Health

Mortality: towards reliable estimates in developing countries

Magali barbieri

Nationality

Year of selection 2018

Institution Berkeley University, California

Country United States

Risk Health

Joint Research Initiative

2 years

225000 €

Mortality is an essential parameter in assessing the dynamics of a population, both at the national and global level. Life tables in particular are crucial tools. They describe the age structure of mortality in a given population and they are widely used for descriptive and analytical purposes in demography, public health, epidemiology, population geography, biology, and many other branches of science. However, in low- and middle-income countries, the basic data input needed for their construction, namely, vital registration and detailed population data, are often unavailable, incomplete, or unreliable. “This dearth of information and a high degree of uncertainty do not allow for a reliable estimation of current mortality levels and patterns, let alone for assessing possible trends in the future”, reports Dr. Magali Barbieri, a researcher at the University of California, Berkeley and at the French Institute for Demographic Studies (INED). Aiming to find ways to compensate for these statistical flaws, the demographer is currently leading a Joint Research Initiative (JRI) involving other demographers from the Human Mortality Database (HMD) project (an open access database on mortality and population), as well as operational experts from the AXA Group and AXA entities, with technical support from the Mortality Branch of the United Nations Population Division. Their overall objective is to build a library of tools to improve accuracy of mortality estimation in countries with imperfect statistics and to assess the reliability of the resulting life tables for monitoring actuarial risks. Two countries will serve as case studies, Hong Kong and Mexico.

“Global mortality trends in the 21st century will depend primarily on the experience of developing countries, where the potential for large increases in life expectancy is the greatest, explains Dr. Barbieri. Consequently, there has been growing interest in the actuarial and demographic research communities to investigate the data situation in some of these countries.” The present project seeks to meet this demand by enabling the construction of reliable life table series on the basis of complete but unreliable vital statistics systems. “This endeavor is a natural extension of the on-going effort to expand to developing countries the Human Mortality Database approach”, remarks the lead investigator, who is also the associate director of the HMD. Indeed, the purpose of this inter-university initiative is to provide a uniformly constructed series of mortality rates, life tables, death counts and population exposures for as many countries as possible. Currently, the database only covers countries with reliable demographic data, 40 of them exactly, but the output of this collaborative research project seeks to increase this number and enable it to expand to countries with previously ineligible vital statistics systems.

Getting the most out of unreliable data, and actuarial applications

Indeed, by attempting to prove that the mortality datasets available for Mexico and Hong Kong can be exploited to produce reliable life tables, the JRI aims to set a standard methodology that can then be applicable to other countries with similar profiles. The research team’s approach will consist in three consecutive steps, starting with the actual production of the life tables for the two countries, covering as many years as possible, and constructed from yet unadjusted data. The second step will consist in establishing a standard set of data quality indicators to assess the reliability of both the input information and the output mortality series. The last step of this approach will consist in finding ways to adjust the flaws in the statistical information if and where it is necessary. To do this, the researchers intend to use existing indirect estimation techniques, and make the necessary adjustments. Once these steps are completed, the work with the AXA teams (AXA Group, AXA Mexico and AXA China Region) can start. Together, they aim to determine how the resulting mortality series can be used for actuarial purposes. More specifically, they want to use them for assessing variations in what insurers call biometrical risks – which refers to all risks related to the human condition, an essential aspect when calculating the premium of prospective applicants –, and future mortality trends in these countries. “Actuaries represent a quarter of subscriptions to the HMD database, Dr. Barbieri specifies. That’s actually how Marine Habart, AXA Group Life, Savings & Health Chief Risk Officer, who is leading the project on AXA’s side, had the idea for the project in the first place. Mexico and Hong Kong were identified as the best candidates for a case study, because both countries offered interesting and complementary characteristics, both academically and business-wise. Hong Kong has excellent mortality data, while Mexico, on the other hand, has a challenging statistics system”.

As Dr. Barbieri points out, the future of human longevity is largely predicated on what will happen in Asia, Latin America and Africa over the next few decades, as the population of these regions increasingly dwarves that of Europe, North America and Oceania. Reliable mortality estimates for countries in these regions are thus crucial in many aspects, including but not limited to insurance policy design. By providing such insight in open access, the present project would make a considerable contribution to some of these countries’ political strategies, for instance, notably with regard to resource allocation and health policy.