The Demography and Epidemiology of Human Health and Aging

1008 Pages·2012·8.68 MB·English

by  Jacob S. Siegel (auth.)

The Demography and Epidemiology
of Human Health and Aging

Jacob S. Siegel
The Demography and
Epidemiology of
Human Health and Aging
In consultation with S. Jay Olshansky
123
JacobS.Siegel
J.StuartSiegelDemographicServices
NicholsonLane5809
20852-5710NorthBethesda
Maryland
Unit808
USA
[email protected]
InConsultationwith
S.JayOlshansky
SchoolofPublicHealth
UniversityofIllinoisatChicago
WestTaylorStreet1603
60186ChicagoIllinois
Room885
USA
[email protected]
ISBN978-94-007-1314-7 e-ISBN978-94-007-1315-4
DOI10.1007/978-94-007-1315-4
SpringerDordrechtHeidelbergLondonNewYork
LibraryofCongressControlNumber:2011929938
(cid:2)c SpringerScience+BusinessMediaB.V.2012
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To Irv,Ronnie,and Daveandourparents

Preface and Acknowledgments
Health demography and its companion, the epidemiology of aging, are not well
definedfieldsamongthe academicareasof study.A subdisciplineof demography
labeled health demography has been identified and it essentially applies the
materials,methods,andperspectivesofdemographytothestudyofhealth.Health
demographyoverlaps greatly with the epidemiology of aging, and the distinction
mainly reflects the difference in the academic training of the analyst. This book
triestosetforththebasicmaterialsofthisareaofstudyandtogiveitmoreformal
definitionandscope.
Healthdemographyandtheepidemiologyofagingincorporatematerialsfroma
number of established disciplines, mainly sociology, demography, epidemiology,
public health, gerontology, and actuarial science, but also bioethics, genetics,
biostatistics,biology,medicine,geography,andcomputerscience.Althoughthelist
above is long, the natural home of the subject is in departments of gerontology,
demography, and epidemiology. The scope of the subject, as I envision it, is
suggestedbytheTableofContentsofthebook.ItisapparentthatIcovera broad
area.Thefield rangesfromthe highlytheoreticaltothe verypractical.Idealwith
the theories regarding human aging and longevity, derived from molecular and
evolutionary biology and biodemography, as well as with the issues involved in
theexpansionofhospitalfacilitiesinacitybylocalhealthadministrators,derived
fromapplieddemographyandspatialepidemiology.Iconsidertherangeoftheories
regarding the question of how long humans can live, and I consider the practical
problems of how to bring demographic and epidemiological methods, materials,
andperspectivestoservethehealthneedsoflocalcommunities.
Thebookdescribesthelatestsourcesofdataonmortalityandpopulationhealth
and presents the principal research findings based on these sources. It brings
together the latest methodsof measuring populationhealth phenomena,including
those for mortality, morbidity, and combinations of measures of mortality and
morbidity.In this connectionit considerssuch varied measuresas the manytypes
of life tables, the design of health surveys, and geographic information systems
for health research and administration. While maintaining a primary focus on the
demographicand epidemiologicalaspects of the subjects treated, the book covers
vii
viii PrefaceandAcknowledgments
socioeconomic variations in mortality and health, reproductive health, the health
determinants and consequences of migration, health policy and administration,
and selected bioethical issues. The measures described are often illustrated with
examplesin the form of calculationparadigms,so that the reader hasa modelfor
replicatingthe measures, andI suggestsoftwarepackagesforimplementingsome
ofthemoreelaboratemethodsdescribed.
The geographic scope of the text, the tabular material, and the references and
suggested readings relate to both the national and international area. The health
demographyofthelessdevelopedcountriesisgivenasubstantialshareofattention,
indeferencetothesizeanddistinctivecharacteroftheirpopulationsandtheextent
and complexity of their health problems. At the same time, primary attention is
giventothepopulationhealthoftheindustrializedcountries,especiallytheUnited
States,wheremostofthereadersofthisvolumeworkorwillworkasprofessional
demographers,gerontologists,orepidemiologists.Ifnoothergeographicreference
is given, the reader may assume that the area referred to is the United States.
Nevertheless,readersfromothercountriesandstudentsofinternationalcomparative
populationepidemiologywillfindmuchinitofinterestforthem.
Since this book is intended to be comprehensive and interdisciplinary, it can
be used as a text for courses taught in a broad range of scientific disciplines
relating to population health and the epidemiology of aging, and as a reference
workandhandbookfordemographers,epidemiologists,gerontologists,andpublic
healthspecialistswhoworkinthisarea.Thebookisofferedasatextforadvanced
undergraduate and graduate students in medical sociology, the demography and
epidemiologyofaging,healthdemography,andsocialgerontology,andassupple-
mentaryreadingin the instructionalprogramsof these disciplines.It should serve
the needs of the many instructors who prefer a single integrated comprehensive
text in the area of health demographyfor use in their courses. There is sufficient
materialforatwo-semestercourse,butwithselectiveomissions,itcanbeadapted
foruseinaone-semestercourse.Forshorterandlessadvancedstudyofthesubject,
suchsectionsofthebookmaybeomittedasthoseonmortalitymodelsinChap.3,
multistate life tables in Chap. 8, and the methods of preparing local population
estimatesinChap.16,andChaps.12and17.
Inasmuch as human aging/longevity is the subject of study, the reader may
look for material on the characteristics of various health conditions, the risks of
succumbing to them, and ways of treating them, even specific recommendations
forhowtoovercomethem.Thisbookisconcernedwiththeprevalenceofdiseases
andtherisksassociatedwithvarioushealthconditions,butitisnotahow-to-do-it
handbookfortreatingspecificillnessesorforachievingalonglife.Itdoes,however,
describetheresearchrelatingtolongevity/agingandsoimplicitlyitprovidesgeneral
guidelinesforextendinghumanlongevity.
Readersmaynotetheabsenceofmeasuresofreliabilityorstatisticalsignificance.
Although much is said qualitatively about the accuracy of the underlying data,
discussion and presentation of measures of statistical significance are omitted,
partlyintheinterestsofsimplifyingthewritingandtabularpresentation.Computer
software for calculatingmany of the measures in this book includethe associated
measuresofsignificance.
PrefaceandAcknowledgments ix
It is always a matter of great interest and concern to the prospective reader
to ascertain what prior technical preparation is required to take most advantage
of a book of this kind. Training in some areas is essential, training in others in
advisable, and training in still other areas is helpful. Training is essential in the
fundamentals of statistics, and in mathematics up to the equivalent of a basic
course in mathematical analysis. Courses in demographic techniques and social
researchmethodsareadvisablebutnotessential,andabasiccourseinepidemiology,
biostatistics, or medical sociology is helpful. A course in biostatistics provides
a strong background for some of the topics treated here. Much of the material
“needed”iscoveredinthisverybook,however,sinceitisintendedtobearelatively
free-standingandself-containedtext.
WhileIhavetriedtomakethisbookrathercomprehensiveinitsfield,itprovides
only an introduction to many topics. Other related works that will extend the
knowledgeofthereaderontopicsbasictothesubjectmatterofthisvolumeinclude:
JacobS.Siegel&DavidA.Swanson(Eds.),Methodsandmaterialsofdemography
(2nded. Elsevier/AcademicPress, 2004):Providesa comprehensivediscussionof
thebasictechniquesofdemographicanalysis.
RichardG.Rogers,RobertA.Hummer,&CharlesB.Nam,Livinganddyinginthe
United States(AcademicPress, 2000):Givesa comprehensivepresentationof the
socialandeconomicdifferentialsin adultmortalityintheUnitedStatesattheend
ofthe20thcentury.
S. Jay Olshansky and Bruce A. Carnes, The Quest for Immortality (W.W. Norton
andCompany,2001):Presentsahighlyreadablediscussionofthefactsandfictions
regardinglongevity.
Louis G. Pol and Richard K. Thomas, The Demography of Health and Health
Care (Second Edition, Kluwer Academic Publishers, Norwall, MA, 2000):
Focuseson appliedhealth demographyand providesadditionalmaterialon health
geodemography.
LeonGordis,Epidemiology(ThirdEdition,Philadelphia:ElsevierSaunders,2004).
StantonA.GlantzPrimerofBiostatistics(SixthEdition.NewYork:McGraw-Hill,
2007).
Thesebookscanbereferredtoforfurtherdiscussionofthetoolsofdemography,the
methods of epidemiologicalanalysis, and the basic issues of “longevity science.”
I cover many of the same topics, but bring them together under one cover as an
integrated,continuousnarrative,evenifinlessdetailedfashion.
Intheinterestofexpeditingthepublicationofthebook,Idrewonsomematerial
that I previously authored and that was published by Elsevier/Academic Press,
to whom I express my thanks. The publications of the U.S. Census Bureau, the
PopulationReferenceBureau,theWorldBank,theWorldHealthOrganization,and
theUnitedNationshavebeenespeciallyhelpfulasdocumentationformanyofthe
topicscoveredinthisbookandIgratefullyacknowledgemyuseofthemalso.
In the preparation of this work, I was fortunate in being able to consult with
S. Jay Olshansky, Professor of Epidemiology and Biostatistics, School of Public