Mortality of Centenarians in the United States

Abstract

AbstractIn the United States, we have not yet reached the point where unedited numerators and denominators for death rates or probabilities are of satisfactory quality for measuring the mortality of centenarians. Ignoring this reality can lead to an estimation of extreme-age mortality which is unacceptable, as is the case for the NCHS’ Data Brief no. 233. Even the better-quality data from the Medicare health insurance program are beset by problems of (1) unreported or unrecorded deaths and (2) date of birth misstatement. On the other hand, there are steps that can be taken to improve the quality of the underlying data, so that the threshold age at which a mathematical model replaces actual data and closes out the life table is pushed further out.The paper begins with a description of the unacceptable results published in Data Brief no. 233 and a critical examination of their sources. The main part of the paper presents some steps to improve the quality of the Medicare enrollment counts. By rearranging the historical series on Medicare enrollment by cohort, it is possible to eliminate unreported and unrecorded deaths. A simple model is then introduced to deal with date of birth misstatement.