As the United States and the rest of the world face the unprecedented challenge of aging populations, this volume draws together for the first time state-of-the-art work from the emerging field of the demography of aging. The nine chapters, written by experts from a variety of disciplines, highlight data sources and research approaches, results, and proposed strategies on a topic with major policy implications for labor forces, economic well-being, health care, and the need for social and family supports. Table of Contents Front Matter 1 Introduction 2 The Formal Demography of Population Aging, Transfers, and the Economic Life Cycle 3 Retirement and Labor Force Behavior of the Elderly 4 Income, Wealth, and Intergenerational Economic Relations of the Aged 5 The Elderly and Their Kin: Patterns of Availability and Access 6 Care of the Elderly: Division of Labor Among the Family, Market, and State 7 Medical Demography: Interaction of Disability Dynamics and Mortality 8 Socioeconomic Differences in Adult Mortality and Health Status 9 Geographic Concentration, Migration, and Population Redistribution Among the Elderly 10 Research on the Demography of Aging in Developing Countries Appendix: Letter to Richard Suzman of the National Institute on Aging from the Committee on Population, March 2, 1993

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

Fatal Years is the first systematic study of child mortality in the United States in the late nineteenth century. Exploiting newly discovered data from the 1900 Census of Population, Samuel Preston and Michael Haines present their findings in a volume that is not only a pioneering work of demography but also an accessible and moving historical narrative. Despite having a rich, well-fed, and highly literate population, the United States had exceptionally high child-mortality levels during this period: nearly one out of every five children died before the age of five. Preston and Haines challenge accepted opinion to show that losses in privileged social groups were as appalling as those among lower classes. Improvements came only with better knowledge about infectious diseases and greater public efforts to limit their spread. The authors look at a wide range of topics, including differences in mortality in urban versus rural areas and the differences in child mortality among various immigration groups. "Fatal Years is an extremely important contribution to our understanding of child mortality in the United States at the turn of the century. The new data and its analysis force everyone to reconsider previous work and statements about U.S. mortality in that period. The book will quickly become a standard in the field."--Maris A. Vinovskis, University of Michigan Originally published in 1991. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

"Fatal Years" is the first systematic study of child mortality in the United States in the late nineteenth century. Exploiting newly discovered data from the 1900 Census of Population, Samuel Preston and Michael Haines present their findings in a volume that is not only a pioneering work of demography but also an accessible and moving historical narrative. Despite having a rich, well-fed, and highly literate population, the United States had exceptionally high child-mortality levels during this period: nearly one out of every five children died before the age of five. Preston and Haines challenge accepted opinion to show that losses in privileged social groups were as appalling as those among lower classes. Improvements came only with better knowledge about infectious diseases and greater public efforts to limit their spread. The authors look at a wide range of topics, including differences in mortality in urban versus rural areas and the differences in child mortality among various immigration groups. "Fatal Years is an extremely important contribution to our understanding of child mortality in the United States at the turn of the century. The new data and its analysis force everyone to reconsider previous work and statements about U.S. mortality in that period. The book will quickly become a standard in the field."--Maris A. Vinovskis, University of Michigan

Originally published in 1991.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

This is a reproduction of a book published before 1923. This book may have occasional imperfections such as missing or blurred pages, poor pictures, errant marks, etc. that were either part of the original artifact, or were introduced by the scanning process. We believe this work is culturally important, and despite the imperfections, have elected to bring it back into print as part of our continuing commitment to the preservation of printed works worldwide. We appreciate your understanding of the imperfections in the preservation process, and hope you enjoy this valuable book.

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