The fragility of the future and the tug of the past

Abstract

BACKGROUND: Cohorts that will attain age 60 after 2010 in the Latin American and Caribbean region (LAC) are beneficiaries of a massive mortality decline that began as early as 1930. The bulk of this decline is due to diffusion of low-cost medical technology that improved recovery rates from infectious diseases. This changes the composition of elderly cohorts in a distinct way: more among those who could experience the deleterious impact of adverse early conditions as adults survive to attain old ages. OBJECTIVE: To compute bounds for the size of effects on old age mortality of changes in cohorts' composition by exposure to early conditions. We calculate estimates for countries in the LAC region that span the entire range of post-1950 mortality decline. METHODS: We use counterfactual population projections to estimate bounds of changes in the composition of cohorts by exposure to early conditions. These are combined with empirical effects of adverse early conditions on adult mortality to generate estimates of foregone gains in life expectancy at age 60. RESULTS: under somewhat conservative assumptions life expectancy at age 60 will at best increase much more slowly than in the past and at worst reach a steady state or decline. Foregone gains may be as high as 20% of projected values over a period of 30 to 50 years, the time it takes for cohorts that reaped the benefits of the secular mortality decline to become extinct. CONCLUSIONS: Changing composition of cohorts by early exposures constitutes a powerful force that could drag down or halt short-run progress of life expectancy at older ages.

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