Prospects of longer life are viewed as a positive change for individuals and as a substantial social achievement but have led to concern over their implications for public spending on old-age support. This paper makes a critical assessment of knowledge about mortality change. It is oriented toward the problem of forecasting the course of mortality change and the potential of existing work to contribute to the development of useful forecasts in Canada, Mexico, and the U.S. We first examine broad patterns in the historical decline in death rates in the three countries, the effect of these on trends in life expectancy, and the epidemiological transition. Next we review theories of the age pattern and evolution of mortality, including graduations, evolutionary theory, reliability models, dynamic models, and relational models. The analysis and forecasting of mortality change have been shaped largely by some key historical lessons, which we summarize next. We emphasize issues that have been or are likely to be significant in mortality analysis, especially the questions of the age pattern and time trend in mortality at old ages; we distinguish patterns and facts that are established from those that remain uncertain. Next, we consider mortality differentials in characteristics such as sex, marital status, education, and socioeconomic variables; we summarize their key features and also point to the substantial gaps in our understanding of their determinants. Finally, we review methods of forecasting, including the scenario method used by the U.S. Social Security Administration and the time series method of Lee and Carter. We set out some important recommendations for forecasters: forecasting assumptions should be made more formal and explicit; there should be retrospective evaluations of forecast performance; and greater attention should be paid to the assessment and consequences of forecast uncertainty.
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