Declining Mortality (Increasing Longevity):

At What Rate? At What Ages?

Steve Goss, Chief Actuary

US Social Security Administration

2020 Living to 100 Symposium

General Session IV - Mortality Projection from a Social Security Panel

January 14, 2020
2

Perspective: “Aging” Not Mainly from Mortality

Aging (change in age distribution) mainly due to drop in birth rates

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

0.40

0.45

0.50

1940 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100

Aged Dependency Ratio 2019 TR

Population 65+/(20-64) 

Actual and TR Intermediate

TFR remains at 3.0 after 1964

TFR remains at 3.3 after 1964

2
Considerations in Projecting Mortality

Variation over time periods

Variation by age

Variation by earnings level

Changing causes of death

Cohort considerations

Health spending, obesity, smoking, opioids

Is there a limit on human longevity?

Our projections for the United States

3
Life Expectancy at Birth Not a Useful Indicator; 

Age Distribution of Death Rates Most Important

4
Mortality Decline Varies Over Time

Conditions: Antibiotics/economy 1936-54; Medicare/Medicaid 1968-82

5
Opioids? Affected Age 15-64 Mortality Decline 

Since 1999, but Not the Deceleration Since 2009

6

-1.5%

-1.0%

-0.5%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

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

Male Comparison of Mortality Improvement Including and Excluding Deaths from Opioids

1999 to 2009

Including

Opioids

2009 to 2017

Including

Opioids

1999 to 2009

Excluding

Opioids

2009 to 2017

Excluding

Opioids
Mortality Experience: All Ages

Reductions falling short of expectations since 2009

700

750

800

850

900

950

1,000

1,050

1,100

1990 1995 2000 2005 2010 2015 2020

Age-Sex-Adjusted Death Rates

(Total, All Ages)

2017TR 2018TR 2019TR Actual

7
Mortality Experience: Ages 65 and Over

Reductions falling short of expectations since 2009

4,000

4,200

4,400

4,600

4,800

5,000

5,200

5,400

5,600

5,800

6,000

1990 1995 2000 2005 2010 2015 2020

Age-Sex-Adjusted Death Rates

(Ages 65 and Older)

2017TR 2018TR 2019TR Actual

8
Variation by Age is Substantial

Age-gradient in past reduction is clear

9
Mortality By Career-Average Earnings 

Level: Actuarial Study #124

Age group 65-69 relative mortality ratios—not diverging?

10
Mortality Decline by Cause of Death: 

Rate of change from 1979 to 2017

11
Age-adjusted Death Rates for Heart Disease, Cancer, Stroke, and 

Unintentional Injuries: United States, 1900-2015

(courtesy Robert Anderson, NCHS)

Rate per 100,000 standard population

NOTE: Data prior to 1933 contain death-registration States only. Data for 2015 is provisional.

Heart disease

Cancer

Stroke

Unintentional injuries

12
Developing Assumptions by Cause

Scientific approach reflecting biology

Trustees and SSA/OCACT develop in 

consultation with other experts

Johns Hopkins survey of medical researchers 

and clinicians came to very similar mediumterm expectations—independently

– Trustees’ medium-term rates by cause had not been 

published 

13
Cardiovascular: JHU Less Optimistic than 

Trustees Over Age 50 for Next 30 Years

14

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

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 2010

2010 to 2038

2038 to 2088

JHU 

0.5

JHU 

1.5 JHU 

1.6

JHU 

1.5

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

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 2010

2010 to 2038

2038 to 2088

JHU 

1.1 JHU 

0.6

JHU 

1.5 JHU 

1.6
Respiratory: JHU More Optimistic Under 

Age 50, Less Optimistic Over Age 85

15

-3.0

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

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 to 2010

2010 to 2038

2038 to 2088

JHU 

0.1 JHU 

0.5

JHU 

0.8 JHU 

1.7

-3.0

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

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 to 2010

2010 to 2038

2038 to 2088

JHU 

0.4 JHU 

0.4

JHU 

0.8

JHU 

1.5
Cancer: JHU Very Similar 

to Trustees’ Expectations

16

-1.0

-0.5

0.0

0.5

1.0

1.5

2.0

2.5

3.0

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 to 2010

2010 to 2038

2038 to 2088

JHU 

0.4

JHU 

0.9

JHU 

1.3 JHU 

1.8

-1.0

-0.5

0.0

0.5

1.0

1.5

2.0

2.5

3.0

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 to 2010

2010 to 2038

2038 to 2088

JHU 

0.6

JHU 

1.2

JHU 

1.1

JHU 

1.3
Cohort Considerations

Post-World War 2 births—special conditions:

– Antibiotics when young; statins, etc. later

What does change up to age x say above age x?

– If cohort is fundamentally healthier at x: 

Then expect lower mortality over age x

– But if medical interventions have just reduced deaths:

Then cohort mortality over age x could be worse, with 

increased numbers of impaired survivors

– What does one cohort imply for the next cohort?

Further changes depend on conditions, not trend

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How Future Conditions Might Change

Smoking decline for women

– Started and stopped later than men

Obesity—sedentary lifestyle

Health spending—must decelerate

– Advances help only if they apply to all

Human limits

– Increasing understanding of deceleration

18
Trends in Obesity: US 1971-2006 

Sam Preston 2010—must consider cumulative effects

Increasing duration of obesity for aged in future

19
Does Health Spending Affect Mortality?

Note rise, at least through 2009

20

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015

National Health Expenditures With and Without 

Medicare and Medicaid as a Percent of GDP

NHE/GDP

(NHE-Med&Med)/GDP

NIPA NHE/GDP
Health Spending Cannot Continue to 

Rise at Historical Rates

Note Trustees’ deceleration

21

-1%

0%

1%

2%

3%

4%

5%

 1970-1980 1980-2010 2010-2040 2040-2070 2070-2085

Annual Percent Change in Medicare Cost per Beneficiary 

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

It appears we are rectangularizing the survival curve

22
23

Death Rates Will Continue to Decline: 

But How Fast and for Whom?

Must understand past and future conditions

– Persistent historical “age gradient”

– Avoid simple extrapolation of past periods

» Cannot ignore changing conditions

 “Limits” on longevity due to physiology

 Latter half of 20th century was extraordinary

» So deceleration seems likely

» Cause-specific rates allow basis for assumptions

– Results: in the 1982 TR, we projected LE65 for 2013 

to be 19.0; actual was 19.1
Ultimate (2043 to 2093) Projected Rates of Decline: 

Similar to Period Since 1900 for Age 50+

Historical and Projected Age-Sex-Adjusted Decline in U.S. Death Rates

1900 to 2016 2009 to 2016

Projected 

2043 to 2093

 Under Age 15 3.01 1.23 1.55

Ages 15 to 49 1.44 -0.60 0.89

Ages 50 to 64 1.02 -0.35 1.06

Ages 65 to 84 0.95 0.79 0.76

Ages 85 and Over 0.55 0.24 0.51

Total 1.58 0.31 0.73

 Intermediate projections in the 2019 Trustees Report

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-1.0

-0.5

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

 Under Age

15

Ages 15 to

49

Ages 50 to

64

Ages 65 to

84

Ages 85 and

Over

Total

Historical and Projected Age-Sex-Adjusted Decline in U.S. Death Rates

1900 to 2016

2009 to 2016

Projected 2043 to 2093
Projected Age-Sex-Adjusted Death 

Rates, All Ages

25

300

3,000

1900 1920 1940 1960 1980 2000 2020 2040 2060 2080

Deaths per 100,000

Year

Total Age-Sex-Adjusted Death Rates for Alternative II of the 2019 TR

LOG Scale

0

500

1,000

1,500

2,000

2,500

3,000

1900 1920 1940 1960 1980 2000 2020 2040 2060 2080

Deaths per 100,000

Year

Total Age-Sex-Adjusted Death Rates for Alternative II of the 2019 TR
Projected Age-Sex-Adjusted Death 

Rates, Ages 65 and Over

26

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

11,000

12,000

13,000

1900 1920 1940 1960 1980 2000 2020 2040 2060 2080

Deaths per 100,000

Year

Age-Adjusted Death Rates for 65 and Older Under Alternative II of 

the 2019 TR

MALE

FEMALE

1,800

1900 1920 1940 1960 1980 2000 2020 2040 2060 2080

Deaths per 100,000

Year

Age-Adjusted Death Rates for 65 and Older Under Alternative II of 

the 2019 TR

LOG Scale

MALE

FEMALE
Ultimately, the Changing Age Distribution of the 

Population is the Main Factor for Social Security

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For More Information...

http://www.ssa.gov/oact/

 Documentation of Trustees Report data & assumptions 

https://www.ssa.gov/oact/TR/2019/2019_LongRange_Demographic_Assumptions.pdf

 Historical and projected mortality rates

https://www.ssa.gov/oact/HistEst/DeathHome.html

 Annual Trustees Reports 

https://www.ssa.gov/oact/TR/index.html

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