A Comparative Study of Adult Mortality in Taiwan and the United States in the Twentieth Century

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2013-05-03

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Abstract

This dissertation is a historically comparative study of adult mortality between Taiwan and the United States throughout the 20th century. The 20th century was characterized by the largest rise in life expectancy at birth and the most rapid decrease in mortality in recorded human history. This dissertation aims not only to examine and compare the trends and levels of life expectancy in Taiwan and the United States over an extended period of time, but also to evaluate the extent to which smoking behavior and obesity play an important role in the recent levels of adult mortality in the United States.

I used logistic models of mortality to examine and compare the trends and levels of life expectancy in Taiwan from 1906 to 2008 and in the United States from 1933 to 2007. Second, I re-estimated life expectancy by introducing smoking-attributable mortality to further compare the levels of life expectancy between the two countries. Third, I estimated event history models to investigate whether and how smoking behavior and obesity are related to mortality in the United States in the 1990 to 2006 and the 2000 to 2006 periods.

At the end of the 20th century, the level of life expectancy at birth for females in the U.S. was higher than in Taiwan, but they were close. In this century, however, the level of life expectancy at birth in Taiwan has increased to a higher level than in the U.S. The levels of male life expectancy at birth for the two countries are similar in this century, but there were significant differences in the 20th century. The great improvements in juvenile, background and senescent mortality rates in Taiwan may be used to explain this correspondence of life expectancy between the two countries today. Besides, higher smoking-attributed mortality can also serve as another possible reason for the stagnant levels of life expectancy in the U.S. Finally, smoking-related and obesity-related mortality have become progressively more important as predictors of adult mortality in the U.S. in past decades.

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