Now showing 1 - 10 of 20
PublicationChild mortality differentials in Sudan(1981-08-01) Preston, Samuel; Preston, SamuelSudan presents an excellent opportunity for studying mortality conditions in poor countries. It is one of the 25 "least developed" countries by U.N. designation, most of whom have very little information on mortality and general health conditions. As the largest African country in area, Sudan is also a land of rich ecological contrast, stretching from desert areas in the North through savannah areas to dense equatorial jungle in the South. The northern portions are Arabic and Islamic, the southern portions black African. The 1955/56 census enumerated 597 tribes speaking some 115 languages. Aridity in the North and swamps in the South have retarded the development of these areas and fostered nomadism, population concentration is greatest in the middle belt and particularly along the Nile and its tributaries. This paper has since been published as: "Child Mortality Differentials in Sudan," by Abdul-Aziz Farah; Samuel H. Preston in, Population and Development Review, Vol. 8, No. 2. (Jun., 1982), pp. 365-383. http://links.jstor.org/sici?sici=0098-7921%28198206%298%3A2%3C365%3ACMDIS%3E2.0.CO%3B2-4 PublicationEffects of Age Misreporting on Mortality Estimates at Older Ages(1997-09-01) Preston, Samuel H.; Elo, Irma T.; Preston, Samuel H.; Elo, Irma T.; Stewart, QuincyThis study examines how age misreporting typically affects estimates of mortality at older ages. We investigate the effects of three patterns of age misreporting & age overstatement, age understatement, and symmetric age misreporting & on mortality estimates at ages 40 and above. We consider five methods to estimate mortality: conventional estimates derived from vital statistics and censuses; longitudinal studies where age is identified at baseline; variable-r procedures based on age distributions of the population; variable-r procedures based on age distributions of deaths; and extinct generation methods. For each of the age misreporting patterns and each of the methods of mortality estimation, we find that age misstatement biases mortality estimates downwards at the oldest ages. Publication1994-95 Advisory Council on Social Security Technical Panel on Assumptions and Methods Final Report(1996) Young, Howard; Allen, Barry; Crimmins, Eileen; Cutler, David; Holmer, Martin; Manunovich, Diane; Preston, Samuel H.; Preston, Samuel H.; Steuerle, Eugene; Sze, Michael; Utgoff, Kathleen; Wiltse, Larry; Wolfe, BarbaraThe Panel's major conclusions are: The "intermediate" projection of the Trustees Report for the Old-Age. Survivors. and Disability Insurance (OASDI) program provide a reasonable evaluation of the financial status. Although the Panel suggests that modifications be considered in various specific assumptions, the overall effect of those suggestions would not significantly change the financial status evaluation. There should be evolutionary implementation of procedures to indicate more adequately the uncertainties involved in the projections. Even though such uncertainties are unavoidable, stochastic analysis should be used to examine more explicitly the probabilities of alternative projections. It is emphasized that there should be an extended period during which the new procedures would supplement, rather than replace, the current methods of considering high-cost and low-cost projections and individual assumption sensitivity analysis. Evaluation of the long-range financial status should put less emphasis on the "75-year actuarial balance" and the "test of long-range close actuarial balance." Prior to enactment of legislation reforming the program, primary emphasis should be on the projected date the Trust Fund Ratio would fall below 100 percent; when definitive legislative revisions are adopted, subsequent long-range evaluation should compare up-dated projections with the intended results of the legislation. There should be a substantial expansion of SSA's resources and its interaction with experts in related areas: increased recognition should be given to the interrelationships between OASDI and many public and private programs as well as other aspects of the economy. Social Security Administration (SSA) staff does high quality work, but is relatively small and works with inadequate resources. In addition to internal expansion, there should be greater use of outside consultants and contractual research; periodic comprehensive review by technical panels should be supplemented by ongoing arrangements for advice on specific matters. PublicationUsing Successive Censuses to Reconstruct the African-American Population, 1930-1990(1996-12-01) Preston, Samuel H.; Elo, Irma T.; Preston, Samuel H.; Elo, Irma T.; Gale, LynnThe Census Bureau's program to estimate the completeness of decennial census counts for age, sex, and race groups relies principally upon what it terms "demographic analysis." The essence of this approach is to introduce extraneous information on the number of births, deaths, and migrations, derived from non-census sources, to estimate the true size of each birth cohort at the time of a census (Robinson et al., 1993; Himes and Clogg, 1992). Comparison of this alternative estimate to the census count provides an estimate of the degree of under - or over-enumeration in the census, often termed the census undercount. Acceptance of the estimated undercount implies that the census itself is irrelevant to estimating the true size of the population; whatever deficiencies it contained would be accurately and completely revealed by comparison to the estimate based on demographic analysis. PublicationLow Life Expectancy in the United States: Is the Health Care System at Fault?(2010-01-01) Preston, Samuel HY; Ho, Jessica Y; Preston, Samuel HY; Ho, Jessica YLife expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system. PublicationConsistency of Age Reporting on Death Certificates and Social Security Administration Records Among Elderly African-American Decedents(1995) Elo, Irma T.; Preston, Samuel H.; Elo, Irma T.; Preston, Samuel H.; Rosenwaike, Ira; Hill, Mark E.; Cheney, Timothy P.This paper investigates the quality of age reporting in vital statistics and Social Security/Medicare data among elderly African-Americans. The authors examine whether the death certificate or Social Security age is more likely to reflect accurately the decedents' true age at death by matching their sample to the US Censuses of 1900, 1910 and 1920, and identify factors associated with consistency of age reporting on death certificates and social security records. The results reveal significant discrepancies in age at death data. Birth record availability and literacy were identified as key predictors of age agreement. The match to an early-life census record showed greater agreement with Social Security age than with death certificate age at death. The results have implications for the collection of age information in surveys of elderly African-Americans. PublicationAre Educational Differentials in Mortality Increasing in the United States?(1994-08-01) Preston, Samuel H.; Elo, Irma T.; Preston, Samuel H.; Elo, Irma T.Because of the value that individuals place on health and longevity, levels of mortality are among the most central indicators of social and economic well-being. Analysts are concerned not only with the average level of mortality but also with its distribution among social groups, which is a fundamental indicator of social inequality. The principal dimension on which these assessments are now made in the United States is educational attainment. The decisive shift from occupational groups, the classic dimension used by the Registrar-General of England and Wales, to educational groups as the basis for assessment occurred with the publication of Kitagawa and Hauser's (1973) major study of American mortality differentials in 1960. Educational attainment has two main advantages relative to occupation and income, the other common indicators of social stratification. It is available for people who are not in the labor force; and its value is less influenced by health problems that develop in adulthood. Since health problems can lead to both high mortality and low income, comparisons of death rates of different income groups, for example, are biased by their mutual dependence on a third variable, the extent of ill health. For these reasons, educational attainment has become the principal social variable used in epidemiology as well as in demography (Liberatos et al. 1988). PublicationSex Mortality Differentials in the United States: The Role of Cohort Smoking Patterns(2005-02-01) Preston, Samuel; Preston, Samuel; Wang, HaidongThis paper demonstrates that, over the period 1948-2003, sex differentials in mortality in the age range 50-54 to 85+ widened and then narrowed on a cohort rather than on a period basis. The cohort with the maximum excess of male mortality was born shortly after the turn of the century. Three independent sources suggest that the turnaround in sex mortality differentials is consistent with sex differences in cigarette smoking by cohort. An age/period/cohort model reveals a highly significant effect of smoking histories on men’s and women’s mortality. This model suggests that improvements in mortality at older ages are likely to accelerate in the future. PublicationChildhood Conditions that Predict Survival to Advanced Ages Among African Americans(1997) Preston, Samuel H.; Preston, Samuel H.; Hill, Mark E.; Drevenstedt, Greg LeeThis paper investigates the social and economic circumstances of childhood that predict the probability of survival to age 85. It uses a unique study design in which survivors are linked to their records in U.S. Censuses of 1900 and 1910. A control group of age and race-matched children is drawn from Public Use Samples for these censuses. It concludes that the factors most predictive of survival are farm background, having literate parents, and living in a two-parent household. Results support the interpretation that death risks are positively correlated over the life cycle. PublicationIs the High Level of Obesity in the United States Related to Its Low Life Expectancy?(2011-09-22) Preston, Samuel H.; Stokes, Andrew; Preston, Samuel H.; Stokes, AndrewBackground. The US has the highest prevalence of obesity and one of the lowest life expectancies among OECD countries. While it is plausible to assume that these two phenomena are related, no previous attempt has been made to identify the connection between them. Our paper uses primary data on body mass index (BMI) in 16 countries and detailed information on the mortality risks of obesity to estimate the effect of international differences in obesity on comparative levels of longevity. Methods. We estimate the fraction of deaths from all causes attributable to obesity by country, age and sex. We then re-estimate life tables in 2006 by removing deaths attributable to obesity. To allow for the possibility of a secular decline in obesity risks, we employ two alternative sets of risks drawn from a more recent period than the baseline risks. Results. In our baseline analysis, we estimate that US life expectancy at age 50 in 2006 was reduced by 1.54 years (95% condence interval (CI) 1.37-1.93) for women and by 1.85 years (1.62-2.10) for men as a result of obesity. Relative to higher life expectancy countries, allowance for obesity reduces the US shortfall in life expectancy by 42% (36-48) for women and 67% (57-76) for men. Using obesity risks that were recorded more recently, differences in obesity still account for a fifth to a third of the shortfall of life expectancy in the US relative to longer-lived countries. Conclusions. The high prevalence of obesity in the US contributes substantially to its poor international ranking in longevity.