Edward Jow-Ching Tu

Three dimensions of the survival curve: horizontalization, verticalization, and longevity extension

Three dimensions of the survival curve have been developed: (1) “horizontalization,” which corresponds to how long a cohort and how many survivors can live before aging-related deaths significantly decrease the proportion of survivors; (2) “verticalization,” which corresponds to how concentrated aging-related (“normal”) deaths are around the modal age at death (M); and (3) “longevity extension,” which corresponds to how far the highest normal life durations can exceed M. Our study shows that the degree of horizontalization increased relatively less than the degree of verticalization in Hong Kong from 1976 to 2001. After age normalization, the highest normal life durations moved closer to M, implying that the increase in human longevity is meeting some resistance.

Changes in active life expectancy in Taiwan: compression or expansion?

The 1986-1989 supplements on Elderly Living Conditions to the Monthly Surveys of Human Resources in the Taiwan area are used to estimate active life expectancy and to examine evidence for a compression of disability. Unlike recent results generated in Western countries in favour of the expansion of morbidity hypothesis, our findings tend to support the hypothesis that declining mortality leads to a compression of disability. In Taiwan fatal diseases (e.g. heart disease, stroke, and cancer) play a more important role in disability than to nonfatal diseases (e.g. arthritis, dementia, sensory impairments, and osteoporosis, etc.). Fatal diseases are still the leading causes of disability; modern technology has not prolonged life significantly to Taiwanese who contract such diseases. Hence the improvement in recent life expectancy is very slow and the duration between age at onset of fatal diseases and death tends to be short. As a result of such short duration, the area between the disability and the mortality curve in the life table narrows.

Probabilities and lifetime durations of short-stay hospital and nursing home use in the United States, 1985.

OBJECTIVES The authors present a four-state increment-decrement life table model from which estimates of the risk and duration of nursing home and short-term hospital stays in the United States are derived. METHODS Survival analysis was used to generate various transition probabilities while controlling for population heterogeneity. In addition, a newly developed algorithm was applied to construct the multistate life table specifically for health-care use. RESULTS The results reveal that in 1985, a US civilian is expected to spend 72.35 years in the community, 59.5 days in short-stay hospitals, and 2.28 years in nursing homes throughout his or her lifetime. CONCLUSIONS The single-year risk of nursing home and short-stay hospital use is shown to be an increasing function of age, especially for the older adults.

Inter‐regime marriage and mobility: The case of mainland China and Taiwan

The recent increasing socioeconomic and political interactions between mainland China and Taiwan have resulted in a significant number of marriages between the two societies. Why do people cross the Strait to look for a marriage partner? What are the socioeconomic and demographic characteristics of such marriages? And what impact do these marriages have on society as well as on the individuals involved? These are the issues we explore in this paper. Analyzing a survey on cross‐Strait marriages conducted by the authors, this paper concludes that inter‐regime marriages between these two societies predominately involve older Taiwanese males and younger mainland females. The general pattern in these marriages represents an exchange between the intrinsic attributes (age, appearance) of the mainland women and the extrinsic attributes (financial status) of the Taiwanese men. In addition, inter‐regime marriages provide a means for mainland women to attain geographic and eventually social mobility.

Modeling multidimensional transitions in health care

Conventional multistate life table accounting procedures are based on theoretical assumptions that are appropriate primarily for demographic events. Applying these approaches to the area of health care, however, may lead to serious biases given the frequent turnovers of events such as hospitalization and institutionalization. In addition, traditional approaches have been criticized for failing to capture population heterogeneity. This research introduces a new algorithm to estimate multistate life table indicators regarding health care use, taking advantage of the availability of information on average lengths of stay in hospitals and nursing homes. The survival analysis approach is used to estimate age-specific transition probabilities in order to address the issue of population heterogeneity.

Hong Kong’s population policies on immigration: challenges and feasibility

Purpose – The aging crisis in Hong Kong is unique in that it was caused by several waves of immigration and emigration, coupled with inadequate investment in tertiary education (Wong, 2013b). The purpose of this paper is to study the causes and outcomes of the Hong Kong aging crisis and, where appropriate, advise on mitigation strategies. Design/methodology/approach – The paper analyzes the current demographic predicament and makes recommendations. Findings – A viable method for alleviating this demographic problem is to introduce various immigration schemes; however, these have been rendered futile because of a lack of infrastructure necessary for attracting immigrants and mitigating the protectionism that occurs among local workers and in trade unions in Hong Kong. A purely open and proactive immigration policy should involve prioritizing the admission of professionals and laborers across pillar industries and areas where technical skills are in short supply, as well as setting a daily immigration quota...

Ultra-low fertility, gender equity and policy considerations

Purpose The purpose of this paper is to focus on the issue and the reasons why fertility patterns in many industrialized and post-industrialized societies decline so rapidly, primarily in newly industrialized countries, particularly in East Asia, and especially after the countries have adopted the capitalist and market economy as the preferred approach to improve the lives of their population. Design/methodology/approach The authors discuss gender equality and the relationship between fertility and female labor force participation in industrialized and post-industrialized countries, in the context of role incompatibility, mainly for women and the level of the strength and rigidity of family- and gender-role norms/attitudes that affect the behaviors of men and women. Findings The existing family-related policies and programs which have reduced the role conflict and incompatibility experienced by working mothers are reviewed and discussed under national orientations toward the resolution of work–family conflict since they could affect the relevance, acceptance, significance and effectiveness of policies being developed and approved to carry on under institutional context within a nation. Originality/value Specific strategies and policies to reduce role incompatibility and childcare arrangements and their costs are discussed, especially for East Asian nations.

Cardiovascular mortality sex differentials in selected East Asian and Western populations

Background Explaining patterns in the sex ratio (male/female) of cardiovascular disease (CVD) mortality would improve understanding of mortality transitions under modernisation. Little research has examined secular trends in this ratio across populations, taking age and cohort into account. We examine cohort effects in the ratios of CVD mortality (including ischaemic heart disease and cerebrovascular disease) among 4 East Asian populations that vary in the timing of their modernisation, and assess the effect of smoking on these patterns in comparison with Western populations. Methods The sequential method for log-linear models is applied to analyse age, period and cohort effects for sex ratios. Age and cohort effects are fitted first, with population as offset; period effects are fitted in a second model using the fitted values from the first model as the offset. Lung cancer mortality serves as a proxy for smoking. Results Increases in sex ratios of CVD mortality began in earlier cohorts in Western than in East Asian populations. Once begun, increases were more rapid in East Asia. The cohort effect for the sex ratio of CVD mortality differs from that for lung cancer mortality. Trends in sex ratios of CVD mortality by cohort are similar before and after adjustment for lung cancer mortality in East Asia; the increasing trend across 1900–1945 cohorts is maintained in Western populations after adjustment. Conclusions The sex ratio of CVD mortality has increased across successive cohorts living in increasingly modernised environments. There is scant evidence that this increase is attributable to changing sex-specific rates of smoking.

Population policy regarding Mainland Chinese females’ contribution to Hong Kong fertility

Purpose – Hong Kong is considered to be an aging population because of the ultralow fertility rates and long life expectancy of its population. A promising solution to remedy this age imbalance is to recruit young people from outside Hong Kong. The inflow of Type II babies (i.e. babies born of Mainland Chinese women whose spouses are not Hong Kong citizens) has created an abundance of them within the young population. The paper aims to discuss this issue. Design/methodology/approach – These controversies have been evaluated being mindful of the operation of a free economy in Hong Kong and the relevance of upholding the rule of law (Wong, 2012). Findings – Wong’s (2012) recommendations to endow the Hong Kong Government with the authority to approve applications from a one-way permit system and to separate the right of residency of Type II babies from their entitlement to welfare services have also been summarized. Originality/value – The inflow of Type II babies, however, has also generated public controve...

Patterns and Changes in Household Structure in Hong Kong

Hong Kong was a British colony until 1997, when it was returned to China and became a special administrative region. Since its cession from China to Britain in 1842, Hong Kong has experienced massive population growth. At the beginning of its colonial status, Hong Kong was a small fishing village. The first census published in May 1841 found the total population of Hong Kong to be only 7,450 inhabitants (Ng 1984). In 20011, Hong Kong’s population reached 7.07 million (Census and Statistics Department 2012). Now, Hong Kong is a modern city characterized by a high level of economic development and an urban population. Hong Kong attracts residents from all over the world, although the majority of its population is Chinese (Census and Statistics Department 2012).