Future Mortality in Low Mortality Countries

Abstract

This chapter provides an overview of past and expected future trends in life expectancy in populations with low levels of mortality. High and low mortality populations were separated on the basis of the level of child mortality in the year 2010 according to the revised estimates of the United Nations Inter-agency Group for Child Mortality Estimation (2011), with the threshold being 40 deaths per 1,000 children below the age of 5 years. The low mortality population is comprised of 132 countries including Europe, North America, most of Oceania and Latin America, large parts of Asia (excluding the high mortality area in Central and Southern Asia), and Northern Africa. The populations of these countries are already engaged in an advanced phase of the demographic and ‘epidemiologic transition’. Because they previously experienced strong decreases in infant mortality, the future mortality trends are driven mainly by mortality in adult ages, primarily the old and oldest-old. Although the data sources on which the existing estimates of life expectancy for these populations are based vary considerably (owing to differences in the death registration systems and the estimation techniques, see, e.g., Luy, 2010), we have relatively good knowledge of past and current mortality levels and trends and their causes. Despite the similar general trends, today’s low mortality countries are very heterogeneous in various aspects, including medical standards, access to health care, and behavioural risk factors, such as smoking prevalence. These diversities are strongly related to the populations’ stages of economic development and contribute to a broad variance of life expectancy levels. Among men, life expectancy at birth for the years 2005–10 ranges between 60.2 in Kazakhstan and 79.5 in Iceland. Among women, the range is between 67.8 in the Solomon Islands and 86.1 in Japan. To demonstrate this relationship between economic development and life expectancy we classified countries according to their current per capita income as an indicator of the economic development level of the populations. We used the World Bank classification, which groups countries into high income (≥$12,276 annually), upper middle income ($3,976–$12,275), lower middle income ($1,006–$3,975), and low income (≤$1,005).