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17th November 2011 3pm, University of Southampton 58/1009
Michael Murphy, LSE Health/Department of Social Policy, London School of Economics and Political Science
At present, verall age standardised mortality rates (both sexes combined) are improving at a historically unprecedented rate of about 2.5% per annum in England and Wales, but estimates are heavily influenced by patterns at ages where deaths are concentrated. The latest official ONS/GAD projections assume that mortality improvement will decline by more than 50% to a value of 1.2% per annum in about 25 years time (ONS, 2011).
There are divergent views about how mortality trends may evolve. For example, Olshansky et al (2005, p. 1142) argue that as a result of the substantial rise in the prevalence of obesity and its life-shortening complications such as diabetes, life expectancy at birth and at older ages could level off or even decline in the first half of the 21st century. On the other hand, Christensen et al (2009, p. 1139) state that most babies born today in high life expectancy countries will live at least 100 years if trends over the past two centuries continues through the 21st century.
In 2005, just over 50% of deaths in England and Wales occurred between ages 65 and 85, 56% for men and 45% for women, people born in the period 1925 to 1945, birth cohorts frequently referred to as the ?Golden generations? Who have been identified as having experienced especially high rates of improvement in mortality (Dunnell, 2008). Current British official mortality projections assume that these cohorts will continue to enjoy such advantages in years to come up to the highest ages but that as these cohorts are replaced in the main mortality age groups by less favoured cohorts, rates of mortality improvement will decline to the much lower level in decades to come (ONS, 2011). The magnitude of such effects and possible reasons for and against the expectation that they will are persist in years to come include: differences in smoking patterns; better diet and environmental conditions during and after the Second World War; differing birth rates; the introduction in the late 1940s of the Welfare State; and medical advances.
An Age-Period-Cohort (APC) model is used to estimate the contribution of smoking-related mortality to cohort changes in adult mortality in Britain since 1950. Lung cancer and overall mortality can be satisfactorily modelled by a cohort relative risk and fixed age pattern. The results of the model suggest that smoking by itself can account for a substantial fraction of cohort mortality change for those born around the first half of the Twentieth century. In particular, smoking provides an explanation for the higher than average mortality improvement of the ?Golden generations?. These results are compared with those of the Peto-Lopez and Preston-Glei-Wilmoth models that also estimate the contribution of smoking-related to overall mortality using different approaches.
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