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Understanding Mid-Life and Older Age Mortality Declines: Evidence from Union Army Veterans

  • Dora L. Costa

During the twentieth century the 17 year survival rate of 50-64 year old men rose by 24 percentage points. I examine waiting time until death from all natural causes and from all chronic, all acute, respiratory, stomach, infectious, all heart, ischemic, and myocarditis disease among Union Army veterans first observed in 1900. The effect of such specific early life infections as stomach ailments, rheumatic fever, syphilis, measles, respiratory infections, malaria, diarrhea, and tuberculosis on older age mortality depended upon the cause of death that was being investigated but all of these infections reduced cause-specific longevity. Men who grew up in a large city faced an elevated mortality risk from all causes of death controlling for later residence. The immediate effect of reduced infectious disease rates and reduced mortality from acute disease accounts for 62 percent of the twentieth century increase in survival rates and the long-run effect of reduced early life infectious disease rates accounts for 12 percent of the increase. The findings imply that although the current effects of improved public health and medical care are larger than the cohort effects, cost-benefit analyses and forecasts of future mortality still need to account for long-run effects; that mortality in populations in which infectious, respiratory, and parasitic deaths are common is best described by a competing risks model; and, that the urbanization that accompanied early industrialization was extremely costly.

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File URL: http://www.nber.org/papers/w8000.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 8000.

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Date of creation: Nov 2000
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Publication status: published as Costa, Dora L. "Understanding Mid-Life And Older Age Mortality Declines: Evidence From Union Army Veterans," Journal of Econometrics, 2003, v112(1,Jan), 175-192.
Handle: RePEc:nbr:nberwo:8000
Note: AG DAE HC
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  1. Kenneth Manton & Eric Stallard & Larry Corder, 1997. "Changes in the age dependence of mortality and disability: Cohort and other determinants," Demography, Springer, vol. 34(1), pages 135-157, February.
  2. D. L. Costa, 2000. "Long-Term declines in Disability Among Older Men: Medical Care, Public Health, and Occupational Change," CPE working papers 0005, University of Chicago - Centre for Population Economics.
  3. Costa Dora L., 1993. "Height, Weight, Wartime Stress, and Older Age Mortality: Evidence from the Union Army Records," Explorations in Economic History, Elsevier, vol. 30(4), pages 424-449, October.
  4. Lee, Chulhee, 1997. "Socioeconomic Background, Disease, and Mortality among Union Army Recruits: Implications for Economic and Demographic History," Explorations in Economic History, Elsevier, vol. 34(1), pages 27-55, January.
  5. Dora Costa, 2000. "Understanding the twentieth-century decline in chronic conditions among older men," Demography, Springer, vol. 37(1), pages 53-72, February.
  6. Richard H. Steckel & Roderick Floud, 1997. "Health and Welfare during Industrialization," NBER Books, National Bureau of Economic Research, Inc, number stec97-1, May.
  7. Samuel H. Preston & Michael R. Haines, 1991. "Fatal Years: Child Mortality in Late Nineteenth-Century America," NBER Books, National Bureau of Economic Research, Inc, number pres91-1, May.
  8. David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1998. "Are Medical Prices Declining? Evidence From Heart Attack Treatments," The Quarterly Journal of Economics, MIT Press, vol. 113(4), pages 991-1024, November.
  9. Richard H. Steckel & Roderick Floud, 1997. "Introduction to "Health and Welfare during Industrialization"," NBER Chapters, in: Health and Welfare during Industrialization, pages 1-16 National Bureau of Economic Research, Inc.
  10. Shiro Horiuchi & John Wilmoth, 1998. "Deceleration in the age pattern of mortality at olderages," Demography, Springer, vol. 35(4), pages 391-412, November.
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