Jeroen Spijker

Population ageing: the timebomb that isn’t?

Jeroen Spijker and John MacInnes argue that current measures of population ageing are misleading and that the numbers of dependent older people in the UK and other countries have actually been falling in recent years

The health transition and biological living standards: adult height and mortality in 20th-century Spain.

This paper seeks new insights concerning the health transition in 20th century Spain by analyzing both traditional (mortality-based) and alternative (anthropometric-based) health indicators. Data were drawn from national censuses, vital and cause-of-death statistics and seven National Health Surveys dating from 1987 to 2006 (almost 100,000 subjects aged 20-79 were used to compute cohort height averages). A multivariate regression analysis was performed on infant mortality and economic/historical dummy variables. Our results agree with the general timing of the health transition process in Spain as has been described to date insofar as we document that there was a rapid improvement of sanitary and health care related factors during the second half of the 20th century reflected by a steady decline in infant mortality and increase in adult height. However, the association between adult height and infant mortality turned out to be not linear. In addition, remarkable gender differences emerged: mean height increased continuously for male cohorts born after 1940 but meaningful improvements in height among female cohorts was not attained until the late 1950s.

Changing household patterns of young couples in low- and middle-income countries

While young couples in Western societies generally form a new household, in low-income societies new unions are often incorporated into existing households. However, there is a growing tendency in the nuclearization of households as intergenerational co-residence is undermined by growing wage labour opportunities that provide incentives for rural–urban migration and because small nuclear families adapt better to urban societies characterized by high geographic and social mobility. The objective of this paper is therefore to jointly study for a selection of low- to middle-income countries the socioeconomic and demographic conditions of women aged 15–34 and their partners in relation to their household patterns with particular interest in the comparison of nuclear and extended households. The analysis will mainly rely on data from the Integrated Public Use of Microdata Series International database (https://international.ipums.org/international/) from which census samples for the last two or latest available census rounds for 18 countries have been extracted. Results showed that women being of older age (within the 15–34 range) and at the same time having attained at least primary school education, having a husband who does not work in the primary sector and who is neither much older nor much younger were all associated with living in a nuclear household. However, individual factors explained only a small part of the overall variation in the household arrangements of young couples, suggesting that differences between countries in these dimensions do not explain much of the difference in household structure. Rather, societal indicators like economic development and the average age at marriage – that were significant in our models – may explain better the overall slow transition towards the nuclear family.

Explanations for the age, sex, spatial, and temporal structure of Czech mortality for the period 1987 – 97

The author disentangles the age sex, spatial, and temporal structure of mortality in the Czech Republic during the period 1987–97 for a selection of cause-of-death categories and investigates possible socioeconomic and other causes for the mortality differences uncovered. The clarification of the major effects, as well as possible interactions between them, verifies whether causes of death should be modelled separately, and which interactions should be tested in the explanatory analysis. For instance, it was considered inappropriate to incorporate district-level time-series data in the analysis when spatial mortality differences did not show significant variation between 1987 and 1997—as occurred with cancer and digestive system diseases. In this case, the exogenous variables would take on the average for the study period.

Longevity and Lifespan Variation by Educational Attainment in Spain: 1960–2015

For a long time, studies of socioeconomic gradients in health have limited their attention to between-group comparisons. Yet, ignoring the differences that might exist within groups and focusing on group-specific life expectancy levels and trends alone, one might arrive at overly simplistic conclusions. Using data from the Spanish Encuesta Sociodemográfica and recently released mortality files by the Spanish Statistical Office (INE), this is the first study to simultaneously document (1) the gradient in life expectancy by educational attainment groups, and (2) the inequality in age-at-death distributions within and across those groups for the period between 1960 and 2015 in Spain. Our findings suggest that life expectancy has been increasing for all education groups but particularly among the highly educated. We observe diverging trends in life expectancy, with the differences between the low- and highly educated becoming increasingly large, particularly among men. Concomitantly with increasing disparities across groups, length-of-life inequality has decreased for the population as a whole and for most education groups, and the contribution of the between-group component of inequality to overall inequality has been extremely small. Even if between-group inequality has increased over time, its contribution has been too small to have sizable effects on overall inequality. In addition, our results suggest that education expansion and declining within-group variability might have been the main drivers of overall lifespan inequality reductions. Nevertheless, the diverging trends in longevity and lifespan inequality across education groups represent an important phenomenon whose underlying causes and potential implications should be investigated in detail.

Evolución del perfil de los cuidadores de personas de 65 y más años con discapacidad en la persistencia de un modelo de cuidado familiar

INTRODUCTION The increasing participation of women in the workforce may make it difficult to sustain the current model of elderly care. The aim of this article was to determine the changing sociodemographic profile of informal elderly caregivers with disabilities, the interaction between employment and care, and the view of the public on the responsibility of that care. MATERIALS AND METHODS Cross-sectional analysis of secondary data from four national surveys were used: the disability surveys held in 1999 (N=3,936) and 2008 (N=5,257), the 2011-12 National Health Survey (N=439), and the Family and Gender survey of 2012 (N=1,359). They were analysed using contingency tables based on gender and age. RESULTS Half of the informal caregivers were women aged 45 to 64 years. Between 1999 and 2011-12 they became more concentrated in the 55-64 age-bracket, among whom participation in the workforce doubled from 20% to 40%. Increased care for men was associated with unemployment. Care work had a negative impact on working life, with greater impact among women and those who cared for elderly people with severe disabilities. Less likely to consider that elderly care provision should rest on family are 45-54 year-old economically active women (only 42%) or those who are more educated (40%), compared to 60% of economically inactive women and 55% of less educated women. CONCLUSIONS Economically active and educated women are less inclined to family-based care, but assume it independently of their workforce participation, whereas males do so according to their availability.

Socioeconomic Determinants of Mortality in Europe: Validation of Recent Models Using the Latest Available Data and Short-Term Forecasts

Mortality is forecast for total mortality, lung cancer and circulatory system diseases excluding stroke for 21 countries. The forecasts are produced from models that include non-demographic variables in their model formulation and a time lag of 0–15 years between the exogenous variables and mortality. Separate time-series models are first constructed for men, women, Eastern and Western Europe and 11 causes of death using data for the period ± 1980 to 2000. The three cause-of-death models are then validated by comparing modelled with observed standardised death rates up to 2005–2009, depending on the country, before two short-term forecasts are made up to 2020. The first forecast is called the constant scenario as all exogenous variables are held constant after the year 2009. The second is the convergence scenario as values are set to converge by a certain year. Results showed that in most Western European countries the observed decline in total mortality since the late 1970s is set to continue in the near future for men, but is likely to level off for women. The mortality decline since the mid- to late 1990s in most Eastern European countries is predicted to continue. One important advantage of short-term forecasts is that values of the exogenous variables are already known for those variables for which a time lag has to be incorporated, meaning that both total mortality and specific causes of death can be accurately estimated for about 10–15 years ahead. This should of course be of great interest to policy makers.