Declining Mortality (Increasing Lon

At What Rate?

Steve Goss Office of the Chief Actuar

Social Security Administration

AAA meeting

November 15, 2017
Perspective: “Aging” Not Mainly from M

Aging (change in age distribution) mainly due to drop in b
Mortality Decline Varies Over 

Conditions: Antibiotics/economy 1936-54; Medicare/Medi

Female Historical and Projected (2014 Trustees Report) 

Annual Percent Reduction in U.S. Mortality Rates

012345

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total

Male Historical and Projected (2014 Trustees Report) 

Annual Percent Reduction in U.S. Mortality Rates

-1

012345

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total
Appropriate Data: by Age Cr

Age-gradient in past reduction is clear
Mortality Decline by Cause of D

Rate of change from 1979 to 2013

-4-3-2-1

01234

Under 15 15-49 50-64 65-84 85+

CardiovascularCancerViolenceRespiratoryOther

FEMALE

-3-2-1

01234

Under 15 15-49 50-64 

MALE
Mortality Experience: Ages 65 and 

Reductions since 2009 continue to fall short of expec
Mortality Experience: Ages Unde

Actual increase since 2010
Developing Assumptions by C

Scientific approach reflecting biologyTrustees and SSA/OCACT develop in 

consultation with other experts

Johns Hopkins recent survey of medical 

researchers and clinicians came to very medium term expectations—independen

– Trustees’ medium-term rates by cause had 

published 
Cardiovascular: JHU Less Optimist

Trustees over Age 50 for Next 30 Y

0.00.51.01.52.02.53.03.54.0

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total

Cardiovascular Disease-Female

Average Annual Percent Reduction

JHU values are for the period 2009-2040

1979 to 202010 to 202038 to 20

JHU 

0.5

JHU 

1.5 JHU 

1.6

JHU 

1.5

0.00.51.01.52.02.53.03.54.0

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total

Cardiovascular Disease-Male

Average Annual Percent Reduction

JHU values are for the period 2009-2040

1979 to 202010 to 202038 to 20

JHU 

1.1 JHU 0.6

JHU 

1.5 JHU 1.6
Respiratory: JHU More Optimistic 

Age 50, Less Optimistic over Ag

-3.0-2.0-1.0

0.01.02.03.04.0

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total

Respiratory-Female

Average Annual Percent Reduction

JHU values are for the period 2009-2040

1979 t2010 t2038 t

JHU 

0.1 JHU 0.5 JHU 0.8 JHU 1.7

-3.0-2.0-1.0

0.01.02.03.04.0

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total

Respiratory-Male

Average Annual Percent Reduction

JHU values are for the period 2009-2040

1979 t2010 t2038 t

JHU 

0.4 JHU 0.4 JHU 0.8 JHU 1.5
Cancer: JHU Very Similar 

to Trustees’ Expectations

-1.0-0.5

0.00.51.01.52.02.53.0

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total

Cancer-Female

Average Annual Percent Reduction

JHU values are for the period 2009-2040

1979 2010 2038 

JHU 

0.4

JHU 

0.9

JHU 

1.3 JHU 

1.8

-1.0-0.5

0.00.51.01.52.02.53.0

Under Age 15 Ages 15 - 49 Ages 50 - 64 Ages 65 - 84 Ages 85 and

older

Total

Cancer-Male

Average Annual Percent Reduction

JHU values are for the period 2009-2040

1979 2010 2038 

JHU 

0.6

JHU 

1.2

JHU 

1.1

JHU 

1.3
How Future Conditions Might C

Smoking decline for women

– Started and stopped later than men

Obesity—sedentary lifestyleDifference by income/earningsHealth spending—must decelerate

– Advances help only if apply to all

Human limits

– Increasing understanding of decelerat
Trends in Obesity: US 1971-20

Sam Preston 2010—must consider cumulative eff

Increasing duration of obesity for aged in futu
Death Rates Vary by Career Earnings R

Difference has increased

Female 65-69 Retired-Worker 

Relative Death Rates by AIME Quart

0

0.20.40.60.8

1

1.21.41.6

123

19920
Mortality Decline by Education

Must be careful on changing shares (Bound 

Female Non-Hispanic-White Population 

Annualized Death Rates from Age 65 to 8

by Educational Attainment

0%1%2%3%4%5%

All < High

School

Low 25%

Education

High 75%

Education
Health Spending Cannot Continue 

at Historical Rates

Note Trustees’ deceleration

-1%

0%1%2%3%4%5%

 1970-1980 1980-2010 2010-2040 2040-2070 207

Annual Percent Change in Medicare Cost per Beneficia

Relative to GDP per Worker: 2015 TR
Is There an Omega?

It appears we are rectangularizing the survival cu

Survival Curve U.S. Female: Period Data

0

0.10.20.30.40.50.60.70.80.9

1

0 10 20 30 40 50 60 70 80 90 100 110

Survival Curve U.S. Male: Period Data

0

0.10.20.30.40.50.60.70.80.9

1

0 10 20 30 40 50 60 70 80 90 100 110