Modeling and Forecasting Mortality With Economic Growth: A Multipopulation Approach

Managing Mortality and Aging Risks with a Time-Varying Lee-Carter Model

Influential existing research has suggested that rather than being static, mortality declines decelerate at young ages and accelerate at old ages. Without accounting for this feature, the forecast mortality rates of the popular Lee-Carter (LC) model are less reliable in the long run. To provide more accurate mortality forecasting, we introduce a time-varying coefficients extension of the LC model by adopting the effective kernel methods. With two frequently used kernel functions, Epanechnikov (LC-E) and Gaussian (LC-G), we demonstrate that the proposed extension is easy to implement, incorporates the rotating patterns of mortality decline and is straightforwardly extensible to multi-population cases. Using a large sample of 15 countries over 1950-2019, we show that LC-E and LC-G, as well as their multi-population counterparts, can consistently improve the forecasting accuracy of the competing LC and Li-Lee models in both single- and multi-population scenarios.

Estimation of economic, environmental, and social efficiency for sustainable development in G-8 and SAARC countries: a data envelopment analysis

In the recent era, economic growth is not enough to represent sustainable development. Sustainable development has three dimensions (i.e., economic, social, and environment). This study estimated the economic, social, and environmental efficiency using data from 2000 to 2021. Input-oriented data envelopment analysis shows strong heterogeneity across developed (G-8) and developing countries (SAARC). There is a potential to increase economic and environmental efficiency in the G-8 and SAARC countries. The average economic efficiencies are 0.682 and 0.414, which implies the possibility of the same output (GDP/capita) by using 31.8% and 58.6% fewer inputs in G-8 and SAARC countries, respectively. The social efficiency score is more than 0.980 in both panels. The average environmental efficiencies are 0.712 and 0.724, which implies that selected countries can obtain the same output (CO₂ emission reduction) by using 28.8% and 27.6% fewer inputs in G-8 and SAARC countries, respectively. The top three economically efficient countries are (a) the USA, the UK, and Japan in the G-8 panel and (b) Maldives, Sri Lanka, and Pakistan in the SAARC panel. The top three environmentally efficient countries are (a) France, the UK, and Italy in the G-8 panel and (b) Afghanistan, Nepal, and Bangladesh in the SAARC panel. It is recommended to adopt suitable policies to reduce emission, minimize waste, efficient utilization of resources, increase forest cover, and incentive for clean technologies. It is suggested to promote renewable energy through the provision of micro-credit to the poor, subsidizing renewable energy technologies, implementation of stringent environmental policies, and increasing awareness. It is essential to invest in eco-friendly and innovative technologies; thus, the government should encourage green practices in production. Human development is recommended to increase the living standard and healthy life. The government should invest in the health system and conduct seminars on general health awareness. Investment in basic infrastructure (drinking water, sanitation, and clean fuel) is essential to increase the living standard. The G-8 countries should provide financial and technological help to the SAARC countries.

Politics and health outcomes: A path analytic approach

Social and health policies and political participation are associated with each political tradition related to public health outcomes. However, there is a lack of evidence for the relationship between policy and outcomes. This study seeks to determine the relationship between politics, labour and welfare state indicators, economic inequality, and health outcome indicators. Data to test the model was obtained from the Turkish Statistical Institute (TurkStat) that belongs to the 81 provinces of Turkey. Path analysis was used to model the associations between policy, labour and welfare states, economic inequality, and health outcomes. To test the goodness of fit of the model, multiple criteria of model fit indices were utilised. The fit of the respecified path analytic model data is good (normed fit index [NFI] is 0.91, comparative fit index [CFI] is 0.92, goodness of fit index [GFI] is 0.91, and adjusted goodness of fit index [AGFI] is 0.93). Study results illustrate a strong relationship between voter partisanship, employment rate, satisfaction from both social security and health services, and life expectancy at birth and mortality. These results represent an important step towards understanding the elusive relationship between policy and health outcomes. Designing socially inclusive policies, considering labour market opportunities, and enhancing the population's well-being are advisable strategies for policymakers who wish to optimise public health outcomes.

Do Death Certificates Underestimate the Burden of Rare Diseases? The Example of Systemic Lupus Erythematosus Mortality, Sweden, 2001-2013

OBJECTIVES

Mortality due to rare diseases, which are substantial sources of premature mortality, is underreported in mortality studies. The objective of this study was to determine the completeness of reporting systemic lupus erythematosus (SLE) as a cause of death.

METHODS

In 2017, we linked data on a Swedish population-based cohort (the Swedish Lupus Linkage, 2001-2013) comprising people with SLE (n = 8560) and their matched general population comparators (n = 37 717) to data from the Cause of Death Register. We reviewed death records of deceased people from the cohort (n = 5110) and extracted data on patient demographic characteristics and causes of death. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for not reporting SLE as a cause of death by using multivariable-adjusted logistic regression models.

RESULTS

Of 1802 deaths among SLE patients in the study, 1071 (59%) did not have SLE reported on their death records. Most SLE decedents were aged 75-84 at death (n = 584, 32%), female (n = 1462, 81%), and born in Nordic countries (n = 1730, 96%). Decedents aged ≥85 at death were more likely to have SLE not reported on their death records than were decedents aged <50 (OR = 2.34; 95% CI, 1.48-3.68). Having renal failure listed as a cause of death decreased the likelihood of SLE not being reported on the death record (OR = 0.54; 95% CI, 0.40-0.73), whereas having cancer listed as a cause of death increased this likelihood (OR = 2.39; 95% CI, 1.85-3.07).

CONCLUSIONS

SLE was greatly underreported as a cause of mortality on death records of SLE patients, particularly in older decedents and those with cancer, thereby underestimating the true burden of this disease. Public health resources need to focus on improving the recording of rare diseases in order to enhance the epidemiological utility of mortality data.

Do Death Certificates Underestimate the Burden of Rare Diseases? The Example of Systemic Lupus Erythematosus Mortality, Sweden, 2001-2013

OBJECTIVES

Mortality due to rare diseases, which are substantial sources of premature mortality, is underreported in mortality studies. The objective of this study was to determine the completeness of reporting systemic lupus erythematosus (SLE) as a cause of death.

METHODS

In 2017, we linked data on a Swedish population-based cohort (the Swedish Lupus Linkage, 2001-2013) comprising people with SLE (n = 8560) and their matched general population comparators (n = 37 717) to data from the Cause of Death Register. We reviewed death records of deceased people from the cohort (n = 5110) and extracted data on patient demographic characteristics and causes of death. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for not reporting SLE as a cause of death by using multivariable-adjusted logistic regression models.

RESULTS

Of 1802 deaths among SLE patients in the study, 1071 (59%) did not have SLE reported on their death records. Most SLE decedents were aged 75-84 at death (n = 584, 32%), female (n = 1462, 81%), and born in Nordic countries (n = 1730, 96%). Decedents aged ≥85 at death were more likely to have SLE not reported on their death records than were decedents aged <50 (OR = 2.34; 95% CI, 1.48-3.68). Having renal failure listed as a cause of death decreased the likelihood of SLE not being reported on the death record (OR = 0.54; 95% CI, 0.40-0.73), whereas having cancer listed as a cause of death increased this likelihood (OR = 2.39; 95% CI, 1.85-3.07).

CONCLUSIONS

SLE was greatly underreported as a cause of mortality on death records of SLE patients, particularly in older decedents and those with cancer, thereby underestimating the true burden of this disease. Public health resources need to focus on improving the recording of rare diseases in order to enhance the epidemiological utility of mortality data.