Old age mortality in Eastern and South-Eastern Asia

Abstract

AbstractBACKGROUNDEastern and South-Eastern Asian countries have witnessed a marked decline in old age mortality in recent decades. Yet no studies have investigated the trends and patterns in old age mortality and cause-of-death in the region.OBJECTIVEWe reviewed the trends and patterns of old age mortality and cause-of-death for countries in the region.METHODSWe examined data on old age mortality in terms of life expectancy at age 65 and age-specific death rates from the 2012 Revision of the World Population Prospects for 14 countries in the region (China, Hong Kong, Democratic People's Republic of Korea, Indonesia, Japan, Lao People's Democratic Republic, Myanmar, Malaysi a, Mongolia, Philippines, Republic of Korea, Singapore, Thailand, and Viet Nam) and data on cause-of-death from the WHO for five countries (China, Hong Kong, Japan, Republic of Korea, and Singapore) from 1980 to 2010.RESULTSWhile mortality transitions in these populations took place in different times, and at different levels of socioeconomic development and living environment, changes in their age patterns and sex differentials in mortality showed certain similarities: women witnessed a similar decline to men in spite of their lower mortality, and young elders had a larger decline than the oldest-old. In all five countries examined for cause-of-death, most of the increases in life expectancy at age 65 in both men and women were attributable to declines in mortality from stroke and heart disease. GDP per capita, educational level, and urbanization explained much of the variations in life expectancy and cause-specific mortality, indicating critical contributions of these basic socioeconomic development indicators to the mortality decline over time in the region.CONCLUSIONSThese findings shed light on the relationship between epidemiological transition, changing age patterns of mortality, and improving life expectancy in these populations.(ProQuest: ... denotes formula omitted.)1. IntroductionLike many other countries in the world, Eastern and South-Eastern Asian populations have witnessed a marked decline in old age mortality in recent decades. Life expectancy for both sexes combined at age 65 in Eastern Asia rose from 9.2 years in 1950-1955 to 16.8 years in 2005-2010, a net increase of 7.6 years, and the largest gain of any geographic region of the world. The corresponding gain in life expectancy at age 65 for South-Eastern Asia was 4.0 years rising from 11.2 years in 1950-1955, ranking the middle among all geographic regions in terms of gained years (United Nations Population Division(UNPOP) 2013).Eastern and South-Eastern Asia is unique for studying old age mortality.3 First, this region is home to nearly one-third of the world's total population today, the largest region in the world (UNPOP 2013); some countries 4 in the region have completed the demographic transition while many others are still undergoing transition, which provides promising data for summarizing patterns and trajectories of old age mortality over time (Bongaarts 2009; McNicoll 2006). Second, this region is economically diverse. For example, Japan, Hong Kong,5 and Republic of Korea are high-income economies; China and Thailand are upper middle income countries; Viet Nam and Philippines are lower middle income societies; and Myanmar is a low income country (World Bank 2011). Third, there is a substantial heterogeneity in mortality across countries in the region. Life expectancy at birth for both sexes combined in Japan, Hong Kong, Republic of Korea and Singapore was already above 80 years in 2005-2010, one of the highest in the world, whereas it was just above 64 years in Myanmar, one of the lowest ones in the world among countries not affected by the HIV/AIDS epidemic. Fourth, the low fertility and the declining mortality of populations in the region have contributed remarkably to elderly population growth. …