Thematic Focal Person: Marc Luy
Overall vision
In the field of health and mortality, research increasingly focuses on healthy ageing, which comprises both mortality and morbidity. The determinants of healthy ageing include a wide array of different factors, with gender, socio-economic status (SES), health behaviours and the life course being the most important and most studied aspects. Biological, i.e. mainly genetic, factors also play an important role. The WIC Health and Mortality team contributes to these research fields with several projects. Our research is guided by the idea that we can learn most about the absolute and relative impact of specific risk factors by analysing and understanding differentials in health and mortality, e.g. differences between women and men, SES groups, and migrants and non-migrants, or differences between countries or regional units. Our work uses various data sources ranging from official population statistics and survey data to self-collected data such as the database on the health and mortality of nuns and monks.
Health and mortality differentials are caused by a complex pattern of numerous factors that are often directly or indirectly connected and might operate in different directions. Our overarching goal is to develop a general model that explains these differences by disentangling the various risk factors and evaluating their absolute and relative impacts, along with their variations in different populations and subpopulations. We are developing this model by sequentially analysing specific phenomena connected with health and mortality differentials. We are also studying technical aspects of the available data and methods, as well as practical issues such as the future possibilities of assisted living.
Specific work plans for mid-2011 to mid-2013
During the coming years, the research of the WIC team “Health and Mortality” will concentrate on five projects:
HEMOX
Thanks to its unique character, financial and staff resources, the ERC Starting Grant project HEMOX will be our key research project for the next five years. Its aim is to decisively advance the understanding of the still unexplained male-female health-mortality paradox summarised in the well-known phrase “women are sicker, but men die quicker”. In order to gain deeper insights into the mechanisms behind this phenomenon we will analyse the health-mortality relationship among Catholic nuns and monks in Austria and Germany and compare it to that of women and men in the general population. The fact that members of religious orders live in identical environments with the same daily regimes, lifestyles and beliefs make them a unique human subpopulation, in which most non-biological factors affecting health and mortality of women and men are equal. To accomplish the objectives of our project, we need longitudinal information about the health status, mortality and health transitions preceding death for all subpopulations. For the general population, these data are already available from several surveys. For order members, we will collect the data for a sufficient number of cases to guarantee the appropriate analysis of the health-mortality relationship. We plan to do a ‘mini-panel survey’ comprising a total of three waves among some 1,500 Austrian and German nuns and monks aged 50 and over.
Mortality attributable to smoking and the gender gap in life expectancy
In the project “Mortality attributable to smoking and the gender gap in life expectancy” we will analyse the impact of smoking on past, present and future trends in life expectancy of women and men, and in particular the differences between them. As smoking has been one of the key drivers of trends in life expectancy among men in developed countries since the 1950s and more recently also among women, this study focuses on decisively advancing our understanding of the forces propelling past trends in the different life expectancies of men and women in all OECD countries and to project future trends. Estimating mortality attributable to smoking is crucial for understanding the country-specific trends in gender differences in life expectancy. Therefore, the main task of this project will be to analyse the trends in smoking prevalence and the impact of smoking on female and male mortality separately for each country. Several methods have been suggested for estimating mortality attributable to smoking from prevalence and cause-of-death data. The so-called ‘Peto-Lopez method’ seems to be the most promising approach for international comparisons. We will evaluate this method and develop country-specific parameters for our analyses. This is a highly innovative step in the research on the relationship between smoking and mortality since previous studies applied just one specific set of parameters to very different countries.
Estimating mortality differentials in developed countries with indirect estimation techniques
In the project “Estimating mortality differentials in developed countries with indirect estimation techniques” we will improve the information on specific mortality differentials (e.g. by SES, migration background, parity) in cases where no official data are available. We will also modify and extend several indirect estimation techniques to permit their application to populations of developed countries. The so-called ‘orphanhood method’ seems to be the most promising indirect method for estimating mortality differentials since the survival status of respondents’ parents is included in many surveys and can be expected to be reported adequately. Besides the fact that indirect methods will enable us to examine new research questions, they will also permit us to estimate life expectancy and past mortality trends based on one single cross-sectional survey.
Science-based world population projections
The WIC research team “Health and Mortality” is also involved in the WIC project “Science-based world population projections by age, sex and level of educational attainment,” which is part of Wolfgang Lutz’s ERC Advanced Grant project “Forecasting societies’ adaptive capacity to climate change”, which is described in detail elsewhere. Our team will contribute the part on mortality in low mortality countries.
Future possibilities of assistive living
We currently analyse the future possibilities of assisted living and plan to prepare a research proposal in the field of robotic assistive technologies for older persons in collaboration with the Austrian Institute of Technology (AIT). In this project, we want to explore how older people accept an assistive robot and smart home system (CompanionAble).
Health differentials in an international comparative perspective
Other main and side projects will emerge when the new research team has been enlarged. For instance, we plan to run a major project to combine several international longitudinal surveys on health in order to analyse health differentials in an international comparative perspective.
