Estimation of confidence intervals for decompositions and other complex demographic estimators.

BACKGROUND: While the use of standard errors and confidence intervals is common in regression-based studies in the population sciences, it is far less common in studies using formal demographic measures and methods, including demographic decompositions. OBJECTIVE: This article describes and provides explicit instructions for using four different approaches for computing standard errors for complex demographic estimators. METHODS: Standard errors for Arriaga's decomposition of life expectancy differences are computed using the delta method, the Poisson bootstrap, the binomial bootstrap, and the Monte Carlo approaches. The methods are demonstrated using a 50% sample of vital statistics data on age-specific mortality among urban women in the Pacific region of the United States in 1990 and 2019. RESULTS: All four methods for computing standard errors returned similar estimates, with the delta method, Poisson bootstrap, and Monte Carlo approaches being the most consistent. The Monte Carlo approach is recommended for general use, while the delta method is recommended for specific cases. CONTRIBUTION: This study documents multiple ways of estimating statistical uncertainty for complex demographic estimators and describes in detail how to apply these various methods to nearly any rate-based demographic measure. It also provides advice on when the use of standard errors is and is not appropriate in demographic studies. Explicit formulae for computing standard errors for Arriaga's decomposition using the delta method approach are derived.

Proximate Sources of Change in Trajectories of First Marriage in the United States, 1960-2010.

This study examines proximate sources of change in first-marriage trajectories in the United States between 1960 and 2010. This was a period of tremendous social change: divorce became more common, people started marrying later or not marrying at all, innovations in medicine and changes in social and behavioral factors led to reduced mortality, inequality grew stronger and was reflected by more intense assortative mating, and the country underwent a massive educational expansion. Each of these factors influenced the formation and dissolution of first marriages over this period. This article extends the multiple-decrement life table to incorporate heterogeneity and assortative mating, which allows the quantification of how changes in the incidence of marriage, divorce, and mortality, along with changes in educational attainment and assortative mating, have shaped trends in first-marriage trajectories. The model is used to prove that stronger educational assortative mating leads to longer average durations of first marriage. Using data from multiple sources and this model, this study shows that although the incidence of divorce was the primary determinant of changes in first-marriage trajectories between 1960 and 1980, it has played a relatively smaller role in driving change in marital trajectories between 1980 and 2010. Instead, factors such as later age at first marriage, educational expansion, declining mortality, narrowing sex differences in mortality, and more intense educational assortative mating have been the major drivers of changes in first-marriage trajectories since 1980.

Trends in Education-Specific Life Expectancy, Data Quality, and Shifting Education Distributions: A Note on Recent Research.

Several recent articles have reported conflicting conclusions about educational differences in life expectancy, and this is partly due to the use of unreliable data subject to a numerator-denominator bias previously reported as ranging from 20 % to 40 %. This article presents estimates of life expectancy and lifespan variation by education in the United States using more reliable data from the National Health Interview Survey. Contrary to prior conclusions in the literature, I find that life expectancy increased or stagnated since 1990 among all education-race-sex groups except for non-Hispanic white women with less than a high school education; there has been a robust increase in life expectancy among white high school graduates and a smaller increase among black female high school graduates; lifespan variation did not increase appreciably among high school graduates; and lifespan variation plays a very limited role in explaining educational gradients in mortality. I also discuss the key role that educational expansion may play in driving future changes in mortality gradients. Because of shifting education distributions, within an education-specific synthetic cohort, older age groups are less negatively selected than younger age groups. We could thus expect a greater concentration of mortality at younger ages among people with a high school education or less, which would be reflected in increasing lifespan variability for this group. Future studies of educational gradients in mortality should use more reliable data and should be mindful of the effects of shifting education distributions.

Health among Black children by maternal and child nativity.

OBJECTIVES: We examined 5 health outcomes among Black children born to US-born and foreign-born mothers and whether differences by mother's region of birth could be explained by maternal duration of US residence, child's place of birth, and familial sociodemographic characteristics. METHODS: Data were from the 2000-2011 National Health Interview Surveys. We examined 3 groups of children, based on mother's region of birth: US origin, African origin, and Latin American or Caribbean origin. We estimated multivariate regression models. RESULTS: Children of foreign-born mothers were healthier across all 5 outcomes than were children of US-born mothers. Among children of foreign-born mothers, US-born children performed worse on all health outcomes than children born abroad. African-origin children had the most favorable health profile. Longer duration of US residence among foreign-born mothers was associated with poorer child health. Maternal educational attainment and other sociodemographic characteristics did little to explain these differences. CONCLUSIONS: Further studies are needed to understand the role of selective migration and the behavioral, cultural, socioeconomic, and contextual origins of the health advantage of Black children of foreign-born mothers.

Inequalities in life expectancy and cardiometabolic disease mortality across and within high-income countries.

Cardiometabolic disease is a leading cause of death and plays a key role in recent life expectancy trends worldwide. We highlight inequalities in cardiometabolic disease mortality across sex, race/ethnicity, geographic region, and urbanicity within the United States, as well as across high-income countries.

Smoking and the widening inequality in life expectancy between metropolitan and nonmetropolitan areas of the United States.

Background: Geographic inequality in US mortality has increased rapidly over the last 25 years, particularly between metropolitan and nonmetropolitan areas. These gaps are sizeable and rival life expectancy differences between the US and other high-income countries. This study determines the contribution of smoking, a key contributor to premature mortality in the US, to geographic inequality in mortality over the past quarter century. Methods: We used death certificate and census data covering the entire US population aged 50+ between Jan 1, 1990 and Dec 31, 2019. We categorized counties into 40 geographic areas cross-classified by region and metropolitan category. We estimated life expectancy at age 50 and the index of dissimilarity for mortality, a measure of inequality in mortality, with and without smoking for these areas in 1990-1992 and 2017-2019. We estimated the changes in life expectancy levels and percent change in inequality in mortality due to smoking between these periods. Results: We find that the gap in life expectany between metros and nonmetros increased by 2.17 years for men and 2.77 years for women. Changes in smoking-related deaths are responsible for 19% and 22% of those increases, respectively. Among the 40 geographic areas, increases in life expectancy driven by changes in smoking ranged from 0.91 to 2.34 years for men while, for women, smoking-related changes ranged from a 0.61-year decline to a 0.45-year improvement. The most favorable trends in years of life lost to smoking tended to be concentrated in large central metros in the South and Midwest, while the least favorable trends occurred in nonmetros in these same regions. Smoking contributed to increases in mortality inequality for men aged 70+, with the contribution ranging from 8 to 24%, and for women aged 50-84, ranging from 14 to 44%. Conclusions: Mortality attributable to smoking is declining fastest in large cities and coastal areas and more slowly in nonmetropolitan areas of the US. Increasing geographic inequalities in mortality are partly due to these geographic divergences in smoking patterns over the past several decades. Policies addressing smoking in non-metropolitan areas may reduce geographic inequality in mortality and contribute to future gains in life expectancy.

Immigration and improvements in American life expectancy.

Despite the immigrant mortality advantage and the increasing share of the population born abroad, relatively little is known about how immigration has impacted trends in US life expectancy. How immigrants contribute to national life expectancy trends is of increasing interest, particularly in the context of an unprecedented stagnation in American mortality. We find that immigration increases US life expectancy by 1.5 years for men and 1.4 years for women. Over half of these contributions occur at the prime working ages of 25-64. The difference between foreign-born and US-born mortality has grown substantially since 1990, with the ratio of US-born to foreign-born mortality rates nearly doubling by 2017. In that year, foreign-born life expectancy reached 81.4 and 85.7 years for men and women, respectively-7.0 and 6.2 years higher than their US-origin counterparts. These life expectancy levels are remarkable by most standards. Foreign-born male life expectancy exceeds that of Swiss men, the world leaders in male life expectancy. Life expectancy for foreign-born women is close to that of Japanese women, the world leaders in female life expectancy. The widening mortality difference between the US-born and foreign-born populations, coupled with an increase in the share of the population born abroad, has been responsible for much of the increase in national life expectancy in recent years. Between 2007 and 2017, foreign-born men and women were responsible for 44% and 60% of national life expectancy improvements. Between 2010 and 2017, immigrants experienced gains while the US-born experienced declines in life expectancy. Thus, nearly all of the post-2010 mortality stagnation is due to adverse trends among the US-born. Without immigrants and their children, national life expectancy in 2017 would be reduced to its 2003 levels. These findings demonstrate that immigration acts to bolster American life expectancy, with particularly valuable contributions at the prime working ages.

The implications of changing education distributions for life expectancy gradients.

Recent research has proposed that shifting education distributions across cohorts are influencing estimates of educational gradients in mortality. We use data from the United States and Finland covering four decades to explore this assertion. We base our analysis around our new finding: a negative logarithmic relationship between relative education and relative mortality. This relationship holds across multiple age groups, both sexes, two very different countries, and time periods spanning four decades. The inequality parameters from this model indicate increasing relative mortality differentials over time. We use these findings to develop a method that allows us to compute life expectancy for any given segment of the education distribution (e.g., education quintiles). We apply this method to Finnish and American data to compute life expectancy gradients that are adjusted for changes in the education distribution. In Finland, these distribution-adjusted education differentials in life expectancy between the top and bottom education quintiles have increased by two years for men, and remained stable for women between 1971 and 2010. Similar distribution-adjusted estimates for the U.S. suggest that educational disparities in life expectancy increased by 3.3 years for non-Hispanic white men and 3.0 years for non-Hispanic white women between the 1980s and 2000s. For men and women, respectively, these differentials between the top and bottom education quintiles are smaller than the differentials between the top and bottom education categories by 18% and 39% in the U.S. and by 39% and 100% in Finland. Had the relative inequality parameters of mortality governing the Finnish and U.S. populations remained constant at their earliest period values, the difference in life expectancy between the top and bottom education quintiles would - because of overall mortality reductions - have declined moderately. The findings suggest that educational expansion may bias estimates of trends in educational differences in life expectancy upwards.

Rising geographic inequality in mortality in the United States.

OBJECTIVES: To examine trends in inequality in life expectancy and age-specific death rates across 40 US spatial units from 1990 to 2016. METHODS: We use multiple cause-of-death data from vital statistics to estimate measures of inequality in mortality across metropolitan status and geographic region. We consider trends for 5-year age intervals and examine inequality in cause-specific mortality. RESULTS: For both sexes, spatial inequality in life expectancy and all-cause mortality above age 25 rose between 2002-04 and 2014-16. During this period, the standard deviation in life expectancy at birth increased by 19% for males and by 44% for females. Areas that had higher life expectancy at the beginning of the period enjoyed larger gains in life expectancy. Especially noteworthy are divergent trends between large central metropolitan areas on the coasts and non-metropolitan areas in Appalachia and the South. Spatial inequality in mortality from lung cancer/respiratory diseases rose substantially, particularly for older women. Spatial inequality in mortality from the combination of drug overdose, alcohol use, and suicide increased at ages 30-34, but declined at ages 50-54 and 70-74. Inequality in mortality from circulatory diseases, the largest cause of death, grew for some groups, particularly 30-34 year-old women. Mortality from screenable cancers, an indicator of the performance of medical systems, showed relatively little spatial disparity during the period. CONCLUSIONS: Spatial inequality in life expectancy at birth and adult mortality has increased in recent decades.

Recent trends in life expectancy across high income countries: retrospective observational study.

OBJECTIVES: To assess whether declines in life expectancy occurred across high income countries during 2014-16, to identify the causes of death contributing to these declines, and to examine the extent to which these declines were driven by shared or differing factors across countries. DESIGN: Demographic analysis using aggregated data. SETTING: Vital statistics systems of 18 member countries of the Organisation for Economic Co-operation and Development. PARTICIPANTS: 18 countries with high quality all cause and cause specific mortality data available in 2014-16. MAIN OUTCOME MEASURES: Life expectancy at birth, 0-65 years, and 65 or more years and cause of death contributions to changes in life expectancy at birth. RESULTS: The majority of high income countries in the study experienced declines in life expectancy during 2014-15; of the 18 countries, 12 experienced declines in life expectancy among women and 11 experienced declines in life expectancy among men. The average decline was 0.21 years for women and 0.18 years for men. In most countries experiencing declines in life expectancy, these declines were predominantly driven by trends in older age (≥65 years) mortality and in deaths related to respiratory disease, cardiovascular disease, nervous system disease, and mental disorders. In the United States, declines in life expectancy were more concentrated at younger ages (0-65 years), and drug overdose and other external causes of death played important roles in driving these declines. CONCLUSIONS: Most of the countries that experienced declines in life expectancy during 2014-15 experienced robust gains in life expectancy during 2015-16 that more than compensated for the declines. However, the United Kingdom and the United States appear to be experiencing stagnating or continued declines in life expectancy, raising questions about future trends in these countries.

Globalization and Contemporary Fertility Convergence.

The rise of the global network of nation-states has precipitated social transformations throughout the world. This article examines the role of political and economic globalization in driving fertility convergence across countries between 1965 and 2009. While past research has typically conceptualized fertility change as a country-level process, this study instead employs a theoretical and methodological framework that examines differences in fertility between pairs of countries over time. Convergence in fertility between pairs of countries is hypothesized to result from increased cross-country connectedness and cross-national transmission of fertility-related schemas. I investigate the impact of various cross-country ties, including ties through bilateral trade, intergovernmental organizations, and regional trade blocs, on fertility convergence. I find that globalization acts as a form of social interaction to produce fertility convergence. There is significant heterogeneity in the effects of different cross-country ties. In particular, trade with rich model countries, joint participation in the UN and UNESCO, and joining a free trade agreement all contribute to fertility convergence between countries. Whereas the prevailing focus in fertility research has been on factors producing fertility declines, this analysis highlights specific mechanisms-trade and connectedness through organizations-leading to greater similarity in fertility across countries. Globalization is a process that propels the spread of culturally laden goods and schemas impinging on fertility, which in turn produces fertility convergence.

Trends in U.S. life expectancy gradients: the role of changing educational composition.

BACKGROUND: I examined age patterns and the role of shifting educational distributions in driving trends in educational gradients in life expectancy among non-Hispanic Whites between 1991 and 2005. METHODS: Data were from the 1986-2004 National Health Interview Survey with mortality follow-up through 2006. Life expectancies were computed by sex, period and education. Age decompositions of life expectancy gradients and composition-adjusted life expectancies were computed to account for age patterns and shifting educational distributions. RESULTS: Life expectancy at age 25 among White men increased for all education groups, decreased among the least-educated White women and increased among White women with college degrees. Much of the decline in measured life expectancy for White women with less than a high school education comes from the 85+ age group. Educational gradients in life expectancy widened for White men and women. One-third of the gradient is due to ages below 50. Approximately 26% (0.7 years) and 87% (0.8 years) of the widening of the gradient in life expectancy between ages 25 and 85 for White women and men is attributable to shifting education distributions. Over half of the decline in temporary life expectancy among the least-educated White women is due to compositional change. CONCLUSIONS: Life expectancy has increased among White men for all education groups and has decreased among White women with less than a high school education, though not to the extent reported in previous studies. The fact that a large proportion of the change in education-specific life expectancy among women is due to the 85+ age group suggests changes in institutionalization may be affecting estimates. Much of the change in education-specific life expectancy and the growth in the educational gradient in life expectancy is due to the shifting distribution of individuals across education categories.

IS THERE CONVERGENCE ACROSS COUNTRIES? A SPATIAL APPROACH.

We analyze convergence across countries over the last half century as a result of globalizing forces. Drawing on theories of modernization, dependency, the world-system, political trade blocs, and the world-society, we consider economic, demographic, knowledge, financial, and political dimensions of convergence. Using a new methodology, we calculate the minimum volume ellipsoid encompassing different groupings of countries, finding that during the 1960-2009 period, countries have not evolved significantly closer or similar to one another, although groups of countries based on their core-periphery status or membership in trade blocs exhibit increasing internal convergence and divergence between one another.