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      Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble

      research-article

      , PhD a , b , , , PhD a , b , , , PhD c , , PhD a , d , , PhD a , b , e , , Prof, FMedSci a , b , f , *

      Lancet (London, England)

      Elsevier

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          Summary

          Background

          Projections of future mortality and life expectancy are needed to plan for health and social services and pensions. Our aim was to forecast national age-specific mortality and life expectancy using an approach that takes into account the uncertainty related to the choice of forecasting model.

          Methods

          We developed an ensemble of 21 forecasting models, all of which probabilistically contributed towards the final projections. We applied this approach to project age-specific mortality to 2030 in 35 industrialised countries with high-quality vital statistics data. We used age-specific death rates to calculate life expectancy at birth and at age 65 years, and probability of dying before age 70 years, with life table methods.

          Findings

          Life expectancy is projected to increase in all 35 countries with a probability of at least 65% for women and 85% for men. There is a 90% probability that life expectancy at birth among South Korean women in 2030 will be higher than 86·7 years, the same as the highest worldwide life expectancy in 2012, and a 57% probability that it will be higher than 90 years. Projected female life expectancy in South Korea is followed by those in France, Spain, and Japan. There is a greater than 95% probability that life expectancy at birth among men in South Korea, Australia, and Switzerland will surpass 80 years in 2030, and a greater than 27% probability that it will surpass 85 years. Of the countries studied, the USA, Japan, Sweden, Greece, Macedonia, and Serbia have some of the lowest projected life expectancy gains for both men and women. The female life expectancy advantage over men is likely to shrink by 2030 in every country except Mexico, where female life expectancy is predicted to increase more than male life expectancy, and in Chile, France, and Greece where the two sexes will see similar gains. More than half of the projected gains in life expectancy at birth in women will be due to enhanced longevity above age 65 years.

          Interpretation

          There is more than a 50% probability that by 2030, national female life expectancy will break the 90 year barrier, a level that was deemed unattainable by some at the turn of the 21st century. Our projections show continued increases in longevity, and the need for careful planning for health and social services and pensions.

          Funding

          UK Medical Research Council and US Environmental Protection Agency.

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          Most cited references20

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          Demography. Broken limits to life expectancy.

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            Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation.

            In 2000, world leaders agreed on the Millennium Development Goals (MDGs). MDG 4 called for a two-thirds reduction in the under-5 mortality rate between 1990 and 2015. We aimed to estimate levels and trends in under-5 mortality for 195 countries from 1990 to 2015 to assess MDG 4 achievement and then intended to project how various post-2015 targets and observed rates of change will affect the burden of under-5 deaths from 2016 to 2030.
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              What has made the population of Japan healthy?

              People in Japan have the longest life expectancy at birth in the world. Here, we compile the best available evidence about population health in Japan to investigate what has made the Japanese people healthy in the past 50 years. The Japanese population achieved longevity in a fairly short time through a rapid reduction in mortality rates for communicable diseases from the 1950s to the early 1960s, followed by a large reduction in stroke mortality rates. Japan had moderate mortality rates for non-communicable diseases, with the exception of stroke, in the 1950s. The improvement in population health continued after the mid-1960s through the implementation of primary and secondary preventive community public health measures for adult mortality from non-communicable diseases and an increased use of advanced medical technologies through the universal insurance scheme. Reduction in health inequalities with improved average population health was partly attributable to equal educational opportunities and financial access to care. With the achievement of success during the health transition since World War 2, Japan now needs to tackle major health challenges that are emanating from a rapidly ageing population, causes that are not amenable to health technologies, and the effects of increasing social disparities to sustain the improvement in population health. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Lancet
                Lancet
                Lancet (London, England)
                Elsevier
                0140-6736
                1474-547X
                01 April 2017
                01 April 2017
                : 389
                : 10076
                : 1323-1335
                Affiliations
                [a ]Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
                [b ]MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
                [c ]Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
                [d ]Department of Mathematics, Physics and Electrical Engineering, Northumbria University, Newcastle-upon-Tyne, UK
                [e ]Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
                [f ]WHO Collaborating Centre on NCD Surveillance and Epidemiology, Imperial College London, London, UK
                Author notes
                [* ]Correspondence to: Prof Majid Ezzati, Imperial College London, London W2 1PG, UKCorrespondence to: Prof Majid EzzatiImperial College LondonLondonW2 1PGUK majid.ezzati@ 123456imperial.ac.uk
                [†]

                Contributed equally

                Article
                S0140-6736(16)32381-9
                10.1016/S0140-6736(16)32381-9
                5387671
                28236464
                363e03a8-bb02-43d3-b926-bcbcce96c075
                © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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