectancy-value theory to adults' learning motivation. Motivation was measured as the anticipated reaction (AR) of German students (N = 300) to receiving their instructions in English as a new learning opportunity. We used structural equation modeling to test our hypotheses. Expectancies of success…

  6. Expectation in Life Review: A Term of Spiritual Needs Easily Understood by Chinese Hospice Patients.

    PubMed

    Deng, Di; Deng, Qing; Liu, Xiaofang; Xie, Cong Hua; Wu, Xin

    2015-11-01

    Terms such as spirituality and spiritual needs are abstract and difficult to understand. Realization of spirituality of hospice patients was premise in addressing expression of their spiritual needs. This study investigated expectations expressed during life review and tried to prove that the expectation was intelligible term for spiritual needs in Chinese hospice from May 2011 to June 2013. Among the 107 recruited patients, families were the most frequent emotion-expressing recipients, and 133 expectations related to patients' spiritual needs were identified. The emotion-expressing recipients and the patient's expectations were not affected by demographic characteristics. The expectations in life review with hospice patients and their families had the features of spiritual essence. The identified expectation contents could be used to address spiritual needs in hospice care in Chinese.

  7. Policy implications of marked reversals of population life expectancy caused by substance use.

    PubMed

    Rehm, Jürgen; Anderson, Peter; Fischer, Benedikt; Gual, Antoni; Room, Robin

    2016-03-10

    Life expectancy has been increasing steadily over the past century in most countries, with only a few exceptions such as during wartimes. Marked reversal of life expectancy has been linked to substance use and related policies. Three such examples are discussed herein, namely the double reversal of life expectancy trends (first to positive, then to negative) associated with reducing alcohol supply in the then Union of Soviet Socialist Republics (USSR), followed by a rapid increase in availability; the impact of the rapid increase of prescription opioids on white non-Hispanics in the US; and the systemic impact of the violence accompanying the drug war in Mexico on the life expectancy of men. Alcohol policies were crucial to initiate the positive reversal in the USSR, and different substance use policies could have avoided the negative impacts on life expectancy of the described large groups or nations. Substance use policies can be responsible for abrupt negative changes in life expectancies. An orientation of such policies towards the goals of public health and societal well-being can help avoid such changes.

  8. Modeling absolute differences in life expectancy with a censored skew-normal regression approach.

    PubMed

    Moser, André; Clough-Gorr, Kerri; Zwahlen, Marcel

    2015-01-01

    Parameter estimates from commonly used multivariable parametric survival regression models do not directly quantify differences in years of life expectancy. Gaussian linear regression models give results in terms of absolute mean differences, but are not appropriate in modeling life expectancy, because in many situations time to death has a negative skewed distribution. A regression approach using a skew-normal distribution would be an alternative to parametric survival models in the modeling of life expectancy, because parameter estimates can be interpreted in terms of survival time differences while allowing for skewness of the distribution. In this paper we show how to use the skew-normal regression so that censored and left-truncated observations are accounted for. With this we model differences in life expectancy using data from the Swiss National Cohort Study and from official life expectancy estimates and compare the results with those derived from commonly used survival regression models. We conclude that a censored skew-normal survival regression approach for left-truncated observations can be used to model differences in life expectancy across covariates of interest.

  9. Okinawa: an exception to the social gradient of life expectancy in Japan.

    PubMed

    Cockerham, W C; Yamori, Y

    2001-01-01

    This paper examines why the social gradient of life expectancy does not apply in Japan when Okinawa is considered. The social gradient thesis links differences in longevity to social rank, with people and populations in higher status hierarchical positions having lower mortality and longer life expectancies than those beneath them in the social scale. Japan has been cited as a major example of this thesis in that Japanese life expectancy improved dramatically as Japan rose to the top echelon of nations in economic rank in the late 20th century. Thus it follows that Japan's most affluent and leading prefectures should be the major catalysts behind the nation's rise in life expectancy as well to the number one position in the world. However, this is not the case as life expectancy in Okinawa, Japan's poorest prefecture, exceeds that of Japan as a whole. We find that the social gradient of life expectancy does not apply at the prefectural level and question its validity for geographical areas. We suggest that healthy lifestyles, especially diet and the social support of family and friends, are more important than sense of hierarchy for longevity in Okinawa.

  10. Modeling absolute differences in life expectancy with a censored skew-normal regression approach

    PubMed Central

    Clough-Gorr, Kerri; Zwahlen, Marcel

    2015-01-01

    Parameter estimates from commonly used multivariable parametric survival regression models do not directly quantify differences in years of life expectancy. Gaussian linear regression models give results in terms of absolute mean differences, but are not appropriate in modeling life expectancy, because in many situations time to death has a negative skewed distribution. A regression approach using a skew-normal distribution would be an alternative to parametric survival models in the modeling of life expectancy, because parameter estimates can be interpreted in terms of survival time differences while allowing for skewness of the distribution. In this paper we show how to use the skew-normal regression so that censored and left-truncated observations are accounted for. With this we model differences in life expectancy using data from the Swiss National Cohort Study and from official life expectancy estimates and compare the results with those derived from commonly used survival regression models. We conclude that a censored skew-normal survival regression approach for left-truncated observations can be used to model differences in life expectancy across covariates of interest. PMID:26339544

  11. Why did Danish women's life expectancy stagnate? The influence of interwar generations' smoking behaviour.

    PubMed

    Lindahl-Jacobsen, Rune; Oeppen, Jim; Rizzi, Silvia; Möller, Sören; Zarulli, Virginia; Christensen, Kaare; Vaupel, James W

    2016-12-01

    The general health status of a population changes over time, generally in a positive direction. Some generations experience more unfavourable conditions than others. The health of Danish women in the interwar generations is an example of such a phenomenon. The stagnation in their life expectancy between 1977 and 1995 is thought to be related to their smoking behaviour. So far, no study has measured the absolute effect of smoking on the mortality of the interwar generations of Danish women and thus the stagnation in Danish women's life expectancy. We applied a method to estimate age-specific smoking-attributable number of deaths to examine the effect of smoking on the trends in partial life expectancy of Danish women between age 50 and 85 from 1950 to 2012. We compared these trends to those for women in Sweden, where there was no similar stagnation in life expectancy. When smoking-attributable mortality was excluded, the gap in partial life expectancy at age 50 between Swedish and Danish women diminished substantially. The effect was most pronounced in the interwar generations. The major reason for the stagnation in Danish women's partial life expectancy at age 50 was found to be smoking-related mortality in the interwar generations.

  12. The Changing Gender Differences in Life Expectancy in Chinese Cities 2005-2010

    PubMed Central

    Shen, Jie; Li, Tong; Zhang, Cheng-Feng

    2015-01-01

    Objectives To analyze the gender difference in life expectancy in Chinese urban people and explore the age-specific and cause-specific contributions to the changing gender differences in life expectancy. Methods Data of life expectancy and mortality were obtained from “Annual statistics of public health in China.” The gender difference was analyzed by decomposition method, including age-specific decomposition and cause-specific decomposition. Results Women lived much longer than men in Chinese urban areas, with remarkable gains in life expectancy since 2005, respectively. The gender difference reached a peak in 2007. Mortality difference between men and women in the 60–79 age group made the largest contributions to the gender gap in life expectancy in all 6 years. Among causes of death, cancers, circulatory diseases and respiratory diseases made the largest contributions to the gender gap. 33–38% of the gender gap were caused by cancers, among which lung cancer contributed 0.6 years of the overall gap. The contribution of cancers to the gender gap reduced over time, mostly influenced by the narrowing effect of liver cancer on gender gap. Traffic accidents and suicide were the external causes influencing the gender gap, contributing 10–16% of the overall difference. Conclusion Public health efforts to reduce excess mortalities for cancers, circulatory disease, respiratory diseases, and suicide among men in particular might further narrow the gender gap in life expectancy in Chinese cities. PMID:25875494

  13. The changing gender differences in life expectancy in Chinese cities 2005-2010.

    PubMed

    Le, Yan; Ren, Jie; Shen, Jie; Li, Tong; Zhang, Cheng-Feng

    2015-01-01

    To analyze the gender difference in life expectancy in Chinese urban people and explore the age-specific and cause-specific contributions to the changing gender differences in life expectancy. Data of life expectancy and mortality were obtained from "Annual statistics of public health in China." The gender difference was analyzed by decomposition method, including age-specific decomposition and cause-specific decomposition. Women lived much longer than men in Chinese urban areas, with remarkable gains in life expectancy since 2005, respectively. The gender difference reached a peak in 2007. Mortality difference between men and women in the 60-79 age group made the largest contributions to the gender gap in life expectancy in all 6 years. Among causes of death, cancers, circulatory diseases and respiratory diseases made the largest contributions to the gender gap. 33-38% of the gender gap were caused by cancers, among which lung cancer contributed 0.6 years of the overall gap. The contribution of cancers to the gender gap reduced over time, mostly influenced by the narrowing effect of liver cancer on gender gap. Traffic accidents and suicide were the external causes influencing the gender gap, contributing 10-16% of the overall difference. Public health efforts to reduce excess mortalities for cancers, circulatory disease, respiratory diseases, and suicide among men in particular might further narrow the gender gap in life expectancy in Chinese cities.

  14. Why the racial gap in life expectancy is declining in the United States

    PubMed Central

    Firebaugh, Glenn; Acciai, Francesco; Noah, Aggie J.; Prather, Christopher; Nau, Claudia

    2014-01-01

    BACKGROUND Blacks have lower life expectancy than whites in the United States. That disparity could be due to racial differences in the causes of death, with blacks being more likely to die of causes that affect the young, or it could be due to differences in the average ages of blacks and whites who die of the same cause. Prior studies fail to distinguish these two possibilities. OBJECTIVE In this study we determine how much of the 2000–10 reduction in the racial gap in life expectancy resulted from narrowing differences in the cause-specific mean age at death for blacks and whites, as opposed to changing cause-specific probabilities for blacks and whites. METHOD We introduce a method for separating the difference-in-probabilities and difference-inage components of group disparities in life expectancy. RESULTS Based on the new method, we find that 60% of the decline in the racial gap in life expectancy from 2000 to 2010 was attributable to reduction in the age component, largely because of declining differences in the age at which blacks and whites die of chronic diseases. CONCLUSION Our findings shed light on the sources of the declining racial gap in life expectancy in the United States, and help to identify where advances need to be made to achieve the goal of eliminating racial disparities in life expectancy. PMID:25580083

  15. Closing the Gaps: competing estimates of Indigenous Australian life expectancy in the scientific literature

    PubMed Central

    Rosenstock, Amanda; Mukandi, Bryan; Zwi, Anthony B; Hill, Peter S

    2013-01-01

    Objective: Closing the gap in life expectancy between Indigenous and other Australians within a generation is central to national Indigenous reform policy (Closing the Gap). Over time, various methods of estimating Indigenous life expectancy and with that, the life expectancy gap, have been adopted with differing, albeit non-comparable results. We present data on the extent of the gap and elucidate the pattern of use and interpretations of the different estimates of the gap, between 2007 and 2012. Methods: An extensive search was conducted for all peer-reviewed health publications citing estimates of and/or discussing the life expectancy of Indigenous Australians, for the period 2007–2012. Results: Five predominant patterns of citation of the gap estimates were identified: 20 years, 17 years, 15–20 years, 13 years, and 11.5 years for males and 9.7 years for females. Some authors misinterpret the most recent estimates as reflecting improvement from the 17-year figure, rather than the result of different methods of estimation. Support for the direct methods used to calculate Indigenous life expectancy is indicated. Conclusions and Implications: A specific estimate of the life expectancy gap has not been established among stakeholders in Indigenous health. Agreement on the magnitude of the gap is arguably needed in order to evaluate strategies aimed at improving health outcomes for Indigenous Australians. Moreover, measuring progress towards ‘closing the gap’ depends on the availability of comparable estimates, using the same techniques of measurement to assess changes over time. PMID:23895479

  16. Life expectancy and expected years of life lost to oral cancer in Taiwan: a nation-wide analysis of 22,024 cases followed for 10 years.

    PubMed

    Huang, Cheng-Chih; Ou, Chun-Yen; Lee, Wei-Ting; Hsiao, Jenn-Ren; Tsai, Sen-Tien; Wang, Jung-Der

    2015-04-01

    This analysis examined the life expectancies (LE) and expected years of life lost (EYLL) in relation to oral cancer in Taiwan. A semi-parametric extrapolation method was applied to estimate gender, age, histology, subsite, and stage stratified LE, EYLL of 22,024 pathologically verified oral cancer patients retrospectively recruited from the National Cancer Registry of Taiwan during 2002-2009, who were followed up to 2011. The patients were predominantly male 20,101, (91.3%), and over 80% were less than 65years old. The mean age at diagnosis of males was younger than that of females (52.73years vs. 60.76years). The LE after diagnosis was longer among females than males (15.26years vs. 12.73years), with a smaller loss of the corresponding EYLL (8.88years vs. 14.05years), which prevails after stratification by age and stage. More than half of the oral cancer cases were diagnosed at a later stage, with 2921 cases (13.3%) of stage III and 8488 (38.5%) of stage IV. The five-year overall survival rate of oral cancer for stages I, II, III, and IV were 78.98%, 69.38%, 54.62%, and 36.17%, respectively. The earlier the diagnosis, the longer the life expectancy and the smaller the EYLL. We concluded that early detection and early intervention of oral cancer can prolong life expectancy and reduce the years of life lost, indicating the importance of proactive screening and oral hygiene. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Increasing inequality in age of death at shared levels of life expectancy: A comparative study of Scotland and England and Wales.

    PubMed

    Seaman, Rosie; Leyland, Alastair H; Popham, Frank

    2016-12-01

    There is a strong negative correlation between increasing life expectancy and decreasing lifespan variation, a measure of inequality. Previous research suggests that countries achieving a high level of life expectancy later in time generally do so with lower lifespan variation than forerunner countries. This may be because they are able to capitalise on lessons already learnt. However, a few countries achieve a high level of life expectancy later in time with higher inequality. Scotland appears to be such a country and presents an interesting case study because it previously experienced lower inequality when reaching the same level of life expectancy as its closest comparator England and Wales. We calculated life expectancy and lifespan variation for Scotland and England and Wales for the years 1950 to 2012, comparing Scotland to England and Wales when it reached the same level of life expectancy later on in time, and assessed the difference in the level of lifespan variation. The lifespan variation difference between the two countries was then decomposed into age-specific components. Analysis was carried out for males and females separately. Since the 1950s Scotland has achieved the same level of life expectancy at least ten years later in time than England and Wales. Initially it did so with lower lifespan variation. Following the 1980s Scotland has been achieving the same level of life expectancy later in time than England and Wales and with higher inequality, particularly for males. Decomposition revealed that higher inequality is partly explained by lower older age mortality rates but primarily by higher premature adult age mortality rates when life expectancy is the same. Existing studies suggest that premature adult mortality rates are strongly associated with the social determinants of health and may be amenable to social and economic policies. So addressing these policy areas may have benefits for both inequality and population health in Scotland.

  18. Optimism and prostate cancer-specific expectations predict better quality of life after robotic prostatectomy.

    PubMed

    Thornton, Andrea A; Perez, Martin A; Oh, Sindy; Crocitto, Laura

    2012-06-01

    We examined the relations among generalized positive expectations (optimism), prostate-cancer specific expectations, and prostate cancer-related quality of life in a prospective sample of 83 men who underwent robotic assisted laparoscopic prostatectomy (RALP) for prostate cancer. Optimism was significantly associated with higher prostate cancer-specific expectations, β = .36, p < .001. In addition, optimism and prostate cancer-specific expectations were independent prospective predictors of better scores on the following prostate cancer-related quality of life scales: Sexual Intimacy and Sexual Confidence; Masculine Self-Esteem (specific expectations only), Health Worry, Cancer Control, and Informed Decision Making (βs > .21, ps < .05). When considered simultaneously, both optimism and specific expectations contributed uniquely to better Health Worry and Cancer Control scores, optimism was a unique predictor of better Sexual Intimacy and Sexual Confidence scores, and specific expectations uniquely predicted higher scores on Informed Decision Making. Although optimism and prostate-cancer specific expectations are related, they contribute uniquely to several prostate cancer-related quality of life outcomes following RALP and may be important targets for quality of life research with this population.

  19. Convergence and divergence of life expectancy in Europe: a centennial view.

    PubMed

    Mackenbach, Johan P

    2013-03-01

    It has been noted that national life expectancies have diverged in Europe in recent decades, but it is unknown how these recent trends compare to longer term developments. Data on life expectancy, cause-specific mortality and determinants of mortality were extracted from harmonized international data-bases. Variation was quantified with the inter-quartile range, and the contribution of changing economic conditions was analyzed by comparing observed life expectancy variations with those expected on the basis of changes in levels of national income and/or changes in the relation between national income and life expectancy. During the first decades of the 20th century, variation in life expectancy in Europe increased to reach peak values around 1920, then decreased to reach its lowest values in 1960 (among men) and 1970 (among women), and finally increased strongly again. The first widening was due to less rapid decline in mortality in Southern and Central and Eastern Europe, particularly from infectious diseases, and coincided with an increasing strength of the national income-life expectancy relation. The second widening was due to stagnating or increasing mortality in Central and Eastern Europe, particularly from cardiovascular diseases, and coincided with a very strong rise of between-country differences in national income. Despite some similarities, differences between both episodes of widening differences in life expectancy cast doubt on the idea that the current episode of widening represents a simple delay of epidemiological transitions. Instead, it is an alarming phenomenon that should be a main focus of European policy making.

  20. Longevity in Slovenia: Past and potential gains in life expectancy by age and causes of death

    PubMed Central

    Lotrič Dolinar, Aleša; Došenović Bonča, Petra

    2017-01-01

    Abstract Introduction In Slovenia, longevity is increasing rapidly. From 1997 to 2014, life expectancy at birth increased by 7 and 5 years for men and women, respectively. This paper explores how this gain in life expectancy at birth can be attributed to reduced mortality from five major groups of causes of death by 5-year age groups. It also estimates potential future gains in life expectancy at birth. Methods The importance of the five major causes of death was analysed by cause-elimination life tables. The total elimination of individual causes of death and a partial hypothetical adjustment of mortality to Spanish levels were analysed, along with age and cause decomposition (Pollard). Results During the 1997–2014 period, the increase in life expectancy at birth was due to lower mortality from circulatory diseases (ages above 60, both genders), as well as from lower mortality from neoplasms (ages above 50 years) and external causes (between 20 and 50 years) for men. However, considering the potential future gains in life expectancy at birth, by far the strongest effect can be attributed to lower mortality due to circulatory diseases for both genders. If Spanish mortality rates were reached, life expectancy at birth would increase by more than 2 years, again mainly because of lower mortality from circulatory diseases in very old ages. Discussion and conclusions Life expectancy analyses can improve evidence-based decision-making and allocation of resources among different prevention programmes and measures for more effective disease management that can also reduce the economic burden of chronic diseases. PMID:28289472

  1. Education, Life Expectancy and Family Bargaining: The Ben-Porath Effect Revisited

    ERIC Educational Resources Information Center

    Leker, Laura; Ponthiere, Gregory

    2015-01-01

    Following Ben-Porath [1967. "The Production of Human Capital and the Life-Cycle of Earnings." "Journal of Political Economy" 75 (3): 352-365], the influence of life expectancy on education and on human capital has attracted much attention among growth theorists. Whereas existing growth models rely on an education decision made…

  2. Education, Life Expectancy and Family Bargaining: The Ben-Porath Effect Revisited

    ERIC Educational Resources Information Center

    Leker, Laura; Ponthiere, Gregory

    2015-01-01

    Following Ben-Porath [1967. "The Production of Human Capital and the Life-Cycle of Earnings." "Journal of Political Economy" 75 (3): 352-365], the influence of life expectancy on education and on human capital has attracted much attention among growth theorists. Whereas existing growth models rely on an education decision made…

  3. Life expectancy in HIV-positive persons in Switzerland: matched comparison with general population

    PubMed Central

    Gueler, Aysel; Moser, André; Calmy, Alexandra; Günthard, Huldrych F.; Bernasconi, Enos; Furrer, Hansjakob; Fux, Christoph A.; Battegay, Manuel; Cavassini, Matthias; Vernazza, Pietro; Zwahlen, Marcel; Egger, Matthias

    2017-01-01

    Objectives: To estimate life expectancy over 25 years in HIV-positive people and to compare their life expectancy with recent estimates for the general population, by education. Methods: Patients aged 20 years or older enrolled in the Swiss HIV Cohort Study 1988–2013 were eligible. Patients alive in 2001 were matched to up to 100 Swiss residents, by sex, year of birth, and education. Life expectancy at age 20 was estimated for monotherapy (1988–1991), dual therapy (1992–1995), early combination antiretroviral therapy (cART, 1996–1998), later cART (1999–2005) and recent cART (2006–2013) eras. Parametric survival regression was used to model life expectancy. Results: In all, 16 532 HIV-positive patients and 927 583 residents were included. Life expectancy at age 20 of HIV-positive individuals increased from 11.8 years [95% confidence interval (CI) 11.2–12.5] in the monotherapy era to 54.9 years (95% CI 51.2–59.6) in the most recent cART era. Differences in life expectancy across educational levels emerged with cART. In the most recent cART period, life expectancy at age 20 years was 52.7 years (95% CI 46.4–60.1) with compulsory education, compared to 60.0 years (95% CI 53.4–67.8) with higher education. Estimates for the general population were 61.5 and 65.6 years, respectively. Male sex, smoking, injection drug use, and low CD4+ cell counts at enrolment were also independently associated with mortality. Conclusion: In Switzerland, educational inequalities in life expectancy were larger among HIV-infected persons than in the general population. Highly educated HIV-positive people have an estimated life expectancy similar to Swiss residents with compulsory education. Earlier start of cART and effective smoking-cessation programs could improve HIV-positive life expectancy further and reduce inequalities. PMID:27831953

  4. Maximum likelihood estimate of life expectancy in the prehistoric Jomon: Canine pulp volume reduction suggests a longer life expectancy than previously thought.

    PubMed

    Sasaki, Tomohiko; Kondo, Osamu

    2016-09-01

    Recent theoretical progress potentially refutes past claims that paleodemographic estimations are flawed by statistical problems, including age mimicry and sample bias due to differential preservation. The life expectancy at age 15 of the Jomon period prehistoric populace in Japan was initially estimated to have been ∼16 years while a more recent analysis suggested 31.5 years. In this study, we provide alternative results based on a new methodology. The material comprises 234 mandibular canines from Jomon period skeletal remains and a reference sample of 363 mandibular canines of recent-modern Japanese. Dental pulp reduction is used as the age-indicator, which because of tooth durability is presumed to minimize the effect of differential preservation. Maximum likelihood estimation, which theoretically avoids age mimicry, was applied. Our methods also adjusted for the known pulp volume reduction rate among recent-modern Japanese to provide a better fit for observations in the Jomon period sample. Without adjustment for the known rate in pulp volume reduction, estimates of Jomon life expectancy at age 15 were dubiously long. However, when the rate was adjusted, the estimate results in a value that falls within the range of modern hunter-gatherers, with significantly better fit to the observations. The rate-adjusted result of 32.2 years more likely represents the true life expectancy of the Jomon people at age 15, than the result without adjustment. Considering ∼7% rate of antemortem loss of the mandibular canine observed in our Jomon period sample, actual life expectancy at age 15 may have been as high as ∼35.3 years.

  5. The impact of avoidable mortality on life expectancy at birth in Spain: changes between three periods, from 1987 to 2001

    PubMed Central

    Gispert, R; Serra, I; Barés, M A; Puig, X; Puigdefàbregas, A; Freitas, A

    2008-01-01

    Objective: To evaluate the impact of avoidable mortality on the changes in life expectancy at birth in Spain. Methods: Standard life table techniques and the Arriaga method were used to calculate and to decompose life expectancy (LE) changes by age, effects and groups of causes of avoidable mortality among three periods (1987–91, 1992–6 and 1997–2001). A list of causes of avoidable mortality reached by consensus and previously published in Spain was used. Main results: Life expectancy increased in all ages and both sexes. The main contribution to the increase of LE at birth was due to people over 50. Mortality in young adults produced a reduction in LE between the first two periods, but there was an important increase in LE between the last two periods; in both cases, this was the result of factors amenable to health policy interventions. The highest improvement in LE was due to non-avoidable causes, but avoidable mortality through health service interventions showed improvements in LE in those younger than 1 year and in those aged 45–75 years. Conclusions: Making a distinction between several groups of causes of avoidable mortality and using decomposition by causes, ages and effects allowed us to better explain the impact of avoidable mortality on the LE of the whole population and gave a new dimension to this indicator that could be very useful in public health. PMID:18701727

  6. Evaluating compression or expansion of morbidity in Canada: trends in life expectancy and health-adjusted life expectancy from 1994 to 2010

    PubMed Central

    Colin, Steensma; Lidia, Loukine; Bernard, C. K. Choi

    2017-01-01

    Introduction: The objective of this study was to investigate whether morbidity in Canada, at the national and provincial levels, is compressing or expanding by tracking trends in life expectancy (LE) and health-adjusted life expectancy (HALE) from 1994 to 2010. “Compression” refers to a decrease in the proportion of life spent in an unhealthy state over time. It happens when HALE increases faster than LE. “Expansion” refers to an increase in the proportion of life spent in an unhealthy state that happens when HALE is stable or increases more slowly than LE. Methods: We estimated LE using mortality and population data from Statistics Canada. We took health-related quality of life (i.e. morbidity) data used to calculate HALE from the National Population Health Survey (1994–1999) and the Canadian Community Health Survey (2000–2010). We built abridged life tables for seven time intervals, covering the period 1994 to 2010 and corresponding to the year of each available survey cycle, for females and males, and for each of the 10 Canadian provinces. National and provincial trends were assessed at birth, and at ages 20 years and 65 years. Results: We observed an overall average annual increase in HALE that was statistically significant in both Canadian females and males at each of the three ages assessed, with the exception of females at birth. At birth, HALE increased an average of 0.2% (p = .08) and 0.3% (p < .001) annually for females and males respectively over the 1994 to 2010 period. At the national level for all three age groups, we observed a statistically nonsignificant average annual increase in the proportion of life spent in an unhealthy state, with the exception of men at age 65, who experienced a non-significant decrease. At the provincial level at birth, we observed a significant increase in proportion of life spent in an unhealthy state for Newfoundland and Labrador (NL) and Prince Edward Island (PEI). Conclusion: Our study did not detect a

  7. Evaluating compression or expansion of morbidity in Canada: trends in life expectancy and health-adjusted life expectancy from 1994 to 2010.

    PubMed

    Steensma, Colin; Loukine, Lidia; Choi, Bernard C

    2017-03-01

    The objective of this study was to investigate whether morbidity in Canada, at the national and provincial levels, is compressing or expanding by tracking trends in life expectancy (LE) and health-adjusted life expectancy (HALE) from 1994 to 2010. "Compression" refers to a decrease in the proportion of life spent in an unhealthy state over time. It happens when HALE increases faster than LE. "Expansion" refers to an increase in the proportion of life spent in an unhealthy state that happens when HALE is stable or increases more slowly than LE. We estimated LE using mortality and population data from Statistics Canada. We took health-related quality of life (i.e. morbidity) data used to calculate HALE from the National Population Health Survey (1994-1999) and the Canadian Community Health Survey (2000-2010). We built abridged life tables for seven time intervals, covering the period 1994 to 2010 and corresponding to the year of each available survey cycle, for females and males, and for each of the 10 Canadian provinces. National and provincial trends were assessed at birth, and at ages 20 years and 65 years. We observed an overall average annual increase in HALE that was statistically significant in both Canadian females and males at each of the three ages assessed, with the exception of females at birth. At birth, HALE increased an average of 0.2% (p = .08) and 0.3% (p < .001) annually for females and males respectively over the 1994 to 2010 period. At the national level for all three age groups, we observed a statistically non-significant average annual increase in the proportion of life spent in an unhealthy state, with the exception of men at age 65, who experienced a non-significant decrease. At the provincial level at birth, we observed a significant increase in proportion of life spent in an unhealthy state for Newfoundland and Labrador (NL) and Prince Edward Island (PEI). Our study did not detect a clear overall trend in compression or expansion of

  8. Estimation of the effects of ambient air pollution on life expectancy of urban residents in China

    NASA Astrophysics Data System (ADS)

    Wang, Cuicui; Zhou, Xiaodan; Chen, Renjie; Duan, Xiaoli; Kuang, Xingya; Kan, Haidong

    2013-12-01

    The air quality in China's cities has improved in recent years, but its impact on public health has rarely been investigated. This study was aimed at estimating the potential effects of air quality on life expectancy between 2003 and 2010 in China. We collected annual average concentrations of particulate matter less than 10 microns in aerodynamic diameter (PM10) in 113 key cities, covering all provinces in China, along with the national average age-specific mortality from 2003 to 2010. We constructed a cause-eliminated life table after excluding premature deaths attributable to PM10. The annual average PM10 levels in these cities decreased from 125.3 μg m-3 in 2003 to 88.3 μg m-3 in 2010. As the result, life expectancy loss due to PM10 decreased from 2.13 years in 2003 to 1.30 years in 2010. The estimated life expectancy increase due to PM10 mitigation accounted for 34% of the total increase in life expectancy in the same period. Our results suggested that air quality might have contributed substantially to life expectancy in China.

  9. Violence deaths and its impact on life expectancy: a comparison between Mexico and Brazil.

    PubMed

    González-Pérez, Guillermo Julián; Vega-López, María Guadalupe; Souza, Edinilsa Ramos de; Pinto, Liana Wernersbach

    2017-09-01

    Using official data, this study analyzed violent deaths (homicide, suicide, events of undetermined intent and deaths due to legal intervention) in Brazil and Mexico in the three-year periods 2002-2004 and 2012-14, the impact of these causes of death on life expectancy in both countries and the role of the different age groups in years of life expectancy lost (YLEL). Abridged life tables were constructed for both countries for both periods. Temporary life expectancy and YLEL between zero and 80 years by selected causes and age groups were calculated for each triennium. The leading cause of YLEL among men was homicide in both periods in Brazil (1.5 years) and in the second period in Mexico (one year). Violent deaths (VD) accounted for around 16% of YLEL in Brazil and 13% in Mexico in 2012-2014. Among women, YLEL due to homicides and suicides showed the greatest relative increase in both countries, although VD accounted for barely 3% of total YLEL. The highest percentage of YLEL due to VDwas found among the 15 to 29 year age groups in both countries and for both sexes. The increase in rates of VD in Mexico, above all among young people, has curbed further increases in life expectancy in recent years, especially among men. Likewise, the high rates of VD in Brazil in both periods have hindered the growth of life expectancy.

  10. The increase of firearm mortality and its relationship with the stagnation of life expectancy in Mexico.

    PubMed

    González-Pérez, Guillermo Julián; Vega-López, María Guadalupe; Flores-Villavicencio, María Elena

    2017-09-01

    This study analyzes firearms mortality (FA) and their impact on life expectancy in Mexico -compared to other causes of deaths- during the three-year periods 2000-2002 and 2010-2012 and the weight of the different age groups in years of life expectancy lost (YLEL) due to this cause. Based on official death and population data, abridged life tables in Mexico were constructed for the three-year periods studied. Temporary life expectancy and YLEL for aged 15 to 75 by selected causes and age groups were calculated in each three-year period. Among men, FA mortality went from being the cause less YLEL caused in 2000-2002 to be the main cause of YLEL between 15 and 75 years in 2010-2012. Among women, YLEL for FA mortality had a higher relative growth. In both sexes, the greatest increase in YLEL by FA mortality was between 20 and 34 years. Findings indicate that the increase in FA mortality, especially among young people, has substantially contributed to the stagnation of life expectancy in recent years, and even his decline in the case of men. This reflects that violence linked to the FA is not only a security problem but also a collective health problem that must be copied in an interdisciplinary and intersectoral form if it is to increase the life expectancy of the country.

  11. Cohabitation Expectations among Young Adults in the United States: Do They Match Behavior?

    PubMed

    Manning, Wendy D; Smock, Pamela J; Dorius, Cassandra; Cooksey, Elizabeth

    2014-04-01

    Cohabitation continues to rise, but there is a lack of knowledge about expectations to cohabit and the linkage between expectations and subsequent cohabitation. We capitalize on a new opportunity to study cohabitation expectations by drawing on the National Longitudinal Study of Youth (NLSY79) main youth and two waves (2008 and 2010) of the NLSY young adult (YA) surveys (n=1,105). We find considerable variation in cohabitation expectations: 39.9% have no expectation of cohabiting in the future and 16.6% report high odds of cohabiting in the next two years. Cohabitation expectations are associated with higher odds of entering a cohabiting relationship, but are not perfectly associated. Only 38% of young adults with certain cohabitation expectations in 2008 entered a cohabiting union by 2010. Further investigation of the mismatch between expectations and behaviors indicates that a substantial minority (30%) who entered a cohabiting union had previously reported no or low expectations, instances of what we term "unplanned cohabitation." Our findings underscore the importance of considering not just behavior, but also individuals' expectations for understanding union formation, and more broadly, family change.

  12. Cohabitation Expectations among Young Adults in the United States: Do They Match Behavior?

    PubMed Central

    Manning, Wendy D.; Smock, Pamela J.; Dorius, Cassandra; Cooksey, Elizabeth

    2014-01-01

    Cohabitation continues to rise, but there is a lack of knowledge about expectations to cohabit and the linkage between expectations and subsequent cohabitation. We capitalize on a new opportunity to study cohabitation expectations by drawing on the National Longitudinal Study of Youth (NLSY79) main youth and two waves (2008 and 2010) of the NLSY young adult (YA) surveys (n=1,105). We find considerable variation in cohabitation expectations: 39.9% have no expectation of cohabiting in the future and 16.6% report high odds of cohabiting in the next two years. Cohabitation expectations are associated with higher odds of entering a cohabiting relationship, but are not perfectly associated. Only 38% of young adults with certain cohabitation expectations in 2008 entered a cohabiting union by 2010. Further investigation of the mismatch between expectations and behaviors indicates that a substantial minority (30%) who entered a cohabiting union had previously reported no or low expectations, instances of what we term “unplanned cohabitation.” Our findings underscore the importance of considering not just behavior, but also individuals’ expectations for understanding union formation, and more broadly, family change. PMID:25147419

  13. Using a survey to estimate health expectancy and quality-adjusted life expectancy to assess inequalities in health and quality of life.

    PubMed

    Collins, Brendan

    2013-06-01

    There has been a policy debate in the United Kingdom about moving beyond traditional measures of life expectancy and economic output to developing more meaningful ways of measuring national well-being. To test whether quality adjusted life expectancy (QALE) was a useful indicator of health inequalities. EuroQol five-dimensional questionnaire data from a well-being survey was combined with actuarial life expectancy (LE) data to estimate healthy LE (HLE), that is, years of life lived in good health, and QALE, that is, quality-adjusted life-years (QALYs) lived for Wirral, a borough in the north west of England. The gap between Wirral and the most deprived areas was 4.45 years for LE, 5.34 for QALE, and 7.55 for HLE. The gap in QALE was 20% greater than the gap in LE, while the gap in HLE was 70% greater. The fact that the QALE gap value lies between the HLE value and the LE value suggests that QALE is a more sensitive indicator than HLE, as in this study QALE is derived from 243 possible EuroQol five-dimensional questionnaire profiles whereas HLE is based only on whether or not an individual rates his or her health as good, a binary variable. This study discusses how QALE could be a useful indicator for measuring health inequalities in future, especially as cost utility and QALYs are seen as the gold standard used by the National Institute for Health and Clinical Excellence in the United Kingdom to measure outcomes for health interventions in England, and discusses how a monetary valuation of QALYs could be used to put a societal cost on health inequalities. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. [Socioeconomic inequalities in active life expectancy and disability related to obesity among older people].

    PubMed

    Albala, Cecilia; Sánchez, Hugo; Lera, Lydia; Angel, Bárbara; Cea, Ximena

    2011-10-01

    The rapid increase in life expectancy in Chile, with obesity as the main nutritional problem in all age groups, makes it necessary to ask whether the years gained are healthy. To study the trajectories of disability associated with obesity in Chilean elderly groups from different socio-economic and demographic backgrounds. Longitudinal study of 3 cohorts of older adults from Santiago: the SABE cohort including 1235 people born before 1940; the Alexandros cohort including 950 people born between 1940 and 1948 from Primary Health Care centers and the ISAPRES cohort of 266 people from private health insurance registries (ISAPRES) born before 1947. An interview yielded socio demographic data and history of diseases. Anthropometric measurements and hand dynamometry were performed. Cognitive status was assessed by the Mini Mental State Examination, depressive symptoms through the geriatric depression score-5 and functional limitations through self-reporting of basic (ADL), instrumental (IADL) and advanced daily living (AADL) activities. We report here baseline results from ISAPRES and SABE cohorts. Important social and gender differentials were observed. After adjustment by age and gender, a significant lower frequency of limitations in ADL (odds ratio (OR) = 0.17; 95% confidence intervals (CI): 0.079-0.343), IADL (OR = 0.27; 95%CI: 0.159-0.452), and AADL (OR = 0.42; 95%CI: 0.298-0.599) persisted in the ISAPRE cohort, compared to the SABE cohort. Obesity was associated with functional limitations only in AADL (OR = 1.65; 95%CI: 1.18-2.31) and hand dynamometry was associated with lower functional limitation in ADL, IADL and AADL. This study demonstrates profound socio-economic and gender inequalities in older people, thus showing that the years of healthy life gained are not the same for the whole society.

  15. Transfer from paediatric rheumatology to the adult rheumatology setting: experiences and expectations of young adults with juvenile idiopathic arthritis.

    PubMed

    Hilderson, Deborah; Eyckmans, Leen; Van der Elst, Kristien; Westhovens, Rene; Wouters, Carine; Moons, Philip

    2013-05-01

    Adolescents with juvenile idiopathic arthritis (JIA) are transferred from paediatrics to adult-oriented healthcare when they reach early adulthood. Research on the extent to which patients' expectations about the adult healthcare setting match their actual experience after transfer, may promote successful transfer from paediatrics to adult care. As part of the 'Don't Retard' project ( http://www.kuleuven.be/switch2/rheuma.html ), experiences and expectations of young adults regarding their transfer from paediatric rheumatology to adult rheumatology were explored. A qualitative study was conducted using semi-structured, in-depth interviews of 11 patients with JIA, aged 18 to 30. Data were analysed using procedures inherent to the content analysis approach. For both concepts, experiences and expectations, three main themes emerged: 'preparation', 'parental involvement' and an 'adapted setting for the late-adolescent or early adult'. The need for a gradual process covered the themes 'preparation' and 'parental involvement'. Young people with JIA prefer to have a say in the moment of transfer and in the reduction of parental involvement. The majority of the participants like their parents' presence at the first consultation at the adult rheumatology department. They expect a healthcare setting adapted to their needs and the possibility to meet peers in this setting. Sudden confrontation with older patients with severe rheumatoid arthritis at adult rheumatology was an unsettling experience for some of the young patients and they declared that better preparation is needed. This study enabled us to define three main themes important in transfer. These themes can facilitate healthcare professionals in developing specific interventions to prepare the young people to transfer, to regulate parental involvement and to arrange an adapted setting for them. Since we included patients who were in follow-up at one tertiary care centre, in which both paediatric and adult

  16. Anatomy of a Municipal Triumph: New York City's Upsurge in Life Expectancy.

    PubMed

    Preston, Samuel H; Elo, Irma T

    2014-03-01

    Over the period 1990-2010, the increase in life expectancy for males in New York City was 6.0 years greater than for males in the United States. The female relative gain was 3.9 years. Male relative gains were larger because of extremely rapid reductions in mortality from HIV/AIDS and homicide, declines that reflect effective municipal policies and programs. Declines in drug- and alcohol-related deaths also played a significant role in New York City's advance, but every major cause of death contributed to its relative improvement. By 2010, New York City had a life expectancy that was 1.9 years greater than that of the US. This difference is attributable to the high representation of immigrants in New York's population. Immigrants to New York City, and to the United States, have life expectancies that are among the highest in the world. The fact that 38 percent of New York's population consists of immigrants, compared to only 14 percent in the United States, accounts for New York's exceptional standing in life expectancy in 2010. In fact, US-born New Yorkers have a life expectancy below that of the United States itself.

  17. Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden.

    PubMed

    Westman, J; Wahlbeck, K; Laursen, T M; Gissler, M; Nordentoft, M; Hällgren, J; Arffman, M; Ösby, U

    2015-04-01

    To analyse mortality and life expectancy in people with alcohol use disorder in Denmark, Finland and Sweden. A population-based register study including all patients admitted to hospital diagnosed with alcohol use disorder (1,158,486 person-years) from 1987 to 2006 in Denmark, Finland and Sweden. Life expectancy was 24-28 years shorter in people with alcohol use disorder than in the general population. From 1987 to 2006, the difference in life expectancy between patients with alcohol use disorder and the general population increased in men (Denmark, 1.8 years; Finland, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Denmark (0.3 years) but decreased in Finland (-0.8 years) and Sweden (-1.8 years). People with alcohol use disorder had higher mortality from all causes of death (mortality rate ratio, 3.0-5.2), all diseases and medical conditions (2.3-4.8), and suicide (9.3-35.9). People hospitalized with alcohol use disorder have an average life expectancy of 47-53 years (men) and 50-58 years (women) and die 24-28 years earlier than people in the general population. © 2014 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

  18. Population Well-Being Measures Help Explain Geographic Disparities In Life Expectancy At The County Level

    PubMed Central

    Arora, Anita; Spatz, Erica; Herrin, Jeph; Riley, Carley; Roy, Brita; Kell, Kenneth; Coberley, Carter; Rula, Elizabeth; Krumholz, Harlan M.

    2016-01-01

    Geographic disparities in life expectancy are substantial and not fully explained by differences in race and socioeconomic status. To develop policies that address these inequalities, it is essential to identify other factors that account for this variation. In this study we investigated whether population well-being—a comprehensive measure of physical, mental, and social health—helps explain geographic variation in life expectancy. At the county level, we found that for every 1-standarddeviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males. Life expectancy and well-being remained positively associated, even after race, poverty, and education were controlled for. In addition, well-being partially mediated the established associations of race, poverty, and education with life expectancy. These findings highlight well-being as an important metric of a population’s health and longevity and as a promising focus for intervention. PMID:27834249

  19. Diverging Life Expectancies and Voting Patterns in the 2016 US Presidential Election.

    PubMed

    Bor, Jacob

    2017-10-01

    To assess whether voting patterns in the 2016 US presidential election were correlated with long-run trends in county life expectancy. I examined county-level voting data from the 2008 and 2016 presidential elections and assessed Donald Trump's share of the 2016 vote, change in the Republican vote share between 2008 and 2016, and changes in absolute numbers of Democratic and Republican votes. County-level estimates of life expectancy at birth were obtained for 1980 and 2014 from the Institute for Health Metrics and Evaluation. Changes in county life expectancy from 1980 to 2014 were strongly negatively associated with Trump's vote share, with less support for Trump in counties experiencing greater survival gains. Counties in which life expectancy stagnated or declined saw a 10-percentage-point increase in the Republican vote share between 2008 and 2016. Residents of counties left out from broader life expectancy gains abandoned the Democratic Party in the 2016 presidential election. Since coming to power, the Trump administration has proposed cuts to health insurance for the poor, social programs, health research, and environmental and worker protections, which are key determinants of population health. Health gaps likely will continue to widen without significant public investment in population health.

  20. Anatomy of a Municipal Triumph: New York City's Upsurge in Life Expectancy

    PubMed Central

    Preston, Samuel H.; Elo, Irma T.

    2014-01-01

    Over the period 1990–2010, the increase in life expectancy for males in New York City was 6.0 years greater than for males in the United States. The female relative gain was 3.9 years. Male relative gains were larger because of extremely rapid reductions in mortality from HIV/AIDS and homicide, declines that reflect effective municipal policies and programs. Declines in drug- and alcohol-related deaths also played a significant role in New York City's advance, but every major cause of death contributed to its relative improvement. By 2010, New York City had a life expectancy that was 1.9 years greater than that of the US. This difference is attributable to the high representation of immigrants in New York's population. Immigrants to New York City, and to the United States, have life expectancies that are among the highest in the world. The fact that 38 percent of New York's population consists of immigrants, compared to only 14 percent in the United States, accounts for New York's exceptional standing in life expectancy in 2010. In fact, US-born New Yorkers have a life expectancy below that of the United States itself. PMID:25843989

  1. Disability life expectancy for the elderly, city of Sao Paulo, Brazil, 2000: gender and educational differences.

    PubMed

    Camargos, Mirela Castro Santos; Machado, Carla Jorge; do Nascimento Rodrigues, Roberto

    2007-05-01

    There is evidence that 'health life expectancy' (expected number of years to be lived in health) differs by socioeconomic status. Time spent in health or disability plays a critical role in the use of health care services. The objective of this study was to estimate 'disability life expectancy' by age, gender and education attainment for the elderly of the city of São Paulo, Brazil, in the year 2000. Data came from the SABE database, population censuses and mortality statistics (SEADE Foundation). Life expectancy with disability was calculated using Sullivan's method on the basis of the current probability of death and prevalence of disability by educational level. The prevalence of disability increased with age, for both sexes and both levels of educational attainment studied. Men showed a lower prevalence of disability, in general, and persons with lower educational attainment showed a higher prevalence of disability. Regarding life expectancy, women could expect to live longer than men, with and without disability. For both sexes, the percentage of life expectancy lived with disability decreased with increasing educational attainment. With increasing educational attainment, the sex differences in the percentage of remaining years to be lived with disability increased for most ages. Finally, the percentage of remaining years to be lived with disability increased with age for males and females, except for males with high educational attainment between the ages 70-75 and 75-80. The results may serve as a guide for public policies in the country, since health problems faced by older persons, such as disability, are the result of a number of past experiences during their life-times, such as health care, housing conditions, hygiene practices and education. Education influences health behaviours and is related, to some extent, to all these factors. Therefore, improvements in education for the disadvantaged may improve health.

  2. [Methodological basics of prognosticating the life expectancy of population in big cities].

    PubMed

    Men', T Kh; Zaridze, D G

    2004-01-01

    The reasons of high mortality and of low life expectancy among Russian citizens as well as their sharp fluctuations observed in the 90-ies were explained differently by researchers, however, no attempt was made to analyze the impact made by a huge inflow of immigrant from the republics of the former USSR and "close abroad" in any case studies. In this paper we point at the fact that the mortality statistics and life expectancy in Moscow were influenced, at least for as long as 12 years, by a systemic error, which made the mortality index higher and the life expectancy lower, among Muscovites, due to overestimates of the absolute number of died Muscovites and to underestimates of the city residents. The 2001 life expectancy of men and women in Moscow calculated on the basis of data, from which non-residents who died in the capital were deleted, was 64.7 and 75.0, respectively, but not 61.7 and 73.5 as represented by the official statistics. The maximum negative effect of death cases of non-residents exerted on the life expectancy coincides with the overall mortality peak value in Moscow: life expectancy of Muscovites for 1994 estimated without accounting of the mortality rate for non-residents turned out to be 3.2 years higher for men and 1.5 years higher for women. Supposedly, the Russian mortality statistics is not nation-wide in line with the actual state of affairs. However, the influence of the discussed systemic error in Russia's regions can be expected to be less pronounced since the level of immigration in Moscow is most probably by far higher.

  3. Measuring and managing patient expectations for breast reconstruction: impact on quality of life and patient satisfaction

    PubMed Central

    Pusic, Andrea L; Klassen, Anne F; Snell, Laura; Cano, Stefan J; McCarthy, Colleen; Scott, Amie; Cemal, Yeliz; Rubin, Lisa R; Cordeiro, Peter G

    2014-01-01

    The goal of postmastectomy breast reconstruction is to restore a woman’s body image and to satisfy her personal expectations regarding the results of surgery. Studies in other surgical areas have shown that unrecognized or unfulfilled expectations may predict dissatisfaction more strongly than even the technical success of the surgery. Patient expectations play an especially critical role in elective procedures, such as cancer reconstruction, where the patient’s primary motivation is improved health-related quality of life. In breast reconstruction, assessment of patient expectations is therefore vital to optimal patient care. This report summarizes the existing literature on patient expectations regarding breast reconstruction, and provides a viewpoint on how this field can evolve. Specifically, we consider how systematic measurement and management of patient expectations may improve patient education, shared medical decision-making and patient perception of outcomes. PMID:22458616

  4. [We are living longer, but in good health? Inequality in quality-adjusted life expectancy].

    PubMed

    van Baal, P; Gheorghe, M

    2017-01-01

    Quantifying trends in quality-adjusted life expectancy (QALE) by level of education in the Netherlands 2001-2011. Retrospective study. For this study we used data from several sources. Using regression models we estimated mortality rates and quality of life as functions of age, gender, calendar year and educational level. Quality of life was measured using the SF-6D questionnaire. In order to calculate QALE we combined estimates of mortality rates and quality of life into Sullivan's life tables. Over the period 2001-2011 quality of life and survival increased at all educational levels. This resulted in an increase of QALE varying from 1.5 to 3 years depending on gender and education. QALE increased less strongly in people with lower education than in those with higher education, which to a large extent was due to widening inequalities in mortality. The Dutch are living longer and have a better quality of life but inequalities in QALE have increased.

  5. Change in life expectancy with type 2 diabetes: a study using claims data from lower Saxony, Germany.

    PubMed

    Muschik, Denise; Tetzlaff, Juliane; Lange, Karin; Epping, Jelena; Eberhard, Sveja; Geyer, Siegfried

    2017-02-13

    This study estimates life expectancy with and without type 2 diabetes for individuals in Lower Saxony, Germany in order to detect a trend in population health. Morbidity and mortality data derived from German administrative claims data (statutory health insurance, AOK Niedersachsen, N = 2,900,065) were used covering 10 years from 2005 to 2014. Life table analysis was applied for calculating life expectancy, life expectancy free of type 2 diabetes, life expectancy with type 2 diabetes, and the proportion of life expectancy free of diabetes to total life expectancy using the Sullivan method. The total life expectancy increase is stronger in men than in women: At the age of 20, total life expectancy was 55.0 years in 2005 and 56.3 years in 2014 for men, whereas it was 61.7 years in 2005 and 62.5 years in 2014 for women. Decreases in life expectancy without type 2 diabetes were more pronounced in women than in men. Accordingly, life expectancy with type 2 diabetes increased in both women and in men. The proportion of life expectancy without diabetes to total life expectancy decreased, indicating a similar development in both. For example, at the age of 60, the proportion of life expectancy without diabetes to total life expectancy decreased from 0.75 in 2005 to 0.66 in 2014 for men, while it decreased from 0.77 in 2005 to 0.70 in 2014 for women. Against the background of increasing total life expectancy, the time spent in morbidity increased for the case of type 2 diabetes in Lower Saxony, Germany.

  6. Longitudinal associations between perceived age discrimination and subjective well-being: variations by age and subjective life expectancy.

    PubMed

    Avidor, Sharon; Ayalon, Liat; Palgi, Yuval; Bodner, Ehud

    2017-07-01

    Perceived age discrimination can have negative effects on one's subjective well-being (SWB). The response to age discrimination might differ based on age, and based on perceived longevity, or subjective life expectancy (SLE). These differential effects have not yet been prospectively examined within adult life span samples. We examined the association between perceived age discrimination at baseline (T1) and SWB at follow-up (T2), and the moderation effect of SLE. We compared differences in these effects between middle-aged and older adults. Analyses were based on participants who took part in the 2008 (T1) and 2011 (T2) assessments of the German Ageing Survey (DEAS; listwise N = 1534), a population-based representative sample of the German adult population. Participants were categorized as middle-aged (ages 40-64; n = 919) or older adults (ages 65-93; n = 615). Regression analyses indicated that T1 perceived age discrimination significantly predicts lower T2 SWB among middle-aged, but not among older adults, after adjusting for covariates and T1 SWB. There is a significant interaction between age discrimination and SLE for predicting SWB, only among middle-aged participants, suggesting that age discrimination predicts decreases in SWB for those reporting higher, but not lower levels of SLE. People in the transition from midlife to old age, who hold higher SLE, appear to be more vulnerable to age discrimination. This may be due to the experience of age discrimination as an 'off-time', or unexpected event for those in midlife who have a higher expectation to live longer.

  7. Extracorporeal Life Support in Critically Ill Adults

    PubMed Central

    Muratore, Christopher S.

    2014-01-01

    Extracorporeal life support (ECLS) has become increasingly popular as a salvage strategy for critically ill adults. Major advances in technology and the severe acute respiratory distress syndrome that characterized the 2009 influenza A(H1N1) pandemic have stimulated renewed interest in the use of venovenous extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal to support the respiratory system. Theoretical advantages of ECLS for respiratory failure include the ability to rest the lungs by avoiding injurious mechanical ventilator settings and the potential to facilitate early mobilization, which may be advantageous for bridging to recovery or to lung transplantation. The use of venoarterial ECMO has been expanded and applied to critically ill adults with hemodynamic compromise from a variety of etiologies, beyond postcardiotomy failure. Although technology and general care of the ECLS patient have evolved, ECLS is not without potentially serious complications and remains unproven as a treatment modality. The therapy is now being tested in clinical trials, although numerous questions remain about the application of ECLS and its impact on outcomes in critically ill adults. PMID:25046529

  8. Life expectancy and human capital: evidence from the international epidemiological transition.

    PubMed

    Hansen, Casper Worm

    2013-12-01

    Exploiting preintervention variation in mortality from various infectious diseases, together with the time variation arising from medical breakthroughs in the late 1940s and the 1950s, this study examines how a large positive shock to life expectancy influenced the formation of human capital within countries during the second half of the 20th century. The results establish that the rise in life expectancy was behind a significant part of the increase in human capital over this period. According to the baseline estimate, for one additional year of life expectancy, years of schooling increase by 0.17 year. Moreover, the evidence suggests that declines in pneumonia mortality are the underlying cause of this finding, indicating that improved childhood health increases human capital investments.

  9. Healthy life expectancy in the context of population health and ageing in India.

    PubMed

    Lau, Robin S; Johnson, Shanthi; Kamalanabhan, T J

    2012-01-01

    This study examines life expectancy (LE) and healthy life expectancy (HLE) in India longitudinally over the period 2007 to 2020, providing projections into the future. Specifically, the Indian Healthy Life Expectancy Projection model was developed based on epidemiological data (mortality, disability rates) obtained from the World Health Organization and the Government of India. The current model contributed to 4 key findings: decreases in mortality but not in all age and gender groups; increasing disability in the Indian population over time; increase in LE and HLE into the future in all age and gender groups; and the largest gains in LE and HLE are in the older age bands starting from the 70+ age band in women and 65+ age band in men. This study sheds some light on the population health measures needed to improve the understanding of the determinants of health for the efficient allocation of resources and to inform policy in the planning of health and social services.

  10. Healthy life expectancy in Hong Kong Special Administrative Region of China.

    PubMed Central

    Law, C. K.; Yip, P. S. F.

    2003-01-01

    Sullivan's method and a regression model were used to calculate healthy life expectancy (HALE) for men and women in Hong Kong Special Administrative Region (Hong Kong SAR) of China. These methods need estimates of the prevalence and information on disability distributions of 109 diseases and HALE for 191 countries by age, sex and region of the world from the WHO's health assessment of 2000. The population of Hong Kong SAR has one of the highest healthy life expectancies in the world. Sullivan's method gives higher estimates than the classic linear regression method. Although Sullivan's method accurately calculates the influence of disease prevalence within small areas and regions, the regression method can approximate HALE for all economies for which information on life expectancy is available. This paper identifies some problems of the two methods and discusses the accuracy of estimates of HALE that rely on data from the WHO assessment. PMID:12640475

  11. Discussions of Life Expectancy and Changes in Illness Understanding in Patients With Advanced Cancer.

    PubMed

    Epstein, Andrew S; Prigerson, Holly G; O'Reilly, Eileen M; Maciejewski, Paul K

    2016-07-10

    Accurate illness understanding enables patients to make informed decisions. Evidence of the influence of prognostic discussions on the accuracy of illness understanding by patients would demonstrate the value of discussions. Recent and past oncology provider-patient discussions about prognosis/life expectancy were examined for their association with changes in illness understanding by patients. Patients (N = 178) with advanced cancers refractory to prior chemotherapy whom oncologists expected to die within 6 months were interviewed before and after a visit in which cancer restaging scan results were discussed. Illness understanding scores were the sum of four indicator variables: patient terminal illness acknowledgment, recognition of incurable disease status, knowledge of the advanced stage of the disease, and expectation to live months as opposed to years. Before the restaging scan visit, nine (5%) of 178 patients had completely accurate illness understanding (ie, correctly answered each of the four illness understanding questions). Eighteen patients (10%) reported only recent discussions of prognosis/life expectancy with their oncologists; 68 (38%) reported only past discussions; 24 (13%) reported both recent and past discussions; and 68 (38%) reported that they never had discussions of prognosis/life expectancy with their oncologists. After adjustment for potential confounders (ie, education and race/ethnicity), analysis identified significant, positive changes in illness understanding scores for patients in groups that reported recent only (least-squares mean change score, 0.62; 95% CI, 0.23 to 1.01; P = .002) and both recent and past (least-squares mean change score, 0.37; 95% CI, 0.04 to 0.70; P = 0.028) discussions of prognosis/life expectancy with their oncologists. Patients with advanced cancer who report recent discussions of prognosis/life expectancy with their oncologists come to have a better understanding of the terminal nature of their illnesses.

  12. Inferring frail life expectancies in Chicago from daily fluctuations in elderly mortality.

    PubMed

    Murray, Christian J; Lipfert, Frederick W

    2013-07-01

    Susceptible sub-populations with existing disease have exhibited stronger relationships between air quality and mortality in time-series studies, but their associated life expectancies have largely been overlooked. Murray and Nelson developed a new time-series model that estimated a small unobserved (frail) sub-population and their resulting life expectancies in Philadelphia, including environment relationships. As a further example in a different geographic area, we used this model with 1987-2000 daily mortality data in Chicago and found a stable frail population at risk of ∼900 persons with a mean life expectancy of ∼11 days; fewer than two daily deaths were associated with air pollution. We considered daily concentrations of CO, NO₂, O₃, PM₁₀ and SO₂, and found PM₁₀ and O₃ to have stronger associations with frail mortality. Our estimates of life expectancy and air pollution and temperature relationships are similar to those found in other studies that used different methods. Temperature was more important than air pollution during the 1995 heat wave, when mortality risks increased dramatically after 2 d exposure and life expectancies decreased to 3-5 d. Modeling this event separately had substantial effects on lagged mortality--air pollution relationships and the population at risk. The premises of the Murray-Nelson model were supported by simultaneously considering an additional subgroup of non-frail individuals; they contributed only ∼1% of total elderly deaths. We conclude that frail life expectancies estimated by the Murray-Nelson model are robust, and that under these conditions non-frail persons have little risk of acute mortality, with or without contributions from air pollution.

  13. Long-Term Exposure to Ozone and Life Expectancy in the United States, 2002 to 2008.

    PubMed

    Li, Chaoyang; Balluz, Lina S; Vaidyanathan, Ambarish; Wen, Xiao-Jun; Hao, Yongping; Qualters, Judith R

    2016-02-01

    Long-term exposure to ground-level ozone is associated with increased risk of morbidity and mortality. The association remains uncertain between long-term exposure to ozone and life expectancy. We assessed the associations between seasonal mean daily 8-hour maximum (8-hr max) ozone concentrations measured during the ozone monitoring seasons and life expectancy at birth in 3109 counties of the conterminous U.S. during 2002 to 2008. We used latent class growth analysis to identify latent classes of counties that had distinct mean levels and rates of change in ozone concentrations over the 7-year period and used linear regression analysis to determine differences in life expectancy by ozone levels. We identified 3 classes of counties with distinct seasonal mean daily 8-hr max ozone concentrations and rates of change. When compared with the counties with the lowest ozone concentrations, the counties with the highest ozone concentrations had 1.7- and 1.4-year lower mean life expectancy in males and females (both P < 0.0001), respectively. The associations remained statistically significant after controlling for potential confounding effects of seasonal mean PM2.5 concentrations and other selected environmental, demographic, socio-economic, and health-related factors (both P < 0.0001). A 5 ppb higher ozone concentration was associated with 0.25 year lower life expectancy in males (95% CI: -0.30 to -0.19) and 0.21 year in females (95% CI: -0.25 to -0.17). We identified 3 classes of counties with distinct mean levels and rates of change in ozone concentrations. Our findings suggest that long-term exposure to a higher ozone concentration may be associated with a lower life expectancy.

  14. Long-Term Exposure to Ozone and Life Expectancy in the United States, 2002 to 2008

    PubMed Central

    Li, Chaoyang; Balluz, Lina S.; Vaidyanathan, Ambarish; Wen, Xiao-Jun; Hao, Yongping; Qualters, Judith R.

    2016-01-01

    Abstract Long-term exposure to ground-level ozone is associated with increased risk of morbidity and mortality. The association remains uncertain between long-term exposure to ozone and life expectancy. We assessed the associations between seasonal mean daily 8-hour maximum (8-hr max) ozone concentrations measured during the ozone monitoring seasons and life expectancy at birth in 3109 counties of the conterminous U.S. during 2002 to 2008. We used latent class growth analysis to identify latent classes of counties that had distinct mean levels and rates of change in ozone concentrations over the 7-year period and used linear regression analysis to determine differences in life expectancy by ozone levels. We identified 3 classes of counties with distinct seasonal mean daily 8-hr max ozone concentrations and rates of change. When compared with the counties with the lowest ozone concentrations, the counties with the highest ozone concentrations had 1.7- and 1.4-year lower mean life expectancy in males and females (both P < 0.0001), respectively. The associations remained statistically significant after controlling for potential confounding effects of seasonal mean PM2.5 concentrations and other selected environmental, demographic, socio-economic, and health-related factors (both P < 0.0001). A 5 ppb higher ozone concentration was associated with 0.25 year lower life expectancy in males (95% CI: −0.30 to −0.19) and 0.21 year in females (95% CI: −0.25 to −0.17). We identified 3 classes of counties with distinct mean levels and rates of change in ozone concentrations. Our findings suggest that long-term exposure to a higher ozone concentration may be associated with a lower life expectancy. PMID:26886595

  15. Does Life Expectancy Affect Treatment of Women Aged 80 and Older with Early Stage Breast Cancers?

    PubMed Central

    Schonberg, Mara A.; Marcantonio, Edward R.; Ngo, Long; Silliman, Rebecca A.; McCarthy, Ellen P.

    2011-01-01

    BACKGROUND Data are needed on how life expectancy affects treatment decisions among women ≥80 years with early stage breast cancer. METHODS We used the linked Surveillance Epidemiology and End Results-Medicare claims dataset from 1992–2005 to identify women aged ≥80 newly diagnosed with lymph node negative, estrogen receptor positive tumors, ≤5 centimeters. To estimate life expectancy, we matched these women to women of similar age, region, and insurance, not diagnosed with breast cancer. We examined 5-year mortality of matched controls by illness burden (measured with the Charlson Comorbidity Index [CCI]) using Kaplan-Meier statistics. We examined treatments received by estimated life expectancy within CCI levels. We further examined factors associated with receipt of radiotherapy after breast conserving surgery (BCS). RESULTS Of 9,932 women, 39.6% underwent mastectomy, 30.4% received BCS plus radiotherapy, and 30.0% received BCS alone. Estimated 5-year mortality was 72% for women with CCIs of 3+, yet 38.0% of these women underwent mastectomy and 22.9% received radiotherapy after BCS. Conversely, estimated 5-year mortality was 36% for women with CCIs of 0 and 26.6% received BCS alone. Age 80–84, urban residence, higher grade, recent diagnosis, mammography use, and low comorbidity, were factors associated with receiving radiotherapy after BCS. Among women with CCIs of 3+ treated with BCS, 36.9% underwent radiotherapy. CONCLUSIONS Many women aged ≥80 with limited life expectancies receive radiotherapy after BCS for treatment of early stage breast cancers while many in excellent health do not. More consideration needs to be given to patient life expectancy when considering breast cancer treatments. KEY WORDS: Breast cancer, older women, treatment, life expectancy, radiation PMID:22368726

  16. Impact of bariatric surgery on life expectancy in severely obese patients with diabetes: A Decision analysis

    PubMed Central

    Schauer, Daniel P.; Arterburn, David E.; Livingston, Edward H.; Coleman, Karen J.; Sidney, Steve; Fisher, David; O'Connor, Patrick; Fischer, David; Eckman, Mark H.

    2014-01-01

    Objective To create a decision analytic model to estimate the balance between treatment risks and benefits for severely obese patients with diabetes. Summary Background Data Bariatric surgery leads to many desirable metabolic changes, but long-term impact of bariatric surgery on life expectancy in patients with diabetes has not yet been quantified. Methods We developed a Markov state transition model with multiple Cox proportional hazards models and logistic regression models as inputs to compare bariatric surgery versus no surgical treatment for severely obese diabetic patients. The model is informed by data from three large cohorts: 1) 159,000 severely obese diabetic patients (4,185 had bariatric surgery) from 3 HMO Research Network sites, 2) 23,000 subjects from the Nationwide Inpatient Sample (NIS), and 3) 18,000 subjects from the National Health Interview Survey linked to the National Death Index. Results In our main analyses, we found that a 45 year-old female with diabetes and a BMI of 45 kg/m2 gained an additional 6.7 years of life expectancy with bariatric surgery (38.4 years with surgery vs. 31.7 without). Sensitivity analyses revealed that the gain in life expectancy decreased with increasing BMI, until a BMI of 62 kg/m2 is reached, at which point nonsurgical treatment was associated with greater life expectancy. Similar results were seen for both men and women in all age groups. Conclusions For most severely obese patients with diabetes, bariatric surgery appears to improve life expectancy; however, surgery may reduce life expectancy for the super obese with BMIs over 62 kg/m2. PMID:25844968

  17. Trends in life expectancy by education in Norway 1961-2009.

    PubMed

    Steingrímsdóttir, Olöf Anna; Næss, Øyvind; Moe, Joakim Oliu; Grøholt, Else-Karin; Thelle, Dag Steinar; Strand, Bjørn Heine; Bævre, Kåre

    2012-03-01

    Educational attainment and longevity are strongly related. Large population studies covering long periods to provide evidence of trends in educational inequalities regarding life expectancy are scarce though, especially prior to the 1980s. Our objective was to document changes in life expectancy by education in Norway in the period 1961-2009, and to determine whether the patterns differ between sexes. This is a register-based population study of all Norwegian residents over 34 years, with data from the National Central Population Registry and the National Education Database. For each calendar year during 1961-2009, death rates by 1 year age groups were calculated separately for each sex and three educational categories (primary, secondary and tertiary). Annual life tables were used to calculate life expectancy at age 35 (e ( 35 )) and survival probability for the three age-intervals 35-44, 45-64, and 65-90. All education groups increased their e ( 35 ) over time, but inequalities in e ( 35 ) between tertiary and primary educational categories widened 5.3 years for men and 3.2 years for women during the study period. The probability for women with primary education to survive to age 64 did not improve from 1961 to 2009. The gain in life expectancy lagged about 10 years in lower compared to higher education groups which might suggest that improvements in life sustaining factors reach different segments of the population at different times. The widening of the gap seems to have partly tapered off over the last two decades, and the changes in life expectancy should be followed carefully in the future to document the development.

  18. The Family Life Education Needs of Midlife and Older Adults.

    ERIC Educational Resources Information Center

    Ballard, Sharon M.; Morris Michael Lane

    2003-01-01

    Using a life course perspective, reports the findings from a needs assessment for midlife and older adults regarding family life education. A sample of 264 adults aged 50 and older indicated interest in 29 family life education topics. The highest rated topics were nutrition and health, fitness and exercise, and positive aspects of aging.…

  19. Clinician Factors Associated with Prostate-Specific Antigen Screening in Older Veterans with Limited Life Expectancy

    PubMed Central

    Tang, Victoria L.; Shi, Ying; Fung, Kathy; Tan, Jessica; Espaldon, Roxanne; Sudore, Rebecca; Wong, Melisa L.; Walter, Louise C.

    2017-01-01

    Importance Despite guidelines recommending against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, PSA screening remains common. Objectives Identify clinician characteristics associated with PSA screening in older veterans stratified by life expectancy. Design and Setting Cross-sectional study in the VA healthcare system. Participants 826,286 veterans aged ≥65 years eligible for PSA screening that had VA laboratory tests performed in 2011. Main Outcomes and Measures The primary outcome was the percentage of men with a screening PSA in 2011. Limited life expectancy was defined as age ≥85 with Charlson comorbidity score ≥1 or age ≥65 with Charlson comorbidity score ≥4. Primary predictors were clinician characteristics including degree-training level, specialty, age, and gender. We performed log-Poisson regression models for the association between each clinician characteristic and PSA screening stratified by patient life expectancy and adjusted for patient demographics and clinician clustering. Results In 2011, 56% of older veterans received PSA screening, including 39% of the 203,717 men with limited life expectancy. After adjusting for patient demographics, higher PSA screening in patients with limited life expectancy was associated with having a clinician who was an older male and was no longer in training. PSA screening ranged from 27% for men with a physician trainee to 42% for men with a physician attending (p <0.0001); 22% for men with a geriatrician to 82% for men with a urologist as their clinician (p <0.0001); 29% for men with a clinician ≤35 years old to 41% for those with a clinician ≥56 years old (p <0.0001); and 38% for men with a female clinician older than 55 years versus 43% for men with a male clinician older than 55 years (p=0.0008). Conclusion and Relevance Over a third of men with limited life expectancy received PSA screening. Men whose clinician was a physician trainee had substantially lower

  20. A state-level analysis of life expectancy in Mexico (1990-2006).

    PubMed

    Peláez, Oscar; Guijarro, Marta; Arias, Mercedes

    2010-11-01

    Using a methodology similar to that proposed by Barro & Sala-i-Martin (1995), it is found that, in the period 1990-2006, there was strong convergence among state-level life expectancy series, but a distancing in life expectancy in the Mexican Republic compared with more developed countries, especially during the new millennium. The interior convergence had taken place at the expense of the exterior; that is, not so much as a result of an improvement in living conditions in the poorer states, but more due to the low performance of the richer states. The causes of this situation are explained using the concept of 'epidemiological transition'.

  1. Clinician Factors Associated With Prostate-Specific Antigen Screening in Older Veterans With Limited Life Expectancy.

    PubMed

    Tang, Victoria L; Shi, Ying; Fung, Kathy; Tan, Jessica; Espaldon, Roxanne; Sudore, Rebecca; Wong, Melisa L; Walter, Louise C

    2016-05-01

    Despite guidelines recommending against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, PSA screening remains common. To identify clinician characteristics associated with PSA screening rates in older veterans stratified by life expectancy. Cross-sectional study of 826 286 veterans 65 years or older eligible for PSA screening who had VA laboratory tests performed in 2011 in the VA health care system. The primary outcome was the percentage of men with a screening PSA test in 2011. Limited life expectancy was defined as age of at least 85 years with Charlson comorbidity score of 1 or greater or age of at least 65 years with Charlson comorbidity score of 4 or greater. Primary predictors were clinician characteristics including degree-training level, specialty, age, and sex. We performed log-linear Poisson regression models for the association between each clinician characteristic and PSA screening stratified by patient life expectancy and adjusted for patient demographics and clinician clustering. In 2011, 466 017 (56%) of older veterans received PSA screening, including 39% of the 203 717 men with limited life expectancy. After adjusting for patient demographics, higher PSA screening rates in patients with limited life expectancy was associated with having a clinician who was an older man and was no longer in training. The PSA screening rates ranged from 27% for men with a physician trainee to 42% for men with an attending physician (P < .001); 22% for men with a geriatrician to 82% for men with a urologist as their clinician (P < .001); 29% for men with a clinician 35 years or younger to 41% for those with a clinician 56 years or older (P < .001); and 38% for men with a female clinician older than 55 years vs 43% for men with a male clinician older than 55 years (P < .001). More than one-third of men with limited life expectancy received PSA screening. Men whose clinician was a physician trainee had

  2. Medical center characteristics associated with PSA screening in elderly veterans with limited life expectancy.

    PubMed

    So, Cynthia; Kirby, Katharine A; Mehta, Kala; Hoffman, Richard M; Powell, Adam A; Freedland, Stephen J; Sirovich, Brenda; Yano, Elizabeth M; Walter, Louise C

    2012-06-01

    Although guidelines recommend against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, screening is common. We sought to identify medical center characteristics associated with screening in this population. We conducted a prospective study of 622,262 screen-eligible men aged 70+ seen at 104 VA medical centers in 2003. Primary outcome was the percentage of men at each center who received PSA screening in 2003, based on VA data and Medicare claims. Men were stratified into life expectancy groups ranging from favorable (age 70-79 with Charlson score = 0) to limited (age 85+ with Charlson score ≥1 or age 70+ with Charlson score ≥4). Medical center characteristics were obtained from the 1999-2000 VA Survey of Primary Care Practices and publicly available VA data sources. Among 123,223 (20%) men with limited life expectancy, 45% received PSA screening in 2003. Across 104 VAs, the PSA screening rate among men with limited life expectancy ranged from 25-79% (median 43%). Higher screening was associated with the following center characteristics: no academic affiliation (50% vs. 43%, adjusted RR = 1.14, 95% CI 1.04-1.25), a ratio of midlevel providers to physicians ≥3:4 (55% vs. 45%, adjusted RR = 1.20, 95% CI 1.09-1.32) and location in the South (49% vs. 39% in the West, adjusted RR = 1.25, 95% CI 1.12-1.40). Use of incentives and high scores on performance measures were not independently associated with screening. Within centers, the percentages of men screened with limited and favorable life expectancies were highly correlated (r = 0.90). Substantial practice variation exists for PSA screening in older men with limited life expectancy across VAs. The high center-specific correlation of screening among men with limited and favorable life expectancies indicates that PSA screening is poorly targeted according to life expectancy.

  3. Quality of Life in Adults with Strabismus

    PubMed Central

    Chang, Melinda Y.; Velez, Federico G.; Demer, Joseph L.; Isenberg, Sherwin J.; Coleman, Anne L.; Pineles, Stacy L.

    2015-01-01

    Purpose To assess relative quality of life in patients with strabismus. Design Retrospective cohort study Methods The 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was performed in 42 strabismic adults over the age of 50 years at a single institution. Subscale scores were compared with those of patients with other ocular diseases, including diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, cataract, cytomegalovirus (CMV) retinitis, and low vision. Results Median visual acuity was 20/20 (range 20/12.5 to 20/50), and 34 patients (81%) reported diplopia. Strabismic patients performed the same or worse on nearly all vision-related subscales than did patients with diabetic retinopathy, age-related macular degeneration, glaucoma, cataract, and CMV retinitis. Additionally, strabismic patients reported significantly worse ocular pain than all comparison groups before any surgery was performed. Conclusions Strabismus impacts quality of life through both functional and psychosocial factors. Physicians treating strabismic patients should recognize these quality of life issues and address them accordingly. PMID:25498355

  4. Positive Expectations Regarding Aging Linked to More New Friends in Later Life.

    PubMed

    Menkin, Josephine A; Robles, Theodore F; Gruenewald, Tara L; Tanner, Elizabeth K; Seeman, Teresa E

    2017-09-01

    Negative perceptions of aging can be self-fulfilling prophecies, predicting worse cognitive and physical outcomes. Although older adults are portrayed as either lonely curmudgeons or perfect grandparents, little research addresses how perceptions of aging relate to social outcomes. We considered whether more positive expectations about aging encourage older adults to maintain or bolster their social network connections and support. This study examined baseline, 12-, and 24-month questionnaire data from the Baltimore Experience Corps Trial, a longitudinal randomized volunteer intervention for adults aged 60 years and older. The associations between expectations regarding aging and different types of social support were tested using negative binomial and multiple regression models controlling for relevant covariates such as baseline levels of perceived support availability. Participants with more positive expectations at baseline made more new friends 2 years later and had greater overall perceived support availability 12 months later. Notably, only participants with at least average perceived support availability at baseline showed an association between expectations and later support availability. These results are the first to link overall expectations regarding aging to the social domain and suggest that the influence of perceptions of aging is not limited to physical or cognitive function.

  5. A systematic literature review of life expectancy prediction tools for localized prostate cancer patients

    PubMed Central

    Kent, Matthew; Vickers, Andrew J.

    2015-01-01

    Purpose We aimed to develop a clinical decision support tool for clinicians counseling patients with localized prostate cancer. The tool would provide estimates of patient life expectancy from age, comorbidities, and tumor characteristics. We reviewed the literature to find suitable prediction models. Materials and Methods We searched the literature for prediction models for life expectancy. Models were evaluated in terms of whether they provided an estimate of risk, incorporated comorbidities, were clinically feasible and gave plausible estimates. Clinical feasibility was defined in terms of whether the model provided coefficients, could be used in the initial consultation for men across a wide range of ages without an undue burden of data gathering. Results Models in the literature were characterized by the use of life years rather than a risk of death, questionable approaches to comorbidities, implausible estimates, questionable recommendations, and poor clinical feasibility. We found tools based on applying an unvalidated approach to assessing comorbidities to a clearly erroneous life expectancy table, or required a treatment decision be made before life expectancy could be calculated or gave highly implausible estimates, such as a substantial risk of prostate cancer specific mortality even for a highly comorbid 80 year old with Gleason 6 disease. Conclusions We found gross deficiencies in current tools that predict risk of death from other causes. No existing model was suitable for implementation in our clinical decision support system. PMID:25463998

  6. Rough Set Theory based prognostication of life expectancy for terminally ill patients.

    PubMed

    Gil-Herrera, Eleazar; Yalcin, Ali; Tsalatsanis, Athanasios; Barnes, Laura E; Djulbegovic, Benjamin

    2011-01-01

    We present a novel knowledge discovery methodology that relies on Rough Set Theory to predict the life expectancy of terminally ill patients in an effort to improve the hospice referral process. Life expectancy prognostication is particularly valuable for terminally ill patients since it enables them and their families to initiate end-of-life discussions and choose the most desired management strategy for the remainder of their lives. We utilize retrospective data from 9105 patients to demonstrate the design and implementation details of a series of classifiers developed to identify potential hospice candidates. Preliminary results confirm the efficacy of the proposed methodology. We envision our work as a part of a comprehensive decision support system designed to assist terminally ill patients in making end-of-life care decisions.

  7. Impact of depression on quality-adjusted life expectancy (QALE) directly as well as indirectly through suicide

    PubMed Central

    Zack, Matthew M.; Thompson, William W.; Crosby, Alex E.; Gottesman, Irving I.

    2015-01-01

    Purpose To estimate quality-adjusted life expectancy (QALE) loss among US adults due to depression and QALE losses associated with the increased risk of suicide attributable to depression. Method We ascertained depressive symptoms using the eight-item Patient Health Questionnaire (PHQ-8) on the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) surveys. We estimated health-related quality of life (HRQOL) scores from BRFSS data (n = 276,442) and constructed life tables from US Compressed Mortality Files to calculate QALE by depression status. QALE loss due to depression is the difference in QALE between depressed and non-depressed adults. QALE loss associated with suicide deaths is the difference between QALE from only those deaths that did not have suicide recorded on the death certificate and QALE from all deaths including those with a suicide recorded on the death certificate. Results At age 18, QALE was 28.0 more years for depressed adults and 56.8 more years for non-depressed adults, a 28.9-year QALE loss due to depression. For depressed adults, only 0.41 years of QALE loss resulted from deaths by suicide, and only 0.26 years of this loss could be attributed to depression. Conclusion Depression symptoms lead to a significant burden of disease from both mortality and morbidity as assessed by QALE loss. The 28.9-year QALE loss at age 18 associated with depression markedly exceeds estimates reported elsewhere for stroke (12.4-year loss), heart disease (10.3-year loss), diabetes mellitus (11.1-year loss), hypertension (6.3-year loss), asthma (7.0-year loss), smoking (11.0-year loss), and physical inactivity (8.0-year loss). PMID:25660550

  8. Life expectancy of HIV-positive individuals on combination antiretroviral therapy in Canada.

    PubMed

    Patterson, Sophie; Cescon, Angela; Samji, Hasina; Chan, Keith; Zhang, Wendy; Raboud, Janet; Burchell, Ann N; Cooper, Curtis; Klein, Marina B; Rourke, Sean B; Loutfy, Mona R; Machouf, Nima; Montaner, Julio S G; Tsoukas, Chris; Hogg, Robert S

    2015-07-17

    We sought to evaluate life expectancy and mortality of HIV-positive individuals initiating combination antiretroviral therapy (ART) across Canada, and to consider the potential error introduced by participant loss to follow-up (LTFU). Our study used data from the Canadian Observational Cohort (CANOC) collaboration, including HIV-positive individuals aged ≥18 years who initiated ART on or after January 1, 2000. The CANOC collaboration collates data from eight sites in British Columbia, Ontario, and Quebec. We computed abridged life-tables and remaining life expectancies at age 20 and compared outcomes by calendar period and patient characteristics at treatment initiation. To correct for potential underreporting of mortality due to participant LTFU, we conservatively estimated 30% mortality among participants lost to follow-up. 9997 individuals contributed 49,589 person-years and 830 deaths for a crude mortality rate of 16.7 [standard error (SE) 0.6] per 1000 person-years. When assigning death to 30% of participants lost to follow-up, we estimated 1170 deaths and a mortality rate of 23.6 [SE 0.7] per 1000 person-years. The crude overall life expectancy at age 20 was 45.2 [SE 0.7] and 37.5 [SE 0.6] years after adjusting for LTFU. In the LTFU-adjusted analysis, lower life expectancy at age 20 was observed for women compared to men (32.4 [SE 1.1] vs. 39.2 [SE 0.7] years), for participants with injection drug use (IDU) history compared to those without IDU history (23.9 [SE 1.0] vs. 52.3 [SE 0.8] years), for participants reporting Aboriginal ancestry compared to those with no Aboriginal ancestry (17.7 [SE 1.5] vs. 51.2 [SE 1.0] years), and for participants with CD4 count <350 cells/μL compared to CD4 count ≥350 cells/μL at treatment initiation (36.3 [SE 0.7] vs. 43.5 [SE 1.3] years). Life expectancy at age 20 in the calendar period 2000-2003 was lower than in periods 2004-2007 and 2008-2012 in the LTFU-adjusted analyses (30.8 [SE 0.9] vs. 38.6 [SE 1.0] and 54.2 [SE

  9. How Important Are Health Care Expenditures for Life Expectancy? A Comparative, European Analysis.

    PubMed

    van den Heuvel, Wim J A; Olaroiu, Marinela

    2017-03-01

    The relationship between health care expenditures and health care outcomes, such as life expectancy and mortality, is complex. Research outcomes show different and contradictory results on this relationship. How and why health care expenditures affect health outcomes is not clear. A causal link between the two is not proven. Without such knowledge, effects of increase/decrease in health care expenses on health outcomes may be overestimated/underestimated. This study analyzes the relationship between life expectancy at birth and expenditures on health care, taking into account expenditures of social production and education, as well as the quantity and quality of health care provisions and lifestyles. This is a cross-sectional study, analyzing national data of 31 European countries. First, the bivariate correlation between the dependent variable and independent variables are calculated and described. Next a forward linear regression analysis is applied. The data are derived from standardized, comparative data bases as available in the Organisation for Economic Co-operation and Development and Eurostat. Health care expenditures are assessed as a percentage of the Gross Domestic Product (GDP). Health care expenditures are not the main determinant of life expectancy at birth, but social protection expenditures are. The regression analysis shows that in countries that spend a high percentage of their GDP on social protection, that have fewer curative beds and low infant mortality, whose citizens report fewer unmet health care needs and drink less alcohol, citizens have a significant longer life expectancy. To realize high life expectancy of citizens, policy measures have to be directed on investment in social protection expenditures, on improving quality of care, and on promoting a healthy life style. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  10. IF THEY GROW UP: EXPLORING THE NEIGHBORHOOD CONTEXT OF ADOLESCENT AND YOUNG ADULT SURVIVAL EXPECTATIONS

    PubMed Central

    Swisher, Raymond R.; Warner, Tara D.

    2013-01-01

    Using data from the National Longitudinal Study of Adolescent Health, this paper examines individual and neighborhood predictors of adolescent and young adult survival expectations — their confidence of surviving to age 35. Analyses revealed that within-person increases in depression and violent perpetration decreased the odds of expecting to survive. Individuals who rated themselves in good health and received routine physical care had greater survival expectations. Consistent with documented health disparities, Black and Hispanic youth had lower survival expectations than did their White peers. Neighborhood poverty was linked to diminished survival expectations both within and between persons, with the between person association remaining significant controlling for mental and physical health, exposure to violence, own violence, and a wide range of socio-demographic factors. PMID:24273393

  11. Mammary gland: From embryogenesis to adult life.

    PubMed

    Musumeci, Giuseppe; Castrogiovanni, Paola; Szychlinska, Marta Anna; Aiello, Flavia Concetta; Vecchio, Giada Maria; Salvatorelli, Lucia; Magro, Gaetano; Imbesi, Rosa

    2015-01-01

    The aim of this review is to focus on the molecular factors that ensure the optimal development and maintenance of the mammary gland thanks to their integration and coordination. The development of the mammary gland is supported, not only by endocrine signals, but also by regulatory molecules, which are able to integrate signals from the surrounding microenvironment. A major role is certainly played by homeotic genes, but their incorrect expression during the spatiotemporal regulation of proliferative, functional and differentiation cycles of the mammary gland, may result in the onset of neoplastic processes. Attention is directed also to the endocrine aspects and sexual dimorphism of mammary gland development, as well as the role played by ovarian steroids and their receptors in adult life.

  12. Adolescents' Changing Future Expectations Predict the Timing of Adult Role Transitions

    ERIC Educational Resources Information Center

    Beal, Sarah J.; Crockett, Lisa J.; Peugh, James

    2016-01-01

    Individual differences in the transition to adulthood are well established. This study examines the extent to which heterogeneity in pathways to adulthood that have been observed in the broader U.S. population are mirrored in adolescents' expectations regarding when they will experience key adult role transitions (e.g., marriage). Patterns of…

  13. A Phenomenological Study to Discover Low-Income Adults' Perceptions and Expectations Regarding Financial Literacy

    ERIC Educational Resources Information Center

    Schaffer, Brigid Ann

    2013-01-01

    This phenomenological study explored the perceptions and expectations of low income adults regarding financial literacy to discover ways to increase attendance in financial literacy programs designs for this cohort. The study utilized interviews with closed-ended questions to establish the participants' backgrounds, then opened-ended questions to…

  14. Adolescents' Changing Future Expectations Predict the Timing of Adult Role Transitions

    ERIC Educational Resources Information Center

    Beal, Sarah J.; Crockett, Lisa J.; Peugh, James

    2016-01-01

    Individual differences in the transition to adulthood are well established. This study examines the extent to which heterogeneity in pathways to adulthood that have been observed in the broader U.S. population are mirrored in adolescents' expectations regarding when they will experience key adult role transitions (e.g., marriage). Patterns of…

  15. Examining Emerging-Adults' and Parents' Expectations about Autonomy during the Transition to College

    ERIC Educational Resources Information Center

    Kenyon, DenYelle Baete; Koerner, Susan Silverberg

    2009-01-01

    Our research goals were to document levels and examine the potential discrepancies of emerging-adults' and parents' expectations for autonomous behavior during the transition to college. Quantitative and qualitative data were collected from 204 incoming college freshmen (n = 150 females, n = 54 males) and 226 parents (n = 173 mothers, n = 53…

  16. Examining Emerging-Adults' and Parents' Expectations about Autonomy during the Transition to College

    ERIC Educational Resources Information Center

    Kenyon, DenYelle Baete; Koerner, Susan Silverberg

    2009-01-01

    Our research goals were to document levels and examine the potential discrepancies of emerging-adults' and parents' expectations for autonomous behavior during the transition to college. Quantitative and qualitative data were collected from 204 incoming college freshmen (n = 150 females, n = 54 males) and 226 parents (n = 173 mothers, n = 53…

  17. Adults Pursuing E-Learning in Ghana--Opportunities, Challenges and Expectations

    ERIC Educational Resources Information Center

    Boateng, John Kwame

    2015-01-01

    It has been said that the debate over effectiveness of learning online has ended and that several large-scale studies are reporting better learning outcomes for online learning than for some face-to-face courses. In the Central Region of Ghana, a study was carried out to explore opportunities, challenges and expectations confronting adults who…

  18. A Phenomenological Study to Discover Low-Income Adults' Perceptions and Expectations Regarding Financial Literacy

    ERIC Educational Resources Information Center

    Schaffer, Brigid Ann

    2013-01-01

    This phenomenological study explored the perceptions and expectations of low income adults regarding financial literacy to discover ways to increase attendance in financial literacy programs designs for this cohort. The study utilized interviews with closed-ended questions to establish the participants' backgrounds, then opened-ended questions to…

  19. Staff Expectations and Views of Cognitive Behaviour Therapy (CBT) for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Kroese, Biza Stenfert; Jahoda, Andrew; Pert, Carol; Trower, Peter; Dagnan, Dave; Selkirk, Mhairi

    2014-01-01

    Background: The role of support workers and other professionals in the psychotherapeutic process has been commented upon but not as yet been systematically investigated. Method: To explore their views and expectations of cognitive behaviour therapy (CBT) for adults with intellectual disabilities, eleven paid support workers and professionals were…

  20. Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada

    PubMed Central

    Steensma, C.; Loukine, L.; Orpana, H.; McRae, L.; Vachon, J.; Mo, F.; Boileau-Falardeau, M.; Reid, C.; Choi, B. C.

    2016-01-01

    Abstract Introduction: Few studies have evaluated the impact of depression in terms of losses to both premature mortality and health-related quality of life (HRQOL) on the overall population. Health-adjusted life expectancy (HALE) is a summary measure of population health that combines both morbidity and mortality into a single summary statistic that describes the current health status of a population. Methods: We estimated HALE for the Canadian adult population according to depression status. National Population Health Survey (NPHS) participants 20 years and older (n = 12 373) were followed for mortality outcomes from 1994 to 2009, based on depression status. Depression was defined as having likely experienced a major depressive episode in the previous year as measured by the Composite International Diagnostic Interview Short Form. Life expectancy was estimated by building period abridged life tables by sex and depression status using the relative risks of mortality from the NPHS and mortality data from the Canadian Chronic Disease Surveillance System (2007–2009). The Canadian Community Health Survey (2009/10) provided estimates of depression prevalence and Health Utilities Index as a measure of HRQOL. Using the combined mortality, depression prevalence and HRQOL estimates, HALE was estimated for the adult population according to depression status and by sex. Results: For the population of women with a recent major depressive episode, HALE at 20 years of age was 42.0 years (95% CI: 40.2–43.8) compared to 57.0 years (95% CI: 56.8–57.2) for women without a recent major depressive episode. For the population of Canadian men, HALE at 20 was 39.0 years (95% CI: 36.5–41.5) for those with a recent major depressive episode compared to 53.8 years (95% CI: 53.6–54.0) for those without. For the 15.0-year difference in HALE between women with and without depression, 12.3 years can be attributed to the HRQOL gap and the remaining 2.7 years to the mortality gap. The

  1. Pleiotropy of segregating genetic variants that affect honey bee worker life expectancy.

    PubMed

    Dixon, Luke R; McQuage, Michelle R; Lonon, Ellen J; Buehler, Dominique; Seck, Oumar; Rueppell, Olav

    2012-08-01

    In contrast to many other complex traits, the natural genetic architecture of life expectancy has not been intensely studied, particularly in non-model organisms, such as the honey bee (Apis mellifera L.). Multiple factors that determine honey bee worker lifespan have been identified and genetic analyses have been performed on some of those traits. Several of the traits are included in a suite of correlated traits that form the pollen hoarding syndrome, which was named after the behavior to store surplus pollen in the nest and is tied to social evolution. Here, seven quantitative trait loci that had previously been identified for their effects on different aspects of the pollen hoarding syndrome were studied for their genetic influence on the survival of adult honey bee workers. To gain a more comprehensive understanding of the genetic architecture of worker longevity, a panel of 280 additional SNP markers distributed across the genome was also tested. Allelic distributions were compared between young and old bees in two backcross populations of the bi-directionally selected high- and low-pollen hoarding strain. Our results suggest a pleiotropic effect of at least one of the behavioral quantitative trait loci on worker longevity and one significant and several other putative genetic effects in other genomic regions. At least one locus showed evidence for strong antagonistic pleiotropy and several others suggested genetic factors that influence pre-emergence survival of worker honey bees. Thus, the predicted association between worker lifespan and the pollen hoarding syndrome was supported at the genetic level and the magnitude of the identified effects also strengthened the view that naturally segregating genetic variation can have major effects on age-specific survival probability in the wild. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Positive Aging Expectations Are Associated With Physical Activity Among Urban-Dwelling Older Adults.

    PubMed

    Andrews, Ryan M; Tan, Erwin J; Varma, Vijay R; Rebok, George W; Romani, William A; Seeman, Teresa E; Gruenewald, Tara L; Tanner, Elizabeth K; Carlson, Michelle C

    2017-08-01

    Regular physical activity is a key component of healthy aging, but few older adults meet physical activity guidelines. Poor aging expectations can contribute to this lack of activity, since negative stereotypes about the aging process can be internalized and affect physical performance. Although prior cross-sectional studies have shown that physical activity and aging expectations are associated, less is known about this association longitudinally, particularly among traditionally underrepresented groups. It is also unclear whether different domains of aging expectations are differentially associated with physical activity. The number of minutes/week of physical activity in which Baltimore Experience Corps Trial participants (N = 446; 92.6% African American) engaged were measured using the CHAMPS questionnaire, while their aging expectations were measured using the ERA-12 survey. Linear mixed effects models assessed the association between physical activity and aging expectations over 2 years, both in full and sex-stratified samples. Separate models were also fit for different ERA-12 domains. We found that higher overall expectations regarding aging are associated with higher engagement in moderate- to high-intensity physical activity over a 2-year period of time for women only. When the ERA-12 domains were examined separately, only the physical domain was associated with physical activity, both in women and overall. Low expectations regarding physical aging may represent a barrier to physical activity for older adults. Given that most older adults do not meet recommended physical activity guidelines, identifying factors that improve aging expectations may be a way to increase physical activity levels in aging populations.

  3. Life Expectancy as an Objective Factor of a Subjective Well-Being

    ERIC Educational Resources Information Center

    Papavlassopulos, Nikolas; Keppler, David

    2011-01-01

    The paper has two parts. In the first part we offer a definition of well-being which makes life expectancy an explicit variable. We recognize the importance of happiness as a significant aspect of any definition of well-being, but we side-step the issue of what determines its level or how to measure it, and concentrate instead on the consequences…

  4. Future life expectations and self-esteem of the adolescent survivor of childhood cancer.

    PubMed

    Overbaugh, K A; Sawin, K

    1992-01-01

    The number of adolescent cancer survivors has increased dramatically over the past decade as the result of improved treatment and diagnostic techniques. This population brings with them unique characteristics and concerns. The present study consisted of interviews with 10 adolescent survivors of childhood cancer and their parents. It investigated the adolescent's present self-esteem, the future life expectations held by both the teenagers and parents, and the relationship between the variables. Results indicated that the adolescents felt moderately competent in their lives (measures of self-esteem) and the parents felt more certain than their children that the teenagers would accomplish the tasks deemed appropriate for entry into a healthy adulthood. Pearson correlations showed a strong relationship between parents' future life expectations and adolescents' self-esteem (r = .82; P = .002), but not between parents' and adolescents' future life expectations or between the adolescents' future life expectations and self-esteem. The results are significant in addressing the impact parents can have on their child's self-esteem.

  5. Decreased cancer-independent life expectancy in the head and neck cancer population.

    PubMed

    Massa, Sean T; Cass, Lauren M; Osazuwa-Peters, Nosayaba; Christopher, Kara M; Walker, Ronald J; Varvares, Mark A

    2017-09-01

    Aside from cancer mortality, patients with head and neck cancer have increased mortality risk. Identifying patients with the greatest loss of cancer-independent life expectancy can guide comprehensive survivorship programs. Age-based survival data from the Surveillance, Epidemiology, and End Result (SEER) database for patients with head and neck cancer were censored for mortality from the index cancer. Life expectancy and years of life lost (YLL) referenced to the general population were calculated. Cox proportional regression models produced hazard ratios (HRs). Cancer-independent life expectancy for patients with head and neck cancer is 6.5 years shorter than expected. The greatest hazard and impact of other-cause mortality was associated with black race (HR 1.23; YLL 8.55), stage IV (HR 1.60; YLL 7.92), Medicaid (HR 1.55; YLL 12.9), and previous marriage (HR 1.49; YLL 11.4). Patients with head and neck cancer lives are foreshortened independent of their cancer diagnosis necessitating management of noncancer mortality to maximize overall survival. © 2017 Wiley Periodicals, Inc.

  6. Extenuating Circumstances in Perceptions of Suicide: Disease Diagnosis (AIDS, Cancer), Pain Level, and Life Expectancy.

    ERIC Educational Resources Information Center

    Martin, Stephen K.; Range, Lillian M.

    1991-01-01

    Examined whether illness type, pain level, and life expectancy affected reactions of undergraduates (n=160) toward a terminal illness suicide with Acquired Immune Deficiency Syndrome (AIDS) or cancer. AIDS patients were more stigmatized than cancer patients; suicide was more tolerated if victim was suffering greater pain. (Author/ABL)

  7. The social gradient in life expectancy: the contrary case of Okinawa in Japan.

    PubMed

    Cockerham, W C; Hattori, H; Yamori, Y

    2000-07-01

    This paper examines the social gradient theory of health and life expectancy presented by Evans and his colleagues [Evans, R.G., Barer, M.L. and Marmor, T.R. (Eds.), 1994. Why are some People Healthy and others not? The Determinants of Health of Populations. Aldine de Gruyter, New York]. They maintain that social hierarchy is the determining factor in the health of large populations largely because it promotes differences in stress or the ability to cope with stress. For example, as Japan has risen to the top ranks of the economic hierarchy of nations in the late 20th century, Japanese life expectancy improved dramatically. Evans [Evans, R.G., 1994. Introduction. In: Evans, R., Barer, M., Marmor T. (Eds.), Why are some People Healthy and others not? The Determinants of Health of Populations. Aldine de Gruyter, New York, pp. 3-26.] notes that something lies behind this rapid increase in longevity and the major change was the hierarchical position of Japan relative to the rest of the world. However, we reviewed life expectancy data within Japan and found that Okinawans traditionally rank at the top in health and life expectancy and at the bottom in socioeconomic indicators. We find that the social gradient thesis does not apply in Japan and suggest that what is more important for health are health lifestyles, especially diet and social support. More research is needed to assess the validity of the social gradient thesis if it is to be used on a cross-national basis.

  8. Life Expectancy as an Objective Factor of a Subjective Well-Being

    ERIC Educational Resources Information Center

    Papavlassopulos, Nikolas; Keppler, David

    2011-01-01

    The paper has two parts. In the first part we offer a definition of well-being which makes life expectancy an explicit variable. We recognize the importance of happiness as a significant aspect of any definition of well-being, but we side-step the issue of what determines its level or how to measure it, and concentrate instead on the consequences…

  9. Measuring Longevity Achievements under Welfare Interdependencies: A Case for Joint Life Expectancy Indicators

    ERIC Educational Resources Information Center

    Ponthiere, Gregory

    2007-01-01

    Whereas period life expectancy constitutes an intuitive indicator of the survival conditions prevailing at a particular period, this paper argues that, given the existence of welfare interdependencies, that widespread indicator is nonetheless an incomplete measure of the longevity achievements relevant for human well-being. The central importance…

  10. Information Processing through the First Year of Life: A Longitudinal Study Using the Visual Expectation Paradigm.

    ERIC Educational Resources Information Center

    Canfield, Richard L.; Smith, Elliott G.; Brezsnyak, Michael P.; Snow, Kyle L.

    1997-01-01

    Used Visual Expectation Paradigm to describe information processing changes and individual differences during first year of life. Found regular age changes in mean reaction time and variability but not in minimum reaction time, suggesting that growth rate of sensory-detection information is constant during first year but age changes occur in level…

  11. Measuring Longevity Achievements under Welfare Interdependencies: A Case for Joint Life Expectancy Indicators

    ERIC Educational Resources Information Center

    Ponthiere, Gregory

    2007-01-01

    Whereas period life expectancy constitutes an intuitive indicator of the survival conditions prevailing at a particular period, this paper argues that, given the existence of welfare interdependencies, that widespread indicator is nonetheless an incomplete measure of the longevity achievements relevant for human well-being. The central importance…

  12. Rise, stagnation, and rise of Danish women’s life expectancy

    PubMed Central

    Lindahl-Jacobsen, Rune; Rau, Roland; Jeune, Bernard; Canudas-Romo, Vladimir; Lenart, Adam; Christensen, Kaare; Vaupel, James W.

    2016-01-01

    Health conditions change from year to year, with a general tendency in many countries for improvement. These conditions also change from one birth cohort to another: some generations suffer more adverse events in childhood, smoke more heavily, eat poorer diets, etc., than generations born earlier or later. Because it is difficult to disentangle period effects from cohort effects, demographers, epidemiologists, actuaries, and other population scientists often disagree about cohort effects’ relative importance. In particular, some advocate forecasts of life expectancy based on period trends; others favor forecasts that hinge on cohort differences. We use a combination of age decomposition and exchange of survival probabilities between countries to study the remarkable recent history of female life expectancy in Denmark, a saga of rising, stagnating, and now again rising lifespans. The gap between female life expectancy in Denmark vs. Sweden grew to 3.5 y in the period 1975–2000. When we assumed that Danish women born 1915–1945 had the same survival probabilities as Swedish women, the gap remained small and roughly constant. Hence, the lower Danish life expectancy is caused by these cohorts and is not attributable to period effects. PMID:27035998

  13. The Influence of Subjective Life Expectancy on Retirement Transition and Planning: A Longitudinal Study

    ERIC Educational Resources Information Center

    Griffin, Barbara; Hesketh, Beryl; Loh, Vanessa

    2012-01-01

    This study examines the construct of subjective life expectancy (SLE), or the estimation of one's probable age of death. Drawing on the tenets of socioemotional selectivity theory (Carstensen, Isaacowitz, & Charles, 1999), we propose that SLE provides individuals with their own unique mental model of remaining time that is likely to affect their…

  14. The Influence of Subjective Life Expectancy on Retirement Transition and Planning: A Longitudinal Study

    ERIC Educational Resources Information Center

    Griffin, Barbara; Hesketh, Beryl; Loh, Vanessa

    2012-01-01

    This study examines the construct of subjective life expectancy (SLE), or the estimation of one's probable age of death. Drawing on the tenets of socioemotional selectivity theory (Carstensen, Isaacowitz, & Charles, 1999), we propose that SLE provides individuals with their own unique mental model of remaining time that is likely to affect their…

  15. Aging expectations are associated with physical activity and health among older adults of low socioeconomic status.

    PubMed

    Dogra, Shilpa; Al-Sahab, Ban; Manson, James; Tamim, Hala

    2015-04-01

    The purpose of the current study was to determine whether aging expectations (AE) are associated with physical activity participation and health among older adults of low socioeconomic status (SES). A cross-sectional analysis of a sample of 170 older adults (mean age 70.9 years) was conducted. Data on AE, physical activity, and health were collected using the 12 item Expectations Regarding Aging instrument, the Healthy Physical Activity Participation Questionnaire, and the Short Form-36, respectively. Adjusted linear regression models showed significant associations between AE and social functioning, energy/vitality, mental health, and self-rated general health, as well as physical activity. These results suggest that AE may help to better explain the established association between low SES, low physical activity uptake, and poor health outcomes among older adults.

  16. Men Want Equality, but Women Don't Expect It: Young Adults' Expectations for Participation in Household and Child Care Chores

    ERIC Educational Resources Information Center

    Askari, Sabrina F.; Liss, Miriam; Erchull, Mindy J.; Staebell, Samantha E.; Axelson, Sarah J.

    2010-01-01

    This study explored whether there was a discrepancy between young adults' ideal and expected participation in household and child care chores as well as what variables predicted expectations for future chore division. Three-hundred fifty-eight unmarried, heterosexual participants with no children completed an online questionnaire assessing the…

  17. Men Want Equality, but Women Don't Expect It: Young Adults' Expectations for Participation in Household and Child Care Chores

    ERIC Educational Resources Information Center

    Askari, Sabrina F.; Liss, Miriam; Erchull, Mindy J.; Staebell, Samantha E.; Axelson, Sarah J.

    2010-01-01

    This study explored whether there was a discrepancy between young adults' ideal and expected participation in household and child care chores as well as what variables predicted expectations for future chore division. Three-hundred fifty-eight unmarried, heterosexual participants with no children completed an online questionnaire assessing the…

  18. Resilience and Life Expectations of Perinatally HIV-1 Infected Adolescents in France

    PubMed Central

    Funck-Brentano, Isabelle; Assoumou, Lambert; Veber, Florence; Moshous, Despina; Frange, Pierre; Blanche, Stéphane

    2016-01-01

    Background: Resilience of perinatally HIV-infected youth in European countries is poorly studied. Life satisfaction and expectations for adulthood are rarely examined. Objective: This cross-sectional, descriptive study of a French cohort of 54 perinatally HIV-infected adolescents raised in France (age 14-20 years) aimed to (1) evaluate their psychosocial adjustment, (2) identify their expectations for adulthood and (3) delineate risk and protective factors associated with mental health, life satisfaction, and HIV-1 viral load level. Method: Medical evaluation, psychological semi-structured interview, and self-report questionnaires were used. Results: All the adolescents had been receiving Highly Active Anti-Retroviral Therapy (HAART) for 9 to 11 years and 2/3 were healthy with controlled viral load (<50 copies/mL). The majority had medium to high levels of life satisfaction. They viewed HIV as having only minor impact on their current daily life and had positive expectations for adulthood. However, 46% exhibited psychiatric symptomatology. Multivariable analysis showed that having a deceased parent and current worries about HIV were substantial risk factors for psychiatric symptoms. Having two living parents and being satisfied with life were protective factors for mental health. Good quality of caregiver-adolescent relationships and high life satisfaction were significant protective factors for controlled viral load. Conclusion: These data indicate psychosocial resilience among perinatally HIV-1 infected adolescents with 10 years of HAART treatment. These findings demonstrate the influence of life satisfaction, parent’s life status and quality of caregiver-adolescent relationships on resilience and health outcomes in these patients. We conclude that healthcare providers should attend to these factors. PMID:27990195

  19. Resilience and Life Expectations of Perinatally HIV-1 Infected Adolescents in France.

    PubMed

    Funck-Brentano, Isabelle; Assoumou, Lambert; Veber, Florence; Moshous, Despina; Frange, Pierre; Blanche, Stéphane

    2016-01-01

    Resilience of perinatally HIV-infected youth in European countries is poorly studied. Life satisfaction and expectations for adulthood are rarely examined. This cross-sectional, descriptive study of a French cohort of 54 perinatally HIV-infected adolescents raised in France (age 14-20 years) aimed to (1) evaluate their psychosocial adjustment, (2) identify their expectations for adulthood and (3) delineate risk and protective factors associated with mental health, life satisfaction, and HIV-1 viral load level. Medical evaluation, psychological semi-structured interview, and self-report questionnaires were used. All the adolescents had been receiving Highly Active Anti-Retroviral Therapy (HAART) for 9 to 11 years and 2/3 were healthy with controlled viral load (<50 copies/mL). The majority had medium to high levels of life satisfaction. They viewed HIV as having only minor impact on their current daily life and had positive expectations for adulthood. However, 46% exhibited psychiatric symptomatology. Multivariable analysis showed that having a deceased parent and current worries about HIV were substantial risk factors for psychiatric symptoms. Having two living parents and being satisfied with life were protective factors for mental health. Good quality of caregiver-adolescent relationships and high life satisfaction were significant protective factors for controlled viral load. These data indicate psychosocial resilience among perinatally HIV-1 infected adolescents with 10 years of HAART treatment. These findings demonstrate the influence of life satisfaction, parent's life status and quality of caregiver-adolescent relationships on resilience and health outcomes in these patients. We conclude that healthcare providers should attend to these factors.

  20. Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders.

    PubMed

    Wahlbeck, Kristian; Westman, Jeanette; Nordentoft, Merete; Gissler, Mika; Laursen, Thomas Munk

    2011-12-01

    People with mental disorders evince excess mortality due to natural and unnatural deaths. The relative life expectancy of people with mental disorders is a proxy measure of effectiveness of social policy and health service provision. To evaluate trends in health outcomes of people with serious mental disorders. We examined nationwide 5-year consecutive cohorts of people admitted to hospital for mental disorders in Denmark, Finland and Sweden in 1987-2006. In each country the risk population was identified from hospital discharge registers and mortality data were retrieved from cause-of-death registers. The main outcome measure was life expectancy at age 15 years. People admitted to hospital for a mental disorder had a two- to threefold higher mortality than the general population in all three countries studied. This gap in life expectancy was more pronounced for men than for women. The gap decreased between 1987 and 2006 in these countries, especially for women. The notable exception was Swedish men with mental disorders. In spite of the positive general trend, men with mental disorders still live 20 years less, and women 15 years less, than the general population. During the era of deinstitutionalisation the life expectancy gap for people with mental disorders has somewhat diminished in the three Nordic countries. Our results support further development of the Nordic welfare state model, i.e. tax-funded community-based public services and social protection. Health promotion actions, improved access to healthcare and prevention of suicides and violence are needed to further reduce the life expectancy gap.

  1. How Do Patient Expectancies, Quality of Life, and Post-Chemotherapy Nausea Interrelate?

    PubMed Central

    Colagiuri, Ben; Roscoe, Joseph A; Morrow, Gary R; Atkins, James N; Giguere, Jeffrey K; Colman, Lauren K

    2011-01-01

    Background Increasing evidence suggests a relationship between patient expectancies and chemotherapy induced nausea. However, this research has been primarily correlational in nature and has often failed to control for other possible contributing factors. Here, we examined the contribution of patient expectancies to the occurrence and severity of post-chemotherapy nausea using more stringent statistical techniques, namely hierarchical regression, and further extended upon previous research by including quality of life (QoL) in our analysis. Methods Six hundred and seventy-one first time chemotherapy patients taking part in a trial comparing antiemetic regimens answered questions regarding their expectancies for experiencing nausea. Patients then completed a diary assessing both the occurrence and severity of their nausea in the 4 days following treatment. Results Stronger expectancies for nausea corresponded to greater average and peak nausea following chemotherapy and this was after controlling for age, sex, susceptibility to motion sickness, diagnosis, and QoL. Interestingly, patients classified as highly expectant (1st quartile) experienced significantly greater average and peak nausea than those classified as somewhat expectant, slightly expectant, and not expectant (2nd, 3rd and 4th quartile, respectively), while there were no differences between these lower levels of expectancy. Further, increases in average nausea led to a significant reduction in QoL post-chemotherapy. Conclusions Patient expectancies contribute to post-chemotherapy nausea and patients that are highly expectant of experiencing nausea appear to be at particular risk. Interventions that target these patients should reduce the burden of nausea and may also improve QoL. PMID:18521919

  2. A new method of projecting populations based on trends in life expectancy and survival.

    PubMed

    Mayhew, Les; Smith, David

    2013-07-01

    There is increasing concern about the lack of accuracy in population projections at national levels. A common problem has been the systematic underestimation of improvements in mortality, especially at older ages, resulting in projections that are too low. In this paper, we present a method that is based on projecting survivorship rather than mortality, which uses the same data but differs technically. In particular, rather than extrapolating trends in mortality, we use trends in life expectancy to establish a robust statistical relation between changes in life expectancy and survivorship using period life tables. We test the approach on data for England and Wales for the population aged 50 and over, and show that it gives more accurate projections than official projections using the same base data. Using the model to project the population aged 50 and over to 2020, our method suggests nearly 0.6 million more people in this age group than official projections.

  3. Differences in healthy life expectancy for the US population by sex, race/ethnicity and geographic region: 2008.

    PubMed

    Chang, Man-Huei; Molla, Michael T; Truman, Benedict I; Athar, Heba; Moonesinghe, Ramal; Yoon, Paula W

    2015-09-01

    Healthy life expectancy (HLE) varies among demographic segments of the US population and by geography. To quantify that variation, we estimated the national and regional HLE for the US population by sex, race/ethnicity and geographic region in 2008. National HLEs were calculated using the published 2008 life table and the self-reported health status data from the National Health Interview Survey (NHIS). Regional HLEs were calculated using the combined 2007-09 mortality, population and NHIS health status data. In 2008, HLE in the USA varied significantly by sex, race/ethnicity and geographical regions. At 25 years of age, HLE for females was 47.3 years and ∼2.9 years greater than that for males at 44.4 years. HLE for non-Hispanic white adults was 2.6 years greater than that for Hispanic adults and 7.8 years greater than that for non-Hispanic black adults. By region, the Northeast had the longest HLE and the South had the shortest. The HLE estimates in this report can be used to monitor trends in the health of populations, compare estimates across populations and identify health inequalities that require attention. Published by Oxford University Press on behalf of Faculty of Public Health 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Filarial parasites develop faster and reproduce earlier in response to host immune effectors that determine filarial life expectancy.

    PubMed

    Babayan, Simon A; Read, Andrew F; Lawrence, Rachel A; Bain, Odile; Allen, Judith E

    2010-10-19

    Humans and other mammals mount vigorous immune assaults against helminth parasites, yet there are intriguing reports that the immune response can enhance rather than impair parasite development. It has been hypothesized that helminths, like many free-living organisms, should optimize their development and reproduction in response to cues predicting future life expectancy. However, immune-dependent development by helminth parasites has so far eluded such evolutionary explanation. By manipulating various arms of the immune response of experimental hosts, we show that filarial nematodes, the parasites responsible for debilitating diseases in humans like river blindness and elephantiasis, accelerate their development in response to the IL-5 driven eosinophilia they encounter when infecting a host. Consequently they produce microfilariae, their transmission stages, earlier and in greater numbers. Eosinophilia is a primary host determinant of filarial life expectancy, operating both at larval and at late adult stages in anatomically and temporally separate locations, and is implicated in vaccine-mediated protection. Filarial nematodes are therefore able to adjust their reproductive schedules in response to an environmental predictor of their probability of survival, as proposed by evolutionary theory, thereby mitigating the effects of the immune attack to which helminths are most susceptible. Enhancing protective immunity against filarial nematodes, for example through vaccination, may be less effective at reducing transmission than would be expected and may, at worst, lead to increased transmission and, hence, pathology.

  5. The effect of individual differences and manipulated life expectancies on the willingness to engage in sexual coercion.

    PubMed

    Dunkel, Curtis S; Mathes, Eugene

    2011-12-16

    The role of the individual difference variables of mate value, short-term and long-term mating preferences, and life history strategy along with the manipulated variable of life expectancy were used to predict differences in the willingness to engage in sexually coercive behaviors. Short-term preferences and long-term preferences were correlated with the willingness to engage in sexual coercion at all life expectancies. Life history strategy was correlated with the willingness to engage in sexual coercion at only the shortest and longest life expectancies. Most importantly short-term and long-term mating preferences interacted with life expectancy to predict the willingness to engage in sexually coercive behaviors. Short life expectancies increased willingness in individuals with high short-term and low long-term preferences. The results are discussed in terms of the varying theories of sexual coercion with emphasis put on a life history approach.

  6. Disability-Free Life Expectancy Over 30 Years: A Growing Female Disadvantage in the US Population

    PubMed Central

    Wolf, Douglas A.; Spillman, Brenda C.

    2016-01-01

    Objectives. To examine changes in active life expectancy in the United States over 30 years for older men and women (aged ≥ 65 years). Methods. We used the 1982 and 2004 National Long Term Care Survey and the 2011 National Health and Aging Trends Study to estimate age-specific mortality and disability rates, the overall chances of survival and of surviving without disability, and years of active life for men and women. Results. For older men, longevity has increased, disability has been postponed to older ages, disability prevalence has fallen, and the percentage of remaining life spent active has increased. However, for older women, small longevity increases have been accompanied by even smaller postponements in disability, a reversal of a downward trend in moderate disability, and stagnation of active life as a percentage of life expectancy. As a consequence, older women no longer live more active years than men, despite their longer lives. Conclusions. Neither a compression nor expansion of late-life disability is inevitable. Public health measures directed at older women to postpone disability may be needed to offset impending long-term care pressures related to population aging. PMID:26985619

  7. Disability-Free Life Expectancy Over 30 Years: A Growing Female Disadvantage in the US Population.

    PubMed

    Freedman, Vicki A; Wolf, Douglas A; Spillman, Brenda C

    2016-06-01

    To examine changes in active life expectancy in the United States over 30 years for older men and women (aged ≥ 65 years). We used the 1982 and 2004 National Long Term Care Survey and the 2011 National Health and Aging Trends Study to estimate age-specific mortality and disability rates, the overall chances of survival and of surviving without disability, and years of active life for men and women. For older men, longevity has increased, disability has been postponed to older ages, disability prevalence has fallen, and the percentage of remaining life spent active has increased. However, for older women, small longevity increases have been accompanied by even smaller postponements in disability, a reversal of a downward trend in moderate disability, and stagnation of active life as a percentage of life expectancy. As a consequence, older women no longer live more active years than men, despite their longer lives. Neither a compression nor expansion of late-life disability is inevitable. Public health measures directed at older women to postpone disability may be needed to offset impending long-term care pressures related to population aging.

  8. Age of Migration Life Expectancy with Functional Limitations and Morbidity in Mexican Americans.

    PubMed

    Garcia, Marc A; Valderrama-Hinds, Luis M; Chiu, Chi-Tsun; Mutambudzi, Miriam S; Chen, Nai-Wei; Raji, Mukaila

    2017-07-01

    The U.S. Mexican American population enjoys longer life expectancies relative to other racial/ethnic groups but is disproportionately affected by chronic conditions and functional limitations. Studying the impact of heterogeneity in age, time and other characteristics of migration among older Mexican Americans can inform our understanding of health disparities and healthcare needs in later-life. This research used 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to assess the proportion of life spent with functional limitations and one or more morbidity (according to age of migration and sex) in the U.S. Mexican-American population. The results indicate that early-life and late-life migrant women spend more years with Performance-Oriented Mobility Assessment limitations than U.S.-born women. Conversely, midlife migrant women were not statistically different from U.S.-born women in years spent disabled. In men, midlife migrants had longer life expectancies and had more disability-free years than U.S.-born men. For morbidity, late-life migrant women spent a significantly smaller proportion of their elderly years with morbidity than U.S.-born women, but late-life migrant men spent more years with morbidity than U.S.-born men. These findings illustrate that older Mexican Americans in the United States are heterogeneous in nativity and health outcomes. More years spent disabled or unhealthy may result in greater burden on family members and greater dependence on public resources. These findings have implications for the development of social and health policies to appropriately target the medical conditions and disabilities of older Mexican Americans entering late life. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  9. [Healthy life expectancy in the occupied segment of the Turin population].

    PubMed

    Spadea, Teresa; Quarta, D; Demaria, M; Marinacci, Chiara; Costa, G

    2005-01-01

    The indicators of healthy life expectancy measure differences in health among various population subgroups more sensitively than do indicators of mortality. The aim of the study was to analyze some of the above indicators to evaluate the differences among occupational categories in Turin. Mortality tables by occupation were calculated on Turin residents, aged 18-64 years in 1991, using the Turin Longitudinal Study which combines personal, census, and health information for the residents of the city. Longitudinal assessments of health expectancy were obtained by means of record-linkage with the Cancer Registry, the Diabetes Registry, and hospital discharge records. In addition, prevalence estimates of good health, disability, and chronic illness, obtained from ISTAT (Central Statistics Institute) investigations in 1999-2000 were combined with mortality data using Sullivan's algorithm. Among men there was a systematic disadvantage in almost all indicators of health expectancy for some manual occupations, while jobs requiring more qualifications were more advantaged. The health profile for women was more controversial, with an overall disadvantage among women who were professional consultants, although this group showed substantial variability: the legal professions had the lowest life and health expectancies, with approximately 3 years of life less than the health professions, which were among the most advantaged. The various indicators gave results which were at times conflicting, especially because the information obtained from the available sources had major limitations. The development of indicators needs to aim for greater homogeneity between mortality and health data to ensure maximum comparability.

  10. Socio-economic correlates of life expectancy at birth--the case of developing countries.

    PubMed

    Sufian, A J

    1989-12-01

    The effects of socioeconomic and health services related variables on life expectancy at birth and examined. National data for 50 developing countries obtained from the book "Family Planning and Child Survival: 100 Developing Countries" compiled by the Center for Population and Family Health, Columbia University, and from the 1987 World Population Data Sheet, have been used in this analysis. The multiple regression technique has been employed to identify the variables significantly associated with the life expectancy at birth. 13 explanatory variables include energy consumption/capita, male literacy rate, female literacy rate, per capita gross national product, population living in urban areas, % of population with access to safe water supply, population/hospital bed, population/physician, of oral rehyd ration solution packets used/100 diarrhea episodes, and family planning program effort score. Among these the 1st 2 variables were dropped from the analysis as they posed threats of multicollinearity. The remaining 11 variables were considered for inclusion in the regression model. Only female literacy rate, family planning program effort, and per capita daily calories are significantly associated with life expectancy at birth. The female literacy rate has the largest contribution in lowering the life expectancy at birth followed by family planning program effort, and per capita daily calories. These 3 variables have a number of policy implications. High female literacy rate has a depressant effect on infant mortality rate. It is expected that the higher the family planning program effort, the lower the fertility. Also, calorie supply measures nutritional status and differences in food availability. In conclusion, there is a need in developing countries to express development goals in terms of progressive reduction in infant mortality through maternal education, limitation of family size through family planning efforts, and eventual elimination of malnutrition from

  11. Month of birth and life expectancy: role of gender and age in a comparative approach

    NASA Astrophysics Data System (ADS)

    Lerchl, Alexander

    2004-09-01

    The effects of month of birth (MOB) on life expectancy of a German subpopulation was investigated. Data from people who died in North Rhine Westphalia in the years 1984 (n=188,515) and 1999 (n=188,850) were analyzed. For comparative purposes, all deaths that occurred at an age of <50 years were excluded (1984: 8.4%; 1999: 6.2%). In general, individuals born in May through July had the lowest age at death (1984: 75.27±0.09 years; 1999: 77.58±0.09 years), while those born between October and December had the highest (1984: 75.98±0.08 years; 1999: 78.35±0.09 years), supporting earlier findings. The observed amplitudes (differences between highest and lowest values) were more pronounced in men than in women. When comparing these data of MOB effects on life expectancy with earlier findings in Australia, Austria, Denmark, Ukraine, and the USA, it is evident that a negative correlation exists between the average age at death and the MOB amplitudes. Separate analyses by gender, possible for the data from Germany, the Ukraine, and the USA, revealed a significant negative correlation for men, but not for women. A new hypothesis is therefore presented describing an influence of life quality, as reflected by average life expectancy, on the extent of MOB effects; for example, seasonally variable sensitivities during pregnancy/early childhood.

  12. Risk factors that affect life expectancy in Alzheimer's disease: a 15-year follow-up.

    PubMed

    Wattmo, Carina; Londos, Elisabet; Minthon, Lennart

    2014-01-01

    Future disease-modifying therapies might affect the expected life span in Alzheimer's disease (AD). Our aim was to identify factors that influence life expectancy in cholinesterase inhibitor (ChEI)-treated patients. This study included 791 deceased individuals with a clinical diagnosis of AD and a Mini-Mental State Examination score of 10-26 at baseline who were recruited from a 3-year, prospective, multicenter study of ChEI therapy in clinical practice. The participants' date of death was recorded and their survival was compared with the gender- and age-matched general population. The mean survival time after the start of ChEI therapy (time of AD diagnosis) was 5.10 years for men and 6.12 years for women. Better cognitive ability, less impaired basic functional capacity, and fewer medications, but not education level or apolipoprotein E (APOE) genotype, were independent prognostic factors of longer survival after diagnosis, after controlling for gender and age. AD shortens life expectancy in ChEI-treated patients diagnosed before the age of 85 years, similar to that reported previously for untreated individuals. A longer life span was observed in the eldest patients (≥85 years) compared with untreated cohorts, which did not differ from that observed in the general population. Higher education or carrying two APOE ε4 alleles were risk factors for earlier death.

  13. Trends in healthy life expectancy among older Brazilian women between 1998 and 2008

    PubMed Central

    Nepomuceno, Marília Regina; Turra, Cássio Maldonado

    2015-01-01

    OBJECTIVE To analyze conditional and unconditional healthy life expectancy among older Brazilian women. METHODS This cross-sectional study used the intercensal technique to estimate, in the absence of longitudinal data, healthy life expectancy that is conditional and unconditional on the individual’s current health status. The data used were obtained from the Pesquisa Nacional por Amostra de Domicílios (National Household Sample Survey) of 1998, 2003, and 2008. This sample comprised 11,171; 13,694; and 16,259 women aged 65 years or more, respectively. Complete mortality tables from the Brazilian Institute of Geography and Statistics for the years 2001 and 2006 were also used. The definition of health status was based on the difficulty in performing activities of daily living. RESULTS The remaining lifetime was strongly dependent on the current health status of the older women. Between 1998 and 2003, the amount of time lived with disability for healthy women at age 65 was 9.8%. This percentage increased to 66.2% when the women already presented some disability at age 65. Temporal analysis showed that the active life expectancy of the women at age 65 increased between 1998-2003 (19.3 years) and 2003-2008 (19.4 years). However, life years gained have been mainly focused on the unhealthy state. CONCLUSIONS Analysis of conditional and unconditional life expectancy indicated that live years gained are a result of the decline of mortality in unhealthy states. This pattern suggests that there has been no reduction in morbidity among older women in Brazil between 1998 and 2008. PMID:25741653

  14. Individual and spousal education, mortality and life expectancy in Switzerland: a national cohort study.

    PubMed

    Spoerri, Adrian; Schmidlin, Kurt; Richter, Matthias; Egger, Matthias; Clough-Gorr, Kerri M

    2014-09-01

    Household measures of socioeconomic position may better account for the shared nature of material resources, lifestyle, and social position of cohabiting persons, but household measures of education are rarely used. We aimed to evaluate the association of combined educational attainment of married couples on mortality and life expectancy in Switzerland. The study included 3,496,163 ever-married persons aged ≥30 years. The 2000 census was linked to mortality records through 2008. Mortality by combined educational attainment was assessed by gender-age-specific HRs, with 95% CIs from adjusted models, life expectancy was derived using abridged life tables. Having a less educated partner was associated with increased mortality. For example, the HR comparing men aged 50-64 years with tertiary education married to women with tertiary education to men with compulsory education married to women with compulsory education was 2.05 (1.92-2.18). The estimated remaining life expectancy in tertiary educated men aged 30 years married to women with tertiary education was 4.6 years longer than in men with compulsory education married to women with compulsory education. The gradient based on individual education was less steep: the HR comparing men aged 50-64 years with tertiary education with men with compulsory education was 1.74 (1.67-1.81). Using individual educational attainment of married persons is common in epidemiological research, but may underestimate the combined effect of education on mortality and life expectancy. These findings are relevant to epidemiologic studies examining socio-demographic characteristics or aiming to adjust results for these characteristics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Life Events and Psychiatric Symptoms in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Hastings, R. P.; Hatton, C.; Taylor, J. L.; Maddison, C.

    2004-01-01

    Previous research has indicated that children and adults with intellectual disabilities (ID) may respond to traumatic and other life events in a similar way to the general population. However, few studies have charted the extent of exposure to recent life events in samples of adults with ID and the association of such exposure with general…

  16. Remaining Life Expectancy With and Without Polypharmacy: A Register-Based Study of Swedes Aged 65 Years and Older

    PubMed Central

    Wastesson, Jonas W.; Canudas-Romo, Vladimir; Lindahl-Jacobsen, Rune; Johnell, Kristina

    2016-01-01

    Objectives To investigate the remaining life expectancy with and without polypharmacy for Swedish women and men aged 65 years and older. Design Age-specific prevalence of polypharmacy from the nationwide Swedish Prescribed Drug Register (SPDR) combined with life tables from Statistics Sweden was used to calculate the survival function and remaining life expectancy with and without polypharmacy according to the Sullivan method. Setting Nationwide register-based study. Participants A total of 1,347,564 individuals aged 65 years and older who had been prescribed and dispensed a drug from July 1 to September 30, 2008. Measurements Polypharmacy was defined as the concurrent use of 5 or more drugs. Results At age 65 years, approximately 8 years of the 20 remaining years of life (41%) can be expected to be lived with polypharmacy. More than half of the remaining life expectancy will be spent with polypharmacy after the age of 75 years. Women had a longer life expectancy, but also lived more years with polypharmacy than men. Discussion Older women and men spend a considerable proportion of their lives with polypharmacy. Conclusion Given the negative health outcomes associated with polypharmacy, efforts should be made to reduce the number of years older adults spend with polypharmacy to minimize the risk of unwanted consequences. PMID:26341036

  17. Gains and Losses in Creative Personality as Perceived by Adults across the Life Span

    ERIC Educational Resources Information Center

    Hui, Anna N. N.; Yeung, Dannii Y.; Sue-Chan, Christina; Chan, Kara; Hui, Desmond C. K.; Cheng, Sheung-Tak

    2014-01-01

    In this study, we used a life span model to study the subjective perception of creative personality (CP) in emerging, young, middle-aged, and older Hong Kong Chinese adults. We also asked participants to estimate the approximate age by which people develop and lose CP across adulthood. We expected an interesting interplay between internalized age…

  18. Gains and Losses in Creative Personality as Perceived by Adults across the Life Span

    ERIC Educational Resources Information Center

    Hui, Anna N. N.; Yeung, Dannii Y.; Sue-Chan, Christina; Chan, Kara; Hui, Desmond C. K.; Cheng, Sheung-Tak

    2014-01-01

    In this study, we used a life span model to study the subjective perception of creative personality (CP) in emerging, young, middle-aged, and older Hong Kong Chinese adults. We also asked participants to estimate the approximate age by which people develop and lose CP across adulthood. We expected an interesting interplay between internalized age…

  19. Life Satisfaction across Four Stages of Adult Life.

    ERIC Educational Resources Information Center

    Medley, Morris L.

    1980-01-01

    For men life satisfaction was related to age stage in a monotonic increasing fashion. Life satisfaction scores remained relatively constant across the age stages for women. Family life and standard of living were found to be significant determinants of life satisfaction, for both sexes at each stage of adulthood. (Author)

  20. Comparing the Social Support Systems and Friendship Expectancies of Young Adults and Older Adults.

    ERIC Educational Resources Information Center

    Burgio, Maria R.; Tryanski, Mandy

    Some research suggests that sources of social support change through the lifespan. Given that the support network changes because of both the individual's needs and the particular life stage of the individual, peer relationships may emerge as crucial sources of emotional support at different times in the lifespan. This study examined friend and…

  1. Arrhythmogenic effects of anti-Ro/SSA antibodies on the adult heart: more than expected?

    PubMed

    Lazzerini, Pietro Enea; Capecchi, Pier Leopoldo; Acampa, Maurizio; Selvi, Enrico; Guideri, Francesca; Bisogno, Stefania; Rossi, Pier Carlo; Galeazzi, Mauro; Pasini, Franco Laghi

    2009-09-01

    The arrhythmogenicity of anti-Ro/SSA antibodies for the foetal heart and their crucial role in the development of congenital heart block is now well established, representing a paradigmatic model of passively acquired autoimmunity. Recently, intriguing data suggest that also the adult heart may represent a possible target of anti-Ro/SSA antibody-mediated autoimmune injury. The prolongation of the QTc interval, possibly resulting from a direct inhibitory interaction between the anti-Ro/SSA antibodies and the potassium current I(Kr) in the heart seems the abnormality more frequently observed in adults with anti-Ro/SSA-positive CTD. Although the possibility that anti-Ro/SSA positivity may be considered a risk factor for arrhythmic sudden death in adults has not been demonstrated as yet, preliminary data suggest a relationship among anti-Ro/SSA antibodies, QTc prolongation, and the prevalence of ventricular arrhythmias, also life threatening, in adult patients.

  2. Intimate Adult Relationships, Quality of Life and Psychological Adjusment.

    ERIC Educational Resources Information Center

    Khaleque, Abdul

    2004-01-01

    The purpose of this study was to assess relations between adult intimacy, quality of life, and psychological adjustment. Data were collected in the United States from a sample of 64 college students. The measuring instruments used were Personal Information Sheet, Adult version of the Personality Assessment Questionnaire (Adult PAQ), Intimate…

  3. Intimate Adult Relationships, Quality of Life and Psychological Adjusment.

    ERIC Educational Resources Information Center

    Khaleque, Abdul

    2004-01-01

    The purpose of this study was to assess relations between adult intimacy, quality of life, and psychological adjustment. Data were collected in the United States from a sample of 64 college students. The measuring instruments used were Personal Information Sheet, Adult version of the Personality Assessment Questionnaire (Adult PAQ), Intimate…

  4. Telomere dynamics rather than age predict life expectancy in the wild

    PubMed Central

    Bize, Pierre; Criscuolo, François; Metcalfe, Neil B.; Nasir, Lubna; Monaghan, Pat

    2009-01-01

    Despite accumulating evidence from in vitro studies that cellular senescence is linked to telomere dynamics, how this relates to whole-organism senescence and longevity is poorly understood and controversial. Using data on telomere length in red blood cells and long-term survival from wild Alpine swifts of a range of ages, we report that the telomere length and the rate of telomere loss are predictive of life expectancy, and that slow erosion of relatively long telomeres is associated with the highest survival probabilities. Importantly, because telomere dynamics, rather than chronological age, predict life expectancy, our study provides good evidence for a mechanistic link between telomere erosion and reduced organism longevity under natural conditions, chronological age itself possibly not becoming a significant predictor until very old ages beyond those in our sample. PMID:19324831

  5. Donepezil and life expectancy in Alzheimer’s disease: A retrospective analysis in the Tajiri Project

    PubMed Central

    2014-01-01

    Background Cholinesterase inhibitors (ChEIs) such as donepezil have the effect of delaying progression of Alzheimer’s disease (AD), but their effect on life expectancy is unclear. We analyzed the influence of donepezil on life expectancy after onset of AD, together with the effects of antipsychotic drugs and residency in a nursing home. Methods All outpatients at the Tajiri Clinic from 1999–2012 with available medical records and death certificates were included in a retrospective analysis. The entry criteria were a dementia diagnosis based on DSM-IV criteria and diagnosis of AD using NINCDS-ADRDA criteria; medical treatment for more than 3 months; and follow up until less than 1 year before death. Results We identified 390 subjects with medical records and death certificates, of whom 275 had a diagnosis of dementia that met the entry criteria. Of 100 patients diagnosed with AD, 52 had taken donepezil and 48 patients had not received the drug due to treatment prior to the introduction of donepezil in 1999 in Japan. The lifetime expectancies after onset were 7.9 years in the donepezil group and 5.3 years in the non-donepezil group. There was a significant drug effect with a significant covariate effect of nursing home residency. Other covariates did not reach a significant level. Conclusions Although this report has the limitation of all retrospective analyses: the lack of randomization, we found a positive effect of donepezil on lifetime expectancy after onset of AD. This may be due to a decreased mortality rate caused by reduction of concomitant diseases such as pneumonia. The similar life expectancies in patients taking donepezil at home and those not taking donepezil in a nursing home indicated a positive health economic effect of the drug. PMID:24720852

  6. The impact of smoking on gender differences in life expectancy: more heterogeneous than often stated

    PubMed Central

    Wegner-Siegmundt, Christian

    2015-01-01

    Background: Throughout industrialized countries, tobacco consumption is seen as the predominant driver of both the trend and the extent of gender differences in life expectancy. However, several factors raise doubts to this generalization. We hypothesize that the impact of smoking on the gender gap is context-specific and differs between populations. Methods: We decompose the gender differences in life expectancy into fractions caused by smoking and other non-biological factors for 53 industrialized countries and the period 1955–2009 to assess the significance of smoking among the causes that can be influenced by direct or indirect interference. Results: The trend of the gender gap can indeed be attributed to smoking in most populations of the western world. However, with regard to the overall extent of male excess mortality, smoking is the main driver only in the minority of the studied populations. While the impact of smoking to gender differences in life expectancy declines in all populations, the contribution of other non-biological factors is in most cases higher at the end than at the beginning of the observation period. Conclusions: Over-generalized statements suggesting that smoking is the main driver of the gender gap in all populations can be misleading. The results of this study demonstrate that—regardless of the prevailing effect of smoking—many populations have still remarkable potentials to further narrow their gender gaps in life expectancy. Although measures to further reduce the prevalence of tobacco consumption must be continued, more attention should be directed to the growing importance of other non-biological factors. PMID:25505018

  7. [Life expectancy, strenuous work and pension system's fairness. First evidence from the Work Histories Italian Panel].

    PubMed

    Leombruni, Roberto; Richiardi, Matteo; Demaria, Moreno; Costa, Giuseppe

    2010-01-01

    the study aims to estimate the differentials in life expectancy by income and work history in Italy during the 2000's, in order to evaluate the level of actuarial equity of the recent Italian retirement reform in computing benefits proportional to the contributions paid. retrospective cohort study. mortality follow up of a 1% sample of the Italian workforce employed or self employed in the private sector, retired between 1985 and 2003 (about 63,000 people), whose work history and income since 1985 is registered in the National Institute for Social Insurance (INPS) data base. mortality differentials computed through Cox model. social inequalities in survival in favour of the more advantaged categories of income and occupational classes are observed. the principle of actuarial equity assumes that life expectancy varies only according to age and birth cohort; nevertheless inequalities in life expectancy exist also along other dimensions, like income and occupational class: this means that the system is producing an opposite redistribution, from the careers more socially disadvantaged to the less disadvantaged ones.

  8. [Diabetes mellitus: Contribution to changes in the life expectancy in Mexico 1990, 2000, and 2010].

    PubMed

    Dávila-Cervantes, Claudio A; Pardo Montaño, Ana M

    2014-01-01

    To analyze the level and trend of diabetes mellitus (DM) in Mexico, and its contribution to the changes in temporary life expectancy between 20 and 100 years of age, in the period 1990-2010. Data comes from National Mortality Vital Statistics and from the Population Census from the Mexican National Institute of Geography and Statistics (INEGI). We calculated standardized mortality rates. To analyze the impact of DM on the temporary life expectancy (80e20) we used Pollard’s method. Between 1990 and 2010, the standardized mortality rate for people 20 years and older increased by 224 %. The contribution of DM for men to the change in life expectancy during 1990-2000 was a reduction of 0.31 years; for women was a reduction of 0.32 years; in the period 2000-2010 the reduction continued for both men and women (0.34 and 0.12 years respectively). Mortality from DM continues to increase, especially for men, but for women a modest reduction was observed. It is essential to apply health services and programs aimed at reducing mortality from this cause, focused on prevention, early detection and timely treatment, with concrete actions on vulnerable groups.

  9. Age of ovary determines remaining life expectancy in old ovariectomized mice

    PubMed Central

    Cargill, Shelley L.; Carey, James R.; Müller, Hans-Georg; Anderson, Gary

    2008-01-01

    Summary We investigated the capacity of young ovaries, transplanted into old ovariectomized CBA mice, to improve remaining life expectancy of the hosts. Donor females were sexually mature 2-month-olds; recipients were prepubertally ovariectomized at 3 weeks and received transplants at 5, 8 or 11 months of age. Relative to ovariectomized control females, life expectancy at 11 months was increased by 60% in 11-month recipient females and by 40% relative to intact control females. Only 20% of the 11-month transplant females died in the 300-day period following ovarian transplantation, whereas nearly 65% of the ovariectomized control females died during this same period. The 11-month-old recipient females resumed oestrus and continued to cycle up to several months beyond the age of control female reproductive senescence. Across the three recipient age groups, transplantation of young ovaries increased life expectancy in proportion to the relative youth of the ovary. Our results relate to recent findings on the gonadal input upon aging in Caenorhabditis elegans and may suggest how the mammalian gonad, including that of humans, could regulate aging and determine longevity. PMID:12882411

  10. Age of ovary determines remaining life expectancy in old ovariectomized mice.

    PubMed

    Cargill, Shelley L; Carey, James R; Müller, Hans-Georg; Anderson, Gary

    2003-06-01

    We investigated the capacity of young ovaries, transplanted into old ovariectomized CBA mice, to improve remaining life expectancy of the hosts. Donor females were sexually mature 2-month-olds; recipients were prepubertally ovariectomized at 3 weeks and received transplants at 5, 8 or 11 months of age. Relative to ovariectomized control females, life expectancy at 11 months was increased by 60% in 11-month recipient females and by 40% relative to intact control females. Only 20% of the 11-month transplant females died in the 300-day period following ovarian transplantation, whereas nearly 65% of the ovariectomized control females died during this same period. The 11-month-old recipient females resumed oestrus and continued to cycle up to several months beyond the age of control female reproductive senescence. Across the three recipient age groups, transplantation of young ovaries increased life expectancy in proportion to the relative youth of the ovary. Our results relate to recent findings on the gonadal input upon aging in Caenorhabditis elegans and may suggest how the mammalian gonad, including that of humans, could regulate aging and determine longevity.

  11. Canada's global position in life expectancy: a longitudinal comparison with the healthiest countries in the world.

    PubMed

    Fang, Raymond; Millar, John S

    2009-01-01

    To assess the global position of Canadian life expectancy and to determine the areas of greatest negative impact on life expectancy. Using retrospective data on life expectancy at birth (LE(0) and age-standardized mortality rates, Canada was compared with 13 other countries with the longest LE(0). Linear regression models were used to produce trends and projections of LE(0) until 2010. Canadian women and men currently rank 8th and 5th, respectively, in LE(0) among the 14 nations. Canada has one of the smallest annual LE(0) improvement rates among the countries studied. Canadian women progressed significantly slower than nine countries and Canadian men progressed slower than five. Women are improving at only half the rate of men due to narrowing gaps in most mortality risks--mostly for cardiovascular diseases, lung cancer and injury. These trends lowered projected LE(0) ranks of Canadians, especially for women, for 2010. LE(0) of Canadians is slipping relative to most of the other 13 countries, and more so for women than men. This phenomenon is explained by historically higher mortality rates from ischemic heart disease, cancer and respiratory system disease for all Canadians, coupled with recently lower improvement rates in most mortality risks for Canadian women and in cancers and diabetes for Canadian men. Improving the health and wellness of Canadians, particularly women, demands a priority focus on enhanced chronic disease detection and management as well as strategies to reduce obesity and tobacco use by addressing the determinants of these behavioural risk factors.

  12. Symbiotic germination capability of four Epipactis species (Orchidaceae) is broader than expected from adult ecology.

    PubMed

    Tĕšitelová, Tamara; Tĕšitel, Jakub; Jersáková, Jana; RÍhová, Gabriela; Selosse, Marc-André

    2012-06-01

    Both abiotic and biotic factors shape species distributions. Orchids produce minute seeds with few nutrient reserves, thus requiring mycorrhizal fungi for germination. Therefore, both environmental conditions and mycorrhizal fungi distribution affect their germination success, but these ecological requirements and their congruence with habitat preferences of adults remain poorly understood. We investigated the importance of these factors during germination in four forest orchid species of the genus Epipactis. We sowed seeds of three habitat specialists and one generalist in different forest types at sites harboring adults of at least one of these ecologically diverging species. We analyzed germination pattern and identified mycorrhizal fungi of both seedlings and adults. Habitat conditions had little influence on germination pattern as seedlings grew in more habitats than expected from the adults' ecology. Ectomycorrhizal fungi availability did not limit germination. Suitable mycorrhizal fungi, mostly pezizalean ascomycetes, were recruited in various forest types, though the fungal communities differed according to habitat type. Finally, orchids with divergent ecological preferences shared similar mycorrhizal fungi. Limited adult distribution contrasted with successful seed germination at diverse sites and indicates existence of niche differentiation between adults and seedlings. Ecological specialization may thus be determined by factors other than mycorrhizal fungi that act later in the ontogeny, perhaps during the transition to above-ground development.

  13. Impact of particulate air pollution on quality-adjusted life expectancy in Canada.

    PubMed

    Coyle, Douglas; Stieb, Dave; Burnett, Richard T; DeCivita, Paul; Krewski, Daniel; Chen, Yue; Thun, Michael J

    Air pollution and premature death are important public health concerns. Analyses have repeatedly demonstrated that airborne particles are associated with increased mortality and estimates have been used to forecast the impact on life expectancy. In this analysis, we draw upon data from the American Cancer Society (ACS) cohort and literature on utility-based measures of quality of life in relation to health status to more fully quantify the effects of air pollution on mortality in terms of quality-adjusted life expectancy. The analysis was conducted within a decision analytic model using Monte Carlo simulation techniques. Outcomes were estimated based on projections of the Canadian population. A one-unit reduction in sulfate air pollution would yield a mean annual increase in Quality-Adjusted Life Years (QALYs) of 20,960, with gains being greater for individuals with lower educational status and for males compared to females. This suggests that the impact of reductions in sulfate air pollution on quality-adjusted life expectancy is substantial. Interpretation of the results is unclear. However, the potential gains in QALYs from reduced air pollutants can be contrasted to the costs of policies to bring about such reductions. Based on a tentative threshold for the value of health benefits, analysis suggests that an investment in Canada of over 1 billion dollars per annum would be an efficient use of resources if it could be demonstrated that this would reduce sulfate concentrations in ambient air by 1 microg/m(3). Further analysis can assess the efficiency of targeting such initiatives to communities that are most likely to benefit.

  14. [Geriatrics from the 19th to the 21st century. 150 years of geriatric medicine: from increasing life expectancy to improving quality of life for the very old].

    PubMed

    Federspiel C; Keipes M

    2014-01-01

    With the world further aging, geriatric medicine clearly became a necessity: in the 21th century many more people reach older ages by means of continued medical success in expanding lifespan. 150 years ago life expectancy was between 30 to 40 years, but today close to 800 million people are 60 yeas old or more. During the last century aging has been associated with decline and decay, but gradually more people lived ably and healthily in older ages. The expansion in life expectancy has become a synchronism of quality of life: the average 65 year old today is much healthier, physically and mentally fitter, than the average 50 year old 150 years ago, when Alois Alzheimer war born, a period when most nowadays existing geriatric institutions were envisioned and progressively realized over time. Today we strongly believe that a healthy life and, equally, the quality of life of the very old people can be extended with presently existing medical knowledge, based on research, environmental and behavioural changes, by postponing the onset and progression of fatal and disabling diseases and disorders. But very soon ethical considerations concerning all kinds of medical and technological solutions available to maintain or even improve the mental and physical functioning of dependant elderly people will engage our society when deciding how and at what moment in time to make the best decisions and allocate resources. Geriatric medicine will be further challenged by competing and demanding medical and economic needs, when marshalling resources to meet the growing demands of our society for improving care for the very old and often demented adult.

  15. Adolescents' occupational and educational aspirations and expectations: links to high school activities and adult educational attainment.

    PubMed

    Beal, Sarah J; Crockett, Lisa J

    2010-01-01

    This longitudinal study explored adolescents' future-oriented cognitions, current activities, and later educational attainment using data from 317 adolescents (55% female; mean age = 14.98 years, SD = 0.85) followed into early adulthood. Aspirations and expectations regarding work and education showed modest stability from year to year. Exploration of the reciprocal relations between these cognitions and adolescents' activities supported both unidirectional and bidirectional effects, with different patterns emerging for aspirations and expectations. In multiple regression analyses, future-oriented cognitions predicted adult educational attainment; follow-up analyses indicated that the effect of adolescents' expectations was partially mediated by participation in extracurricular activities. These results suggest a potentially important influence of adolescents' future-oriented cognitions on their current behavior and future attainments. Copyright 2009 APA, all rights reserved.

  16. Humor coping, health status, and life satisfaction among older adults residing in assisted living facilities.

    PubMed

    Celso, B G; Ebener, D J; Burkhead, E J

    2003-11-01

    The present study examined the relationships between humor coping, health status, and life satisfaction among older residents of assisted living facilities. A structural equation model with latent variables was specified for the three variables. Health status was expected to directly affect humor coping and life satisfaction. Humor coping was hypothesized to have a direct association with life satisfaction and indirectly affect the relationship between health status and life satisfaction. Participants completed the Multidimensional Functional Assessment Questionnaire, Coping Humor Scale, and Life Satisfaction Index A. The relationships between health status and humor coping and health status and life satisfaction were statistically significant. Both the direct association of humor coping on life satisfaction and the intervening role between health status and life satisfaction were not supported. Humor as a coping strategy seems to be available to older adults who are in better health.

  17. Increase in life expectancy at birth in Japan: some implications for variable patterns of decrease in mortality.

    PubMed

    Masaki, M; Koizumi, A

    1987-02-01

    "The characteristics of the increase in life expectancy at birth...in Japan were analyzed using the life tables of developed countries in which the values of [life expectancy at birth] were almost the same. When the decrease in age-specific probability of dying...and its contribution to total gain in [life expectancy at birth] in Japan were compared to those of other developed countries, the decline in [age-specific probability of dying] in prime, middle and old age groups accounts for much of the change; the decrease in this variable for males aged 50 years and over accounted for 35% of the recent increase in [life expectancy at birth]. Well-organized medical care and public services are discussed in relation to this unique and unusually rapid increase in [life expectancy at birth] for the Japanese population." excerpt

  18. The changing gender differences in life expectancy in Korea 1970-2005.

    PubMed

    Yang, Seungmi; Khang, Young-Ho; Chun, Heeran; Harper, Sam; Lynch, John

    2012-10-01

    Women live much longer than men in Korea, with remarkable gains in life expectancy at birth for the past decades. The gender differential has steadily increased over time, reaching a peak of more than 8 years in 1980s, and decreased thereafter to 6.7 years in 2005. Studies to investigate the pattern and contributing factors to changes in the life expectancy gender gap have been mostly from Western countries, and there has been no such study in Asian countries, except in Japan. We therefore aimed to examine age- and cause-specific contributions to the changing gender differentials in life expectancy in Korea, in particular the decline of the gap, using a decomposition method. Between 1970 and 1979 when the gender gap in life expectancy widened, faster mortality decline among women in ages 20-44 explained 66% of the total increase in the gender gap, which would be due to substantial improvements in reproductive health among women and excess male mortality in occupational injuries and transport accidents. Although greater survival advantage among elderly women over 70 contributed to further increase in the gender gap, the contributions from younger ages with the ages 15-64 contributing the most (-2 years) resulted in the overall reduction of the gender gap which began in 1992 and continued to 2005. Among causes of death, liver diseases (-0.5 years, 38% of the total decline), transport accidents (-0.4 years, 31%), hypertensive diseases (-0.3 years, 19%), stroke (-0.1 years, 11%), and tuberculosis (-0.1 years) contributed the most to the overall 1.4 years reduction in the gender gap. However, changes in mortality from lung cancer (+0.3 years), suicide (+0.3 years), chronic lower respiratory diseases (+0.2 years), and ischemic heart diseases (+0.1 years) contributed to widening the gap during the same period. In sum, while smoking-related causes of death have contributed most to the narrowing gap in most other industrialized countries, these causes contributed toward

  19. Gray matter volume correlates of global positive alcohol expectancy in non-dependent adult drinkers

    PubMed Central

    Ide, Jaime S.; Zhang, Sheng; Hu, Sien; Matuskey, David; Bednarski, Sarah R.; Erdman, Emily; Farr, Olivia M.; Li, Chiang-shan R.

    2013-01-01

    Alcohol use and misuse is known to involve structural brain changes. Numerous imaging studies have examined changes in gray matter (GM) volumes in dependent drinkers, but there is little information on whether non-dependent drinking is associated with structural changes and whether these changes are related to psychological factors – such as alcohol expectancy – that influence drinking behavior. We used voxel based morphometry (VBM) to examine whether the global positive scale of alcohol expectancy, as measured by the Alcohol Expectancy Questionnaire AEQ-3, is associated with specific structural markers and whether such markers are associated with drinking behavior in 113 adult non-dependent drinkers (66 women). Alcohol expectancy is positively correlated with GM volume of left precentrral gyrus (PCG) in men and women combined and bilateral superior frontal gyri (SFG) in women, and negatively correlated with GM volume of the right ventral putamen in men. Furthermore, mediation analyses showed that the GM volume of PCG mediate the correlation of alcohol expectancy and the average number of drinks consumed per occasion and monthly total number of drinks in the past year. When recent drinking was directly accounted for in multiple regressions, GM volume of bilateral dorsolateral prefrontal cortices (DLPFC) correlated positively with alcohol expectancy in the combined sample. To our knowledge, these results are the first to identify the structural brain correlates of alcohol expectancy and its mediation of drinking behaviors. These findings suggest that more studies are needed to investigate increased GM volume in the frontal cortices as a neural correlate of alcohol expectancy. PMID:23461484

  20. Life expectancy of modular Ti6Al4V hip implants: influence of stress and environment.

    PubMed

    Chandra, A; Ryu, J J; Karra, P; Shrotriya, P; Tvergaard, V; Gaisser, M; Weik, T

    2011-11-01

    Stress dependent electrochemical dissolution is identified as one of the key mechanisms governing surface degradation in fretting and crevice corrosion of biomedical implants. The present study focuses on delineating the roles of mechanical stress and chemical conditions on the life expectancy of modular hip implants. First, material removal on a stressed surface of Ti6Al4V subjected to single asperity contact is investigated experimentally to identify the influence of contact load, in-plane stress and chemical environment on mean wear rates. A range of known stress levels are applied to the specimen while its surface is mechanically stimulated in different non-reactive to oxidizing aqueous environments. Evolution of surface degradation is monitored, and its mechanism is elucidated. This phase allows estimation of Preston Constant which is later used in the analysis. Second phase of the work is semi-analytical and computational, where, based on the estimated Preston constant and other material and process parameters, the scratch propensity (consisting of magnitude of scratch depth and their frequency per unit area) due to micro-motion in modular hip implants is estimated. The third phase views these scratches as initial notches and utilizes a mixed-mode fatigue crack propagation model to estimate the critical crack length for onset of instability. The number of loading cycles needed to reach this critical crack length is then labeled as the expected life of the implant under given mechanical and chemical conditions. Implications of different material and process conditions to life expectancy of orthopedic implants are discussed. It is observed that transverse micro-motion, compared to longitudinal micro-motion, plays a far more critical role in determining the implant life. Patient body weight, as well as proximity of the joint fluid to its iso-electric point play key roles in determining wear rates and associated life expectancies of modular hip implants

  1. Differences in life expectancy between olympic high jumpers, discus throwers, marathon and 100 meter runners.

    PubMed

    Lee-Heidenreich, Jeffrey; Lee-Heidenreich, David; Myers, Jonathan

    2017-01-01

    Several studies have demonstrated that body habitus is associated with survival (life expectancy) time. We sought to determine if survival differed between elite athletes with a range of body types. We hypothesized that the survival would differ between athlete types and that ectomorph athletes would have longer survival than heavier athletes. For each Olympics between 1928 and 1948 we identified the top (up to 20) Olympic male and female finishers in the high jump (HJ), discus throw, marathon, and 100-m run. We determined date of death using internet searches and calculated age-specific expected survival using published US life tables. We adjusted life expectancy for country of origin based on Global Burden of Disease data. We identified a death date for 336 of 429 (78%) Olympic athletes including 229 males (55 marathon, 56 100-m 58 high jump, 60 discus), and 107 females (54 100-m, 25 high jump, 28 discus). Discus throwers were heaviest and marathon runners the lightest and oldest athletes (p < 0.01). Observed-expected survival was highest for high jumpers (7.1 years for women, 3.7 years for men) and marathon runners (4.7 years for men) and lowest for sprinters (-1.6 years for women and -0.9 years for men). In multivariate analysis controlling for age and gender, type of sport remained significantly associated with mortality with greatest survival for high jumpers and marathon runners compared to discus throwers and sprinters (p = 0.005). Controlling for weight, reduced the survival benefit of high jumpers over discus throwers, but had little effect on the survival benefit of marathon runners vs. sprinters. Significant differences in long term survival exist for different types of track and field Olympic athletes that were explained in part by weight.

  2. Temporal changes in loss of life expectancy due to cancer in Australia: a flexible parametric approach.

    PubMed

    Baade, Peter D; Youlden, Danny R; Andersson, Therese M; Youl, Philippa H; Walpole, Euan T; Kimlin, Michael G; Aitken, Joanne F; Biggar, Robert J

    2016-08-01

    To evaluate changes in cancer mortality burden over time by assessing temporal trends in life expectation for Australian residents diagnosed with cancer. The study cohort consisted of all people diagnosed with cancer in the period 1990-2000 and aged 15-89 years (n = 1,275,978), with mortality follow-up to 31 December 2010. Flexible parametric survival models incorporating background age-sex-year-specific population mortality rates were applied to generate the observed survival curves for all cancers combined and selected major cancer types. Predicted values of loss of life expectancy (LOLE) in years were generated and then averaged across calendar year and age group (15-49, 50-69 and 70-89 years) or spread of disease (localized, regional, distant, unknown). The greatest LOLE burden was for lung cancer (14.3 years per diagnosis) and lowest for melanoma (2.5 years). There was a significant decrease in LOLE over time (-0.13 LOLE per year) for all cancers combined. Decreases were also observed for female breast cancer (-0.21), prostate cancer (-0.17), colorectal cancer (-0.08), melanoma (-0.07) and stomach cancer (-0.02), with slight increases for lung cancer (+0.04). When restricted to the sub-cohort from New South Wales with spread of disease information, these decreases in LOLE were primarily among cancers categorized as localized or regional spread at diagnosis. In Australia, persons diagnosed with cancer have a steadily improving outlook that exceeds that expected by general improvement in population life expectancy. The overall improvement is observed in persons with localized or regional cancers but not in those with advanced cancers, findings which encourage earlier diagnosis.

  3. Expectations of survivors, caregivers and healthcare providers for testicular cancer survivorship and quality of life.

    PubMed

    De Padova, Silvia; Rosti, Giovanni; Scarpi, Emanuela; Salvioni, Roberto; Amadori, Dino; De Giorgi, Ugo

    2011-01-01

    We compared expectations of testicular cancer survivors and their caregivers with those of healthcare providers for testicular cancer survivorship care and quality of life to identify experiences and potential expectations in which there was disagreement. In a meeting with testicular cancer survivors, their caregivers, and care providers with an interest in testicular cancer, we distributed a structured questionnaire with 24 questions divided into 3 sections: personal information, information on the quality of life of survivors, information on the role of care providers, general practitioners and health-related internet sources in the expectations of survivors. The overall response rate was 91% (29 of 32) for patients and 100% (14 of 14) for caregivers with all questionnaires evaluable, while among 60 care providers, 42 (70%) responded with 41 (68%) evaluable. Between patients/caregivers and care providers, expectations were most incongruent for the role of primary care physicians in testicular cancer follow-up: important/fundamental for 58% of patients/caregivers and 88% of care providers (P = 0.010). Comparing patients/caregivers with care providers in their views of the experience of testicular cancer survivorship, we found several discrepancies: the fear of recurrence was high/very high for 18 of 43 (42%) patients/caregivers and in the perception of 40 of 41 (98%) care providers (P <0.001), and psychological distress was considered as highly relevant by 35% of patients/caregivers and 93% of care providers (P <0.001). Patients/caregivers and care providers have different perceptions of survivors' experiences and discordant expectations with respect to the roles of primary care providers in testicular cancer survivorship care. Uncertainties about the roles and responsibilities of physicians can lead to deficiencies in care, supporting the need to make survivorship care planning a standard component in cancer management.

  4. Disability Transitions and Health Expectancies among Adults 45 Years and Older in Malawi: A Cohort-Based Model

    PubMed Central

    Payne, Collin F.; Mkandawire, James; Kohler, Hans-Peter

    2013-01-01

    Background Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA); by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique challenges because of poverty and inadequate social supports. However, despite its importance for understanding the consequences of population aging, the evidence about the prevalence of disabilities and functional limitations due to poor physical health among older adults in SSA continues to be very limited. Methods and Findings Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. We investigate how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. These disabilities were parameterized based on questions from the SF-12 questionnaire about limitations in daily living activities. We estimated age-specific patterns of functional limitations and the transitions over time between different disability states using a discrete-time hazard model. The estimated transition rates were then used to calculate the first (to our knowledge) microdata-based health expectancies calculated for SSA. The risks of experiencing functional limitations due to poor physical health are high in this population, and the onset of disabilities happens early in life. Our analyses show that 45-y-old women can expect to spend 58% (95% CI, 55%–64%) of their remaining 28 y of life (95% CI, 25.7–33.5) with functional limitations; 45-y-old men can expect to live 41% (95% CI, 35%–46%) of their remaining 25.4 y (95% CI, 23.3–28.8) with such limitations. Disabilities related to functional limitations are shown to have a substantial negative effect on individuals' labor activities, and are negatively related to

  5. Water consumption, not expectancies about water consumption, affects cognitive performance in adults.

    PubMed

    Edmonds, Caroline J; Crombie, Rosanna; Ballieux, Haiko; Gardner, Mark R; Dawkins, Lynne

    2013-01-01

    Research has shown that water supplementation positively affects cognitive performance in children and adults. The present study considered whether this could be a result of expectancies that individuals have about the effects of water on cognition. Forty-seven participants were recruited and told the study was examining the effects of repeated testing on cognitive performance. They were assigned either to a condition in which positive expectancies about the effects of drinking water were induced, or a control condition in which no expectancies were induced. Within these groups, approximately half were given a drink of water, while the remainder were not. Performance on a thirst scale, letter cancellation, digit span forwards and backwards and a simple reaction time task was assessed at baseline (before the drink) and 20 min and 40 min after water consumption. Effects of water, but not expectancy, were found on subjective thirst ratings and letter cancellation task performance, but not on digit span or reaction time. This suggests that water consumption effects on letter cancellation are due to the physiological effects of water, rather than expectancies about the effects of drinking water. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Ethnic and gender specific life expectancies of the Singapore population, 1965 to 2009 – converging, or diverging?

    PubMed Central

    2013-01-01

    Background The increase in life expectancy and the persistence of expectancy gaps between different social groups in the 20th century are well-described in Western developed countries, but less well documented in the newly industrialised countries of Asia. Singapore, a multiethnic island-state, has undergone a demographic and epidemiologic transition concomitant with economic development. We evaluate secular trends and differences in life expectancy by ethnicity and gender in Singapore, from independence to the present. Methods Period abridged life tables were constructed to derive the life expectancy of the Singapore population from 1965 to 2009 using data from the Department of Statistics and the Registry of Births and Deaths, Singapore. Results All 3 of Singapore’s main ethnic groups, and both genders, experienced an increase in life expectancy at birth and at 65 years from 1965 to 2009, though at substantially different rates. Although there has been a convergence in life expectancy between Indians and Chinese, the (substantial) gap between Malays and the other two ethnic groups has remained. Females continued to have a higher life expectancy at birth and at 65 years than males throughout this period, with no evidence of convergence. Conclusions Ethnic and gender differences in life expectancy persist in Singapore despite its rapid economic development. Targeted chronic disease prevention measures and health promotion activities focusing on people of Malay ethnicity and the male community may be needed to remedy this inequality. PMID:24160733

  7. Relative Importance of Demographic, Socioeconomic and Health Factors on Life Expectancy in Low- and Lower-Middle-Income Countries

    PubMed Central

    Mondal, Md. Nazrul Islam; Shitan, Mahendran

    2014-01-01

    Background We attempted to identify the pathways by which demographic changes, socioeconomic inequalities, and availability of health factors influence life expectancy in low- and lower-middle-income countries. Methods Data for 91 countries were obtained from United Nations agencies. The response variable was life expectancy, and the determinant factors were demographic events (total fertility rate and adolescent fertility rate), socioeconomic status (mean years of schooling and gross national income per capita), and health factors (physician density and human immunodeficiency virus [HIV] prevalence rate). Path analysis was used to determine the direct, indirect, and total effects of these factors on life expectancy. Results All determinant factors were significantly correlated with life expectancy. Mean years of schooling, total fertility rate, and HIV prevalence rate had significant direct and indirect effects on life expectancy. The total effect of higher physician density was to increase life expectancy. Conclusions We identified several direct and indirect pathways that predict life expectancy. The findings suggest that policies should concentrate on improving reproductive decisions, increasing education, and reducing HIV transmission. In addition, special attention should be paid to the emerging need to increase life expectancy by increasing physician density. PMID:24390415

  8. Relative importance of demographic, socioeconomic and health factors on life expectancy in low- and lower-middle-income countries.

    PubMed

    Mondal, Md Nazrul Islam; Shitan, Mahendran

    2014-01-01

    We attempted to identify the pathways by which demographic changes, socioeconomic inequalities, and availability of health factors influence life expectancy in low- and lower-middle-income countries. Data for 91 countries were obtained from United Nations agencies. The response variable was life expectancy, and the determinant factors were demographic events (total fertility rate and adolescent fertility rate), socioeconomic status (mean years of schooling and gross national income per capita), and health factors (physician density and human immunodeficiency virus [HIV] prevalence rate). Path analysis was used to determine the direct, indirect, and total effects of these factors on life expectancy. All determinant factors were significantly correlated with life expectancy. Mean years of schooling, total fertility rate, and HIV prevalence rate had significant direct and indirect effects on life expectancy. The total effect of higher physician density was to increase life expectancy. We identified several direct and indirect pathways that predict life expectancy. The findings suggest that policies should concentrate on improving reproductive decisions, increasing education, and reducing HIV transmission. In addition, special attention should be paid to the emerging need to increase life expectancy by increasing physician density.

  9. Total and occupationally active life expectancies in relation to social class and marital status in men classified as healthy at 20 in Finland.

    PubMed Central

    Kaprio, J; Sarna, S; Fogelholm, M; Koskenvuo, M

    1996-01-01

    STUDY OBJECTIVE: To study differences in total life expectancy and in occupationally active life expectancy in relation to social class and marital status in men classified as healthy as young adults. DESIGN: Historical cohort study. SETTING: Finland. PARTICIPANTS: Altogether 1662 men classified as completely healthy at the time of induction to military service (mean birth year 1923), who had been selected as referents for a study of former athletes. Mean follow up time was 46 years. MEASUREMENTS: Vital status was determined by follow up through local parish data up to 1990. Mortality data were obtained from the Cause of Death bureau of the Central Statistical Office of Finland. Occurrence of work disability was assessed from nationwide disability pension register data. Mean total life expectancy and mean occupationally active life expectancy (end points disability pension or death before age 65 years) were estimated. Social class was based on the major lifetime occupation, while marital status was classified as "never married" or "ever married" at the end of follow up. MAIN RESULTS: Mean total life expectancy was highest among executives and managers (73.2 (95% confidence interval (CI): 70.3, 76.1) years), next highest in clerical (white collar) workers (72.0 (70.0, 74.1) years), and lowest in unskilled blue collar workers (63.65 (61.1, 66.2) years). Skilled workers and farmers were intermediate. For the occupationally active life expectancy estimates, a similar gradient was observed: highest for executives (61.9 (60.7, 63.1) years) and lowest for the unskilled (52.2 (50.2, 54.2) years). The ratio of occupationally active life expectancy to total life expectancy was highest for executives (85%) and lowest for farmers (81%) and unskilled workers (82%). CONCLUSIONS: The social class gradient known to exist for mortality is also present for occupational disability. Social class and marital status differences in mortality are already evident in early adulthood and

  10. Expected cycle life versus depth of discharge relationships of well behaved single cells and cell strings

    NASA Technical Reports Server (NTRS)

    Thaller, L. H.

    1982-01-01

    The factors that might influence the cycle life vs. depth of discharge relationship are examined. This is done first at the single cell level using a progressively more complex cell life model. This is then extended to multicell battery strings where the stochastic aspects associated with groupings of cells are introduced. These relationships are important when considering the weight, cost, and life of battery packs. The results of this theoretical study are compared with a recent review of actual cell cycling data. The factors examined are the rate of capacity loss, the amount of excess capacity built into the cells, and the penalty in capacity loss resulting from the use of deep depths of discharge. This study suggests that the relationship between cycle life and depth of discharge is not one that can be varied of significantly improved by cell research. The relationship appears to be determined by certain more or less fixed cell parameters. Among multicell strings, the standard deviation, as expected, plays an important role in determining overall battery life.

  11. New "loss of happy life expectancy" indicator and its use in risk comparison after Fukushima disaster.

    PubMed

    Murakami, Michio; Tsubokura, Masaharu; Ono, Kyoko; Maeda, Masaharu

    2017-09-17

    To assess the effects of policy measures taken to ensure health and promote well-being, we developed a novel indicator, "loss of happy life expectancy" (LHpLE), under the concept that an objective of life is maximization of lifelong happiness, by using objective survival probabilities and a simple question regarding emotional happiness: "Did you experience a feeling of happiness yesterday [yes/no]?" We measured the emotional happiness of 4990 Japanese respondents through a questionnaire. We then used LHpLE to compare risks after the 2011 Fukushima disaster. LHpLE due to psychological distress was estimated from a decline of emotional happiness, whereas that due to radiation exposure was assessed from shortened life expectancy caused by additional cancer mortality. LHpLE values due to psychological distress in evacuees were approximately 1 to >2 orders of magnitude higher than those due to cancer mortality caused by actual radiation exposure, highlighting the importance of measures to minimize distress following public health emergencies. LHpLE could be used for integrated risk comparison among different types of harms and therefore in government policy-making. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  12. Influence of level of education on disability free life expectancy by sex: the ILSA study.

    PubMed

    Minicuci, N; Noale, M

    2005-12-01

    To assess the effect of education on Disability Free Life Expectancy among older Italians, using a hierarchical model as indicator of disability, with estimates based on the multistate life table method and IMaCh software. Data were obtained from the Italian Longitudinal Study on Aging which considered a random sample of 5632 individuals. Total life expectancy ranged from 16.5 years for men aged 65 years to 6 years for men aged 80. The age range for women was 19.6 and 8.4 years, respectively. For both sexes, increasing age was associated with a lower probability of recovery from a mild state of disability, with a greater probability of worsening for all individuals presenting an independent state at baseline, and with a greater probability of dying except for women from a mild state of disability. A medium/high educational level was associated with a greater probability of recovery only in men with a mild state of disability at baseline, and with a lower probability of worsening in both sexes, except for men with a mild state of disability at baseline. The positive effects of high education are well established in most research work and, being a modifiable factor, strategies focused on increasing level of education and, hence strengthening access to information and use of health services would produce significant benefits.

  13. Relevance of management and feeding regimens on life expectancy in captive deer.

    PubMed

    Müller, Dennis W H; Lackey, Laurie Bingaman; Streich, W Jürgen; Hatt, Jean-Michel; Clauss, Marcus

    2010-03-01

    To establish a demographic approach to facilitate the comparison of husbandry success for deer species in zoos and to test for factors that influence the pe