Old-age survival has considerably improved in the second half of the twentieth century. Life expectancy in wealthy countries has increased, on average, from 65 years in 1950 to 76 years in 2005. The rise was more spectacular in some countries: the life expectancy for Japanese women rose from 62 years to 86 years during the same period. Driven by this longevity extension, the population aged 80 and over in those countries has grown fivefold from 8.5 million in 1950 to 44.5 million in 2005. Why has such a substantial extension of human lifespan occurred? How long can we live? In this book, these fundamental questions are explored by experts from such diverse fields as biology, medicine, epidemiology, demography, sociology, and mathematics: they report on recent cutting-edge studies about essential issues of human longevity such as evolution of lifespan of species, genetics of human longevity, reasons for the recent improvement in survival of the elderly, medical and behavioral causes of deaths among very old people, and social factors of long survival in old age.

People are living longer and most countries are experiencing unprecedented increases in the number and proportion of their elderly populations, resulting from declines in mortality, lower fertility, and the baby boom cohorts entering old age. A fundamental issue facing the global community is meeting the challenges of population aging and achieving healthy aging to maintain an active older population and reduce the number of disabled people. Healthy aging is obviously a major goal of all societies and is the central theme of this book.

The focus of this book is on theoretical issues and empirical findings related to trends and determinants of healthy aging, including factors related to "healthy longevity" of the oldest-old, aged 80 and over. The group is the most rapidly increasing elderly sub-population and is most likely to need assistance in daily living in all countries. Chapters include both longitudinal and cross-sectional data from North America, Europe, and Asia in country-specific studies and cross-national comparisons.

We organized the twenty chapters into four parts. Part I focuses on the definition, components, concepts, measurements, and determinants of healthy aging, and discusses the trends and patterns of disability and healthy life expectancy at the macro level. Part II addresses individual healthy aging, including its biological and socio-demographic aspects. Part III focuses on issues concerning the family and healthy aging, and Part IV explores formal and informal care for healthy aging through governmental policy interventions and community service programs.

Old-age survival has considerably improved in the second half of the twentieth century. The life expectancy in wealthy countries has increased, on average, from 65 years in 1950 to 76 years in 2005. The rise was more spectacular in some countries: the life expectancy for Japanese women rose from 62 years to 86 years during the same period. Driven by this longevity extension, the population aged 80 and over in those countries has grown fivefold from 8.5 millions in 1950 to 44.5 millions in 2005. Why has such a substantial extension of human lifespan occurred? How long can we live? In this book, these fundamental questions are explored by experts from such diverse fields as biology, medicine, epidemiology, demography, sociology, and mathematics: they report on recent cutting-edge studies about essential issues of human longevity such as evolution of lifespan of species, genetics of human longevity, reasons for the recent improvement in survival of the elderly, medical and behavioral causes of deaths among very old people, and social factors of long survival in old age.

People are living longer and most countries are experiencing unprecedented increases in the number and proportion of their elderly populations, resulting from declines in mortality, lower fertility, and the baby boom cohorts entering old age. A fundamental issue facing the global community is meeting the challenges of population aging and achieving healthy aging to maintain an active older population and reduce the number of disabled people. Healthy aging is obviously a major goal of all societies and is the central theme of this book.

The focus of this book is on theoretical issues and empirical findings related to trends and determinants of healthy aging, including factors related to "healthy longevity" of the oldest-old, aged 80 and over. The group is the most rapidly increasing elderly sub-population and is most likely to need assistance in daily living in all countries. Chapters include both longitudinal and cross-sectional data from North America, Europe, and Asia in country-specific studies and cross-national comparisons.

We organized the twenty chapters into four parts. Part I focuses on the definition, components, concepts, measurements, and determinants of healthy aging, and discusses the trends and patterns of disability and healthy life expectancy at the macro level. Part II addresses individual healthy aging, including its biological and socio-demographic aspects. Part III focuses on issues concerning the family and healthy aging, and Part IV explores formal and informal care for healthy aging through governmental policy interventions and community service programs.

In 1950 men and women in the United States had a combined life expectancy of 68.9 years, the 12th highest life expectancy at birth in the world. Today, life expectancy is up to 79.2 years, yet the country is now 28th on the list, behind the United Kingdom, Korea, Canada, and France, among others. The United States does have higher rates of infant mortality and violent deaths than in other developed countries, but these factors do not fully account for the country's relatively poor ranking in life expectancy. International Differences in Mortality at Older Ages: Dimensions and Sources examines patterns in international differences in life expectancy above age 50 and assesses the evidence and arguments that have been advanced to explain the poor position of the United States relative to other countries. The papers in this deeply researched volume identify gaps in measurement, data, theory, and research design and pinpoint areas for future high-priority research in this area. In addition to examining the differences in mortality around the world, the papers in International Differences in Mortality at Older Ages look at health factors and life-style choices commonly believed to contribute to the observed international differences in life expectancy. They also identify strategic opportunities for health-related interventions. This book offers a wide variety of disciplinary and scholarly perspectives to the study of mortality, and it offers in-depth analyses that can serve health professionals, policy makers, statisticians, and researchers. Table of Contents Front Matter 1 Introduction and Overview--Eileen M. Crimmins, Samuel H. Preston, and Barney Cohen Part I: Levels and Trends 2 Diverging Trends in Life Expectancy at Age 50: A Look at Causes of Death--Dana A. Glei, France Mesle, and Jacques Vallin 3 Are International Differences in Health Similar to International Differences in Life Expectancy?--Eileen M. Crimmins, Krista Garcia, and Jung Ki Kim Part II: Identifying Causal Explanations 4 Contribution of Smoking to International Differences in Life Expectancy--Samuel H. Preston, Dana A. Glei, and John R. Wilmoth 5 Divergent Patterns of Smoking Across High-Income Nations--Fred Pampel 6 Can Obesity Account for Cross-National Differences in Life-Expectancy Trends?--Dawn E. Alley, Jennifer Lloyd, and Michelle Shardell 7 The Contribution of Physical Activity to Divergent Trends in Longevity--Andrew Steptoe and Anna Wikman 8 Do Cross-Country Variations in Social Integration and Social Interactions Explain Differences in Life Expectancy in Industrialized Countries?--James Banks, Lisa Berkman, and James P. Smith with Mauricio Avendano and Maria Glymour Part III: The U.S. Health System 9 Low Life Expectancy in the United States: Is the Health Care System at Fault?--Samuel H. Preston and Jessica Ho 10 Can Hormone Therapy Account for American Women's Survival Disadvantage?--Noreen Goldman Part IV: Inequality 11 Do Americans Have Higher Mortality Than Europeans at All Levels of the Education Distribution?: A Comparison of the United States and 14 European Countries--Mauricio Avendano, Renske Kok, Maria Glymour, Lisa Berkman, Ichiro Kawachi, Anton Kunst, and Johan Mackenbach with support from members of the Eurothine Consortium 12 Geographic Differences in Life Expectancy at Age 50 in the United States Compared with Other High-Income Countries--John R. Wilmoth, Carl Boe, and Magali Barbieri Part V: International Case Studies 13 Renewed Progress in Life Expectancy: The Case of the Netherlands--Johan Mackenbach and Joop Garssen 14 The Divergent Life-Expectancy Trends in Denmark and Sweden - and Some Potential Explanations--Kaare Christensen, Michael Davidsen, Knud Juel, Laust Mortensen, Roland Rau, and James W. Vaupel Biographical Sketches of Contributors

This handbook presents global research on health expectancies, a measure of population health that examines the interaction between quantity and quality of life. With data from Europe, North America, Asia, and beyond, it explains how to define and measure health and morbidity and how to integrate these measurements with mortality. Coverage first highlights long-term trends in longevity and health. It also considers variations across and within countries, inequalities, and social gaps as well as micro and macro-level determinants. Next, the handbook deals with the methodological aspects of calculating health expectancies. It compares results from different methods and introduces tools, such as decomposition tool for decomposing gaps, an attrition tool for attributing a medical cause to reported disability, and a tool for measuring policy impact on health expectancies. It introduces methods of forecasting health expectancies. The handbook then goes on to examine the synergies and/or trade-off between longevity and health as well as considers such topics as the compression versus the expansion of morbidity/disability and the health-survival paradox. The last section considers new concepts and dimensions of health and, more broadly, well being which can be used in summary measures of population health, including psychological factors. Researchers, clinicians, demographers, and health planners will find this handbook an essential resource to this increasingly important public health and social policy tool. It will help readers gain insight into changes in health over time as well as inequalities between countries, regions, and population subgroups.

During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases. Table of Contents Front Matter Summary 1 Difference Between Life Expectancy in the United States and Other High-Income Countries 2 Causes of Death, Health Indicators, and Divergence in Life Expectancy 3 The Role of Obesity 4 The Role of Physical Activity 5 The Role of Smoking 6 The Role of Social Networks and Social Integration 7 The Role of Health Care 8 The Role of Hormone Therapy 9 The Role of Inequality 10 Conclusions References Biographical Sketches of Committee Members and Staff

For most of human history a natural fertility regime has prevailed throughout the world: there has been almost no conscious limitation of family size within marriage, and women have spent their reproductive lives tied to the wheel of childbearing. Only recently in developed countries has fertility been brought under conscious control by individual couples and childbearing fallen to an average of two births per woman. The explanation of this fertility revolution is the main concern of this book.
Richard A. Easterlin and Eileen M. Crimmins present and test a fertility theory that has gained increasing attention over the last decade, a supply-demand theory that integrates economic and sociological approaches to fertility determination. The results of the tests, which draw on data from four developing countries--Colombia, India, Sri Lanka, and Taiwan--are highly consistent, though a number of the conclusions are likely to arouse controversy. For example, couples' motivation for fertility control appears to be the prime mover in the fertility revolution, rather than access to family planning services or unfavorable attitudes toward such services.
The interdisciplinary approach and nontechnical exposition of this study will attract a wide readership among economists, sociologists, demographers, anthropologists, statisticians, biologists, and others.