Changes In Age Structure Research Articles

Is a rising cesarean delivery rate explained by late birth trend? A decomposition analysis of health insurance claims data (2013–2022) from South Korea

AbstractObjectiveTo analyze the factors influencing the increase in the cesarean delivery (CD) rate in South Korea and test the hypothesis on advanced maternal age driving the trend.MethodThe present study is a population‐based retrospective observational study utilizing administrative data from the Korean National Health Insurance Service. We analyzed a total 3 416 517 births from 2013 to 2022 covered by the national health insurance. The CD rate and contribution of demographic variables to changes in CD rates were calculated using Das Gupta's decomposition method.ResultsThe CD rate increased from 37.8% in 2013 to 61.6% in 2022. The decomposition analysis revealed that changes in maternal age structure contributed only 8.7% to the increase in the CD rate. When parity was added to maternal age, the explained proportion increased to 17.8%. When other factors were added to the model, such as multiple births, residential area, and income level, it did not contribute significantly to the increase in the CD rates, accounting for 19.0%, 18.6%, and 18.0%, respectively.ConclusionsAccording to our analysis, less than one‐fifth of the increase in CD rate was explained by the change in maternal age. The rising CD rate in Korea should not be considered an unavoidable consequence of demographic change. Much more diverse factors, including increased risk of medical lawsuits, changes in childbirth culture, and other health system determinants, may be driving the trend.

Analysis Of the Impact of China's Population Age Structure on Residential Commercial Housing Prices

With the intensification of global aging, the impact of changes in population age structure on the real estate market is becoming increasingly significant. This article aims to explore the impact of changes in China's population age structure on the prices of residential commercial housing, to provide a scientific basis for regulating the real estate market. By analyzing data from 30 provinces and cities in China from 2013 to 2022, this article finds that as aging population intensifies and the number of children decreases, both the old-age dependency ratio and the child-age dependency ratio have a negative impact on housing prices. This means that the aging society and the economic pressure of childcare may weaken the demand for home purchases. Household Saving Rate and increase in total population positively drive house prices, while the relationship between per capita income and house prices is not significant. From a regional perspective, the aging population in the eastern region has a significant effect on suppressing housing prices, while the impact is gradually evident in the central region. The western region has a smaller impact and population growth suppresses housing price increases. The study emphasizes the impact of changes in the age structure of the Chinese population on the prices of residential properties and proposes policy recommendations such as improving old-age security and optimizing the housing supply structure to promote the steady development of the real estate market.

Migration as an Adaptation Measure to Achieve Resilient Lifestyle in the Face of Climate-Induced Drought: Insight from the Thar Desert in Pakistan

A significant number of people, either seasonally or permanently, migrate from the Thar Desert in Pakistan each year due to droughts caused by climate change. This study aims to investigate the determinants and consequences of these migration decisions, examine the effectiveness of migration as a climate adaptation strategy, and identify challenges in adapting to these changes. Data were gathered from 400 migrated households in the Mithi sub-district. A mixed-method approach was used, combining qualitative and quantitative methods. The findings revealed that threats to the standard of living, including lack of food and clean drinking water, unemployment, and limited educational and medical opportunities, were the primary reasons for permanent and temporary migration from ancestral locations. Migration significantly impacted the origin and destination regions, with positive or negative effects. Specifically, migrants identified various consequences for both the origin and destination communities, including population decline (63%), changes in age structure, increased demand for housing, economic fluctuations (73%), alterations in healthcare services, and increased psychological stress (77%). The study also revealed that individuals who migrated from the Thar Desert experienced improved conditions compared to their previous location, such as diversification of income sources, increased job stability, access to clean water and food, reduced health risks, and overall improvements in their living conditions. However, the destination communities faced significant challenges due to widespread resource depletion and environmental deterioration. Migrants encountered barriers to developing resilient livelihoods in destination areas, including lack of proper knowledge and information, institutional and government issues, environmental and technological challenges, and social and cultural issues. The study highlights the urgent need for comprehensive policies and sustainable solutions to address the root causes of migration and support the resilience of vulnerable populations.

The Incidence of Endometriosis, 2014–2022. An Analysis of Nationwide Claims Data From Physicians in Private Practice.

The epidemiological characterization of endometriosis, particularly with regard to its incidence, has been inadequate to date both in Germany and other countries. The goal of this study was to determine trends in the incidence of diagnosed endometriosis and changes in age structure at the time of first diagnosis over the period 2014-2022. Nationwide claims data from physicians in private practice, obtained according to relevant German law (§ 295 SGB V), were used to identify the population at risk for a first assured diagnosis of endometriosis (ICD-10-GM: N80) during each year of the study period, consisting of women and girls aged 10-52 who were insured by the statutory health insurance system and for whom at least two years of prior observation were possible. Patients were defined as incident if they were documented as having received a first confirmed diagnosis of endometriosis, according to the case definition, during the study year. The case definition comprised multiple options for validating the diagnosis. The incidence of diagnosed endometriosis rose over the period of the study from 2.8 per 1000 persons at risk in 2014 to 4.1 per 1000 in 2022, corresponding to a 44% relative increase. There was also a marked shift in age-specific incidence toward higher values at younger ages: the median age at diagnosis fell from 37 years (2014) to 34 (2022). This is the first study providing nationwide population-based data on the incidence of endometriosis in Germany. The observed rise in newly diagnosed cases is presumably mainly due to an increased awareness of endometriosis and to the growing recognition of the disease.

Based on the Analysis of Existing Economic Policies, Compares the Response of Economic Policies to Population Ageing between the UK and Japan

In the context of the changing age structure of the global population, many countries are experiencing the economic consequences of this problem, such as severe dependency ratios and a reduction of qualified workers, which will harm the country's potential economic growth capacity. In order to mitigate the negative effects on the economy, both Japan and the United Kingdom have developed economic policies to deal with population ageing. These policies all revolve around healthcare, pension and employment. These economic policies are similar in some respects, such as in employment, where the two countries try to raise the retirement age of the elderly from various aspects, but show different policy biases in further policy-making for different reasons, such as different cultural backgrounds. This paper analyzes these similarities and differences by reviewing past literature and policy cases, making preliminary conjectures and summaries on the causes of these characteristics through past literature, and analyzing the effectiveness of some of these policies. Finally, we conclude from the study that these policy differences are due to different cultural, and historical backgrounds and current economic situations between the two countries.

Trend and driving factors in burden of age-related macular degeneration in older adults aged 60-89years: a global analysis over three decades.

To explore temporal trends and determine driving factors of age-related macular degeneration (AMD) burden in older adults aged 60-89years at global, regional and national levels from 1990 to 2019. Prevalence and years lived with disability (YLDs) were extracted. Joinpoint regression analysis was adopted to calculate average annual percentage change and to identify the year with the most significant changes. Global trends were stratified by sex, age and sociodemographic index, and regional and national trends were explored. Decomposition analysis was conducted to determine what extent the forces of population size, age structure and epidemiologic change driving alterations of AMD burden. Globally, prevalence rate slightly increased whereas YLDs rate decreased. The year 2005 marked a turning point where both prevalence and YLDs started to decline. Regionally, Western Sub-Saharan Africa had the highest prevalence and YLDs rates in 2019, with East Asia experiencing the most notable rise in prevalence from 1990 to 2019. Global decomposition revealed that the increased case number was primarily driven by population growth and ageing, and epidemiological change was only detected to lessen but far from offset these impacts. Although there was only slight increase or even decrease in prevalence and YLDs rates of AMD in older adults, the case number still nearly doubled, which may be primarily attributed to population growth and ageing, coupled with the emerging growing pattern of prevalence rate from 2015, collectively suggesting a huge challenge in control and management of AMD.

Impact of population aging and declining birth rates on household consumption structure: Evidence from China

The age structure of a population is a crucial indicator of a country's economic development. This study analyzes the impact of population aging and declining birth rates on the household consumption structure in urban and rural China. China, the largest country by population, is selected owing to its significance in population studies. Using a fixed effects model, our findings reveal that in China, a higher proportion of youth in the population positively affects residents’ spending on survival consumption while negatively affecting developmental consumption. Conversely, a higher proportion of older adults in the population negatively affects survival consumption while positively influencing developmental consumption.Through the research in this article, it is hoped that the results can provide some reference significance for the changes in population age structure and the development of resident consumption.

Demographic Trends in Liver Transplant Survivors After 3 Decades of Program Implementation: The Impact of Cohort and Period Effects on Life Expectancy.

Demographic analyses may reveal current patterns of change in the outcomes of rapidly developing medical procedures because they incorporate the period perspective. We analyzed the changes in size, age structure, and hospitalizations in the population of liver transplantation (LT) survivors in our center during the last 30 y (n = 1114 patients) and generated projections, including life expectancy (LE), considering cohort and period effects. Life tables were used to project the complete LE (overall 1990-2020 experience), the cohort LE (according to the decade of surgery: 1990-2000, 2000-2010, and 2010-2020), and the period LE (current 2015-2020 experience). The population of LT recipients in follow-up continued to experience progressive growth and aging since 1990 (492 patients [41.9% >65 y] in 2020), and the magnitude of these phenomena may double in the next 30 y. However, the number of admissions and days of admission has been decreasing. The complete LE at LT was 12.4 y, whereas the period LE was 15.8 y. The cohort LE (limited to 10 y) was 5.3, 6.3, and 7.3 y for the 1990-2000, 2000-2010, and 2010-2020 cohorts, respectively. The target population of our medical care after LT is growing and aging. The prevalence of both of these phenomena is expected to increase in the coming years and is associated with a current improvement in LE. However, the hospitalization burden associated with LT survivors is declining. The period effect should be considered for generating up-to-date information on these current trends, which are crucial when designing health policies for LT survivors.

Aging, low fertility and household debt risk

Population aging is a typical feature of the change of population age structure in many developed countries at present, and the resulting family economic burden is an important factor causing debt risk. This paper uses the sample data of 33 economies of the Bank for International Settlements (BIS) from 1992 to 2021 to study the impact of population age structure on household debt risk and its mechanism. The study found that: First, The rising proportion of the elderly population and the elderly dependency ratio have significantly increased the household debt levels, Population aging can increase the risk of household debt by affecting the pension level, total factor productivity and worker share; second, After the economy has suffered from economic fluctuations, The impact of population aging on household debt risk has changed from nonsignificant to positively significant, Show that the economic crisis has reduced household income levels, It weakens the family's solvency; third, With the relatively sound social security system in developed economies, Higher levels of national income, As a result, the aging population has a weak effect on household debt risk. Fourth, human capital investment can alleviate the negative impact of population aging to a certain extent. The reason is that the improvement of education level will improve the living conditions of families and enhance residents' awareness of independent old-age security. The conclusions of this paper have important policy implications for deeply exploring the social consequences of aging economy and reasonably YESling the spillover of household debt risk.

Cumulative excess deaths in New Zealand in the COVID-19 era: biases from ignoring changes in population growth rates: comment

For measuring mortality and excess deaths, age standardised mortality has been an industry standard for centuries. Methods that acknowledge changes in population age structure should be used when assessing mortality.

SCLEROCHRONOLOGICAL EVIDENCE OF LIFE HISTORY AND AMBIENT TEMPERATURE FROM MODERN AND EARLY PLEISTOCENE GLYCYMERIS AMERICANA (MOLLUSCA:BIVALVIA) OF THE U.S. EASTERN SEABOARD

Abstract Growth-increment and isotopic studies of shells of the marine bivalve Glycymeris americana are a potential source of information bearing on its life history and preferred environment over the late Cenozoic on the U.S. eastern seaboard. We demonstrate that the ages of shells can be determined from growth bands and ontogenetic profiles of oxygen isotope (δ18O) composition, and that shell aragonite is deposited in oxygen isotopic equilibrium with seawater, enabling calculation of ambient temperatures by means of a generic transfer function. Modern specimens from North Carolina rarely reach the large size commonly attained by modern forms from Florida and Early Pleistocene forms from both states, and modern populations from North Carolina probably include fewer old individuals, the most certain disparity being with Early Pleistocene populations from the state. The temporal change in age structure in North Carolina may be an effect of recent scallop trawling but earlier non-anthropogenic environmental change cannot be ruled out as the cause. Maximum and minimum temperatures calculated from the δ18O profiles of Early Pleistocene shells indicate a larger seasonal range than now in both Florida and North Carolina, due to cooler winters. This may reflect greater southward penetration of cool northern waters, with transport along the shelf supplemented by upwelling of water brought south at depth.

THE TRANSFORMATION IN THE AGE STRUCTURE OF THE POPULATION OF UKRAINE IN THE YEARS 2001-2021: GENDER AND INTERREGIONAL ASPECTS

The territorial and gender differences of the transformational process in the age structure of the Ukrainian population during the 20-years’ period are analyzed in the article. The key factors and tendencies in age structure in various regions are determined. The comparative analysis of its changes among urban and country-side population is performed. The general tendency characterizing the age structure of the urban and country-side population of Ukraine is pointed out – that is the decrease in the share of the younger than active work force, and the increase in the share of the senior citizens. In the present-day structure of the urban population every fourth citizen represents the 60+ age group. The differences in the degree and intensity of aging of the rural and urban population are shown. The index of aging among urban population is much higher and makes 175,6% against 146,9% on the rural territory. The intensification of the process of demographic aging by gender is proven. In 2021, in the total number of population of Ukraine the share of men in the 60+ age group was 36,1%, while the share of women of the same age group was 63,9%. In the years 2001- 2021, the share of women at post-workable age grew to 29,5% of the total number of female population, and that of men grew to 19,3% of the total number of male population. The growth in the share of women and men at post-workable age in the urban area and its decline in the rural area are indicated. Interregional differences in the transformational process in the age structure of the Ukrainian population are defined. The smallest share of the citizens in post-workable age is observed in Volyn, Rivne, and Transcarpathean regions. The biggest share of the citizens in post-workable age is observed in Luhansk, Donetsk, Chernihiv, Sumy, Cherkasy, Zaporizhzhia, Kirovohrad, and Poltava regions. The chare of the workable age citizens is growing in 22 administrative units of Ukraine. The consequences of the transformation in the age structure of population are evaluated. The hypothesis has been proven that the age structure changes are correlated with the share of women at reproductive age, and demographic load. The decrease in the share of workable population was caused by the decrease in the share of women at reproductive age from 48,4% to 43,4%. In the years 2000 – 2021 the demographic load on the workable population grew mainly due to the older age group population (in 2021 the demographic load difference between children and the retired was 148 people). The demographic load on the workable population is 7,8% higher in the rural area than in the urban. The attention is drawn to the necessity of taking into consideration territorial peculiarities in the process of transformation in the population age structure when substantiating national programs and measures of active demographic policy. The regions of Ukraine characterized by low economic development are facing the biggest hardships in the adaptation process towards the changes of population age structure. Key words: transformation in the age structure of population, urban and rural population, demographic aging, demographic load.

Analysis of the global burden of cervical cancer in young women aged 15-44 years old.

Understanding the burden of cervical cancer (CC) in young women aged 15-44 years old are essential for formulating effective preventive strategies. Utilizing the Global Burden of Disease 2019 Study, we estimated incidence, disability-adjusted life-years (DALYs), years of life lost (YLLs) and years lived with disability (YLDs) due to CC among young women from 1990 to 2019. Additionally, we evaluated the temporal trends using estimated annual percentage changes (EAPCs) during this period. We conducted a decomposition analysis to assess the absolute contributions of three components: population growth, population age structure and epidemiologic changes. Globally, there were 187 609.22 incident cases of CC worldwide, resulting in 2621 917.39 DALYs in 2019. From1990 to 2019, the age-standardized rates were decline, only the age-standardized YLDs rate (EAPC = 0.02; 95% CI: -0.02 to 0.05) showed a stable trend. The largest increase in age-standardized incidence rate (ASIR) and age-standardized YLDs rate observed in the high-middle social demographic index (SDI) quintiles. Population growth and age structure changes were associated with substantial changes in cases of CC, especially in South Asia and East Asia. Globally, the burden of CC in young women continues to increase, as measured by the absolute number. As populations are growing and age structure changes were associated with substantial changes in cases of CC, governments will face increasing demand for treatment, and support services for CC, especially in South Asia and East Asia.

Demographic Dividend or Demographic Threat in Pakistan?

Population growth and size have remained the focus of debate for centuries but the recent demographic transition in developing countries has made social scientists take note of the changing age structure of the population as well. As a result of declining population growth and consequent changes in age structure, the proportion of working-age population is increasing in most developing countries. An associated decline in the dependent age population offers a window of opportunity, referred to as the ‘demographic dividend’. Pakistan is also going through the demographic transition, and is experiencing a once-in-a-lifetime demographic dividend as the working-age population bulges and the dependency ratio declines. This paper looks into the demographic dividend being offered to Pakistan and its implications for the country, mainly through three mechanisms: labour supply, savings, and human capital. For economic benefits to materialise, there is a need for policies dealing with education, public health, and those that promote labour market flexibility and provide incentives for investment and savings. On the contrary, if appropriate policies are not formulated, the demographic dividend might, in fact, be a cost, leading to unemployment and an unbearable strain on education, health, and old age security.

Fertility decline, changes in age structure, and the potential for demographic dividends: A global analysis

Fertility decline, changes in age structure, and the potential for demographic dividends: A global analysis

Changing landscape of diabetes in Asia - What are the unmet needs?

The incidence rates of type 2 diabetes among adults in Asia have been stable, but the rates in youth and young adults have increased. In territory-wide surveillance in Hong Kong, Special Administrative Region of People's Republic of China, all-cause mortality rates among people with diabetes have exhibited a declining trend in the past 15 years, with a narrowing in the mortality gap between people with and without diabetes. At the same time, the improvement in survival resulted in a changing age structure and disease profile of people with diabetes, towards an increasing proportion of older people with long diabetes duration and multi-morbidities. Reductions in event rates were not observed in the youngest age group who also had the least gains in risk factor control and uptake in organ protective drugs over time. A young age at diabetes diagnosis, associated with exposure to high glycemic burden from an early age, predicted higher risks of complications and premature mortality compared with later-onset of diabetes. People presenting with type 2 diabetes below 40 years of age were 5-fold more likely to die and their life expectancy was shortened by 8 years than age-matched counterparts without diabetes. Analysis of population-based data in Hong Kong Chinese identified hypertension followed by chronic kidney disease as the leading contributor to mortality in young people, indicating that efforts to optimize non-glycemic risk factors and organ protection are as important in young individuals as it is in the older population.

From Bonus to Onus: Taiwan’s Demographic Transition and Economic Development from 1950 to 2020

The driving force behind population change lies in fertility. Over the past 70 years, Taiwan has undergone a fertility transition, rapidly declining from a high peak of natural fertility levels to an ultralow rate. This transition has released a substantial labor force and lead to a significant shift in resource allocation, contributing to rapid economic development in the late 20th century. During the same period, Taiwan’s population aging has progressed faster than that of most countries worldwide. The dependency ratio has negatively impact economic development, making social security an important aspect of resource allocation. The changes in age structure have introduced the concepts of “demographic bonus” and “demographic onus”. As a vibrant economy with a population of over 23 million, Taiwan has enjoyed the demographic bonus for more than a quarter of a century but is now facing the challenges of an aging society and declining fertility rates towards demographic onus. This article examines demographic transitions, economic performance and development in Taiwan from 1950 to 2020, elaborating on the definition, criteria, and quantitative delineation of the demographic bonus and demographic onus. It utilized population and economic statistics for a comparative analysis of the historical evolution, current situation, and prospects of the bonus and onus periods in Taiwan, providing a comprehensive narrative of its historical and empirical developments. Finally, the study underscores the complexity of balancing economic growth with demographic sustainability, emphasizing the necessity for multiple policy adjustments to address the adverse effects of demographic transitions.

The Heterogeneous Impact of Changes in the Age Structure of China’s Elderly Population on Regional Economic Development

Abstract Currently, the impact of population aging on economic development is mainly explored from the dimension of time, ignoring the Heterogeneity between the two. In this paper, we start by measuring the regional economic development level index, use the entropy value method to solve the index weights, and calculate the regional economic development level index using the linear weighting method. The regional development level index is used as an explanatory variable to construct the baseline regression model and the dynamic panel model for the change in the age structure of the elderly population. The panel data of 31 provinces (cities/autonomous regions) in China are used as examples to explore the heterogeneous effects of age structure changes on regional economic development of the elderly population. The results show that when the age structure change of the elderly population increases by 1%, the regional economic development level rises by 0.782%, and the age structure change of the elderly population is positively and significantly affecting the quality of economic development in the central and western regions at the 1% level. The regression coefficient of population aging in the low level stage is 0.007. The effect on the regional economic development level is significantly positive at the 1%. The age structure change of the elderly population affects the regional economic development by mediating health consumption expenditure. The age structure change of the elderly population has Heterogeneity in regional economic development in terms of period, region, and level at different stages.

Quantitative morphological analysis of age structural changes in prostate of experimental animals with ethanol poisoning

Aim: To find out the age remodeling of the structural components of the prostate gland at alcohol poisoning using quantitative morphological analysis. Materials and Methods: The structure of the prostate gland of 4 white male rats groups were morphologically investigated. The 1 group included 30 control intact animals aged 8 months, the 2-nd group – 30 rats aged 24 months, the 3-rd group – 30 8-month-old animals with ethanol intoxication, and the 4-th group included 30 24-month-old rats with the specified simulated pathology. Ethanol intoxication was modeled by intragastric administration of 30% ethyl alcohol solution at a dose of 20 ml/kg once daily for 28 days. Rats were euthanized by bloodletting under general thiopental anesthesia 28 days after the beginning of the experiment. The area of glands, the height of glandular epithelial cells, the area of their nuclei and cytoplasm, the nuclear-cytoplasmic ratio in these cells and the stromal-parenchymal ratio in the organ were studied using light microscopy and were determined morphometrically. Morphometric parameters were processed statistically. Results: It was established that with age in the intact prostate of laboratory sexually mature white male rats, the area of glands, the height of glandular epitheliocytes, the area of their nuclei and cytoplasm, with the stability of nuclear-cytoplasmic ratios in the epithelial cells of the glands, significantly decreases, and the stromal-parenchymal ratio in the organ under study increases. Long-term ethanol poisoning leads to pronounced structural changes in the prostate, which is characterized by pronounced atrophy of the glandular epithelium, a decrease in the area of the glands, a decrease in the height of epithelial cells, a violation of nuclear-cytoplasmic relations in them, an increase in stromal-parenchymal ratio, and a prominent growth of the muscle-elastic stroma. The revealed structural changes of the studied components of the prostate dominated in 24-month-old experimental animals. Conclusions: Morphological analysis of the prostate gland established that morphometric and morphological changed significantly according to the age and were depend on the ethanol poisoning.

Age structure of the population and household consumption expenditure on tourism

Based on data from the China Family Tracking Survey (CFPS), this paper systematically analyzes the impact of family characteristics on family tourism consumption expenditure under the changing age structure of the population. It is found that an increase in the old-age dependency ratio has a significant inhibitory effect on household tourism consumption expenditures. It is further found that households' increased wage income, integration into new social media, and accumulation of health capital can weaken the inhibitory effect of aging on tourism consumption and strengthen the promotional effect of tourism consumption generated by an increase in the juvenile dependency ratio.