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Cited by 110Insurance, Mortality, Demography, Risk ManagementGlobal Maternal and Child HealthSurvey Methodology and Nonresponse

Measuring Adult Mortality Using Sibling Survival: A New Analytical Method and New Results for 44 Countries, 1974–2006

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Obermeyer, Ziad, Rajaratnam, Julie Knoll, Park, Chang H., Gakidou, Emmanuela, Hogan, Margaret C., Lopez, Alan D., Murray, Christopher J. L.·2010·PLoS Medicine
DOI 10.1371/journal.pmed.1000260PMC PMC2854132
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Abstract

BACKGROUND: For several decades, global public health efforts have focused on the development and application of disease control programs to improve child survival in developing populations. The need to reliably monitor the impact of such intervention programs in countries has led to significant advances in demographic methods and data sources, particularly with large-scale, cross-national survey programs such as the Demographic and Health Surveys (DHS). Although no comparable effort has been undertaken for adult mortality, the availability of large datasets with information on adult survival from censuses and household surveys offers an important opportunity to dramatically improve our knowledge about levels and trends in adult mortality in countries without good vital registration. To date, attempts to measure adult mortality from questions in censuses and surveys have generally led to implausibly low levels of adult mortality owing to biases inherent in survey data such as survival and recall bias. Recent methodological developments and the increasing availability of large surveys with information on sibling survival suggest that it may well be timely to reassess the pessimism that has prevailed around the use of sibling histories to measure adult mortality. METHODS AND FINDINGS: We present the Corrected Sibling Survival (CSS) method, which addresses both the survival and recall biases that have plagued the use of survey data to estimate adult mortality. Using logistic regression, our method directly estimates the probability of dying in a given country, by age, sex, and time period from sibling history data. The logistic regression framework borrows strength across surveys and time periods for the estimation of the age patterns of mortality, and facilitates the implementation of solutions for the underrepresentation of high-mortality families and recall bias. We apply the method to generate estimates of and trends in adult mortality, using the summary measure (45)q(15)-the probability of a 15-y old dying before his or her 60th birthday-for 44 countries with DHS sibling survival data. Our findings suggest that levels of adult mortality prevailing in many developing countries are substantially higher than previously suggested by other analyses of sibling history data. Generally, our estimates show the risk of adult death between ages 15 and 60 y to be about 20%-35% for females and 25%-45% for males in sub-Saharan African populations largely unaffected by HIV. In countries of Southern Africa, where the HIV epidemic has been most pronounced, as many as eight out of ten men alive at age 15 y will be dead by age 60, as will six out of ten women. Adult mortality levels in populations of Asia and Latin America are generally lower than in Africa, particularly for women. The exceptions are Haiti and Cambodia, where mortality risks are comparable to many countries in Africa. In all other countries with data, the probability of dying between ages 15 and 60 y was typically around 10% for women and 20% for men, not much higher than the levels prevailing in several more developed countries. CONCLUSIONS: Our results represent an expansion of direct knowledge of levels and trends in adult mortality in the developing world. The CSS method provides grounds for renewed optimism in collecting sibling survival data. We suggest that all nationally representative survey programs with adequate sample size ought to implement this critical module for tracking adult mortality in order to more reliably understand the levels and patterns of adult mortality, and how they are changing. Please see later in the article for the Editors' Summary.

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  1. [25]Gompertz B 1825 On the nature of the function expressive of the law of human mortality, and on a new mode of determining the value of life contingencies. Philosophical Transactions of the Royal Society of London 115 513 583 PMC4360127 25750242

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Authors
Obermeyer, Z., Rajaratnam, J. K., Park, C. H., Gakidou, E., Hogan, M. C., Lopez, A. D., & Murray, C. J. L.
Affiliations
  • Brigham and Women's Hospital (US)
  • University of Washington (US)
Corresponding author
Rajaratnam, Julie Knoll
ORCID
Venue
PLoS Medicine
Publisher
Public Library of Science (PLoS)
Published
2010-04-13
Volume
7
Issue
4
Pages
e1000260
ISSN
  • 1549-1277 (ISSN-L)
  • 1549-1676
DOI
10.1371/journal.pmed.1000260
PMC
PMC2854132
OpenAlex
W2027163336
Cited by
110
References
34
Citations by year
2026: 1 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 7 · 2016: 5 · 2015: 9 · 2014: 16 · 2013: 12 · 2012: 9
FWCI
34.83
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • Bill and Melinda Gates Foundation
  • Institute for Health Metrics and Evaluation
Topics
  • Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
Keywords
adult mortality, recall bias, survivorship bias, Demographic and Health Surveys, mortality trends, age-specific mortality, HIV mortality, sub-Saharan Africa, developing countries, cross-national comparison, population census, Southern Africa, Asia, Latin America
MeSH terms
Adolescent, Adult, Child, Family Characteristics, Female, Humans, Middle Aged, Mortality, Public Health, Siblings, Young Adult

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