Mortality Projections: A US 

Perspective on Approaches 

and Challenges

International Actuarial Association 

Mortality Working Group Meeting

Steve Goss, Chief Actuary

Karen Glenn, Deputy Chief Actuary

US Social Security Administration

17 May 2019
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 3

Various Alternative Projection Approaches Using Data

Extrapolating past trends:

1) Age setback (early method)

2) Mortality rate by age and sex (Lee/Carter)

3) Life expectancy at birth (Vaupel/Oeppen)

4) Mortality rate by trend all ages (2011 Technical Panel, CBO 2013-5)

Or reflect changing conditions:

5) Improvement by cohort (UK CMI, SOA)

6) Mortality rate by age, sex, cause (OCACT/TR, 2015 Technical Panel)
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 4

2) Extrapolation by Age and Sex

• Example: Lee and Carter

• Fit the average trend of a selected period

• Future conditions must replicate the past—on average

• Age gradient never changes

• No deceleration in mortality decline
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 5

Mortality Decline Varies Over Time

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

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

5.0

6.0

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

Male Historical (2018 Trustees Report, Plus 2016 and 2017 Data) 

Annual Percent Reduction in U.S. Mortality Rates

1900 to 1936

1936 to 1954

1954 to 1968

1968 to 1982

1982 to 1999

1999 to 2009

2009 to 2017

-2.0

-1.0

0.0

1.0

2.0

3.0

4.0

5.0

6.0

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

Female Historical (2018 Trustees Report, Plus 2016 and 2017 Data) 

Annual Percent Reduction in U.S. Mortality Rates

1900 to 1936

1936 to 1954

1954 to 1968

1968 to 1982

1982 to 1999

1999 to 2009

2009 to 2017
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 6

3) Will Life Expectancy Rise Linearly?

Vaupel/Oeppen 2002; best nations

• Requires accelerating rate 

of decline in mortality rates 

if retain age gradient

• LE most affected by lowest 

ages—only so much gain 

possible

• Most disagree

– Vallin/Meslé
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 7

4) Extrapolate All Ages the Same

• Ignores historical age gradient

• Result: 

– Substantial bias for population age distribution

• Thus, large bias for cost as % of payroll

– Less mortality decline at young ages raises cost

– More mortality decline at older ages raises cost
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 8

Appropriate Data: by Age Critical

Age-gradient in past reduction is clear
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 9

5) Extrapolation by Cohort

• U.K. (& SOA-RPEC): “Phantoms never die” data issues

• Post-WW2 births: antibiotics young, statins later

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

– Is cohort healthier at x if lower mortality up to x?

– Or is cohort compromised by impaired survivors?

– What does one cohort imply for the next cohort?

• Period effects from known changes in conditions are 

stronger—especially in the U.S.
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 10

6) Projection by Age, Sex, Cause

• SSA/OCACT/Trustees Reports (2015 Technical Panel)

• Requires selecting ultimate rates of decline

• Allows change in age gradient

• Results in deceleration in mortality decline

AGE

1982-99 1999-2009 2009-13 2011-39 2011-89 2039-89 2011-39 2011-89 2039-89

2.79 1.22 2.14 0-14 2.77 2.74 2.72 1.58 1.57 1.57

0.63 0.61 1.06 15-49 1.07 1.06 1.05 0.97 0.93 0.90

1.61 1.27 0.05 50-64 1.34 1.34 1.34 1.17 1.09 1.06

0.92 2.11 0.91 65-84 1.06 1.06 1.05 1.09 0.86 0.74

-0.18 1.30 -0.11 85+ 0.65 0.64 0.63 0.64 0.53 0.48

0.51 1.78 0.48 65+ 0.88 0.86 0.85 0.89 0.71 0.61

0.75 1.59 0.48 Total 0.99 0.96 0.94 0.95 0.80 0.71

* Fit 1950-2011, using Medicare-enrollment data for 65 and over, rather than HMD data

 See Actuarial Note 158 https://www.ssa.gov/oact/NOTES/pdf_notes/note158.pdf

2015TR Intermediate

Comparison of Historical, 2015 Trustees Report, and Ron Lee* 

Average Annual Rates of Decline in Age-Sex-Adjusted Death Rates

Historical (Dec 2015 data) Ron Lee
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 12

Mortality Decline by Cause of Death: 

Rate of change from 1979 to 2017

-3

-2

-1

0

1

2

3

4

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

FEMALE

-3

-2

-1

0

1

2

3

4

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

Cardiovascular

Cancer

Violence

Respiratory

Other

MALE
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 13

Age-Sex Extrapolation vs. Age-Sex-Cause Projection 

Lee maintaining full age-gradient offsets lack of deceleration

Result: OASDI actuarial deficit unchanged using Lee estimates

7.5

8

8.5

9

9.5

1900 1920 1940 1960 1980 2000 2020 2040 2060 2080

Mortality Rate Comparison Age 65+ Unisex

Historical 2015TR Lee

0

1

2

3

4

5

6

7

8

1900 1920 1940 1960 1980 2000 2020 2040 2060 2080

Mortality Rate Comparison Age 0-14 Unisex

Historical 2015TR Lee
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 14

2015 Technical Panel

• Endorsed projections by cause with age-gradient

• Suggested average age-adjusted 1% annual rate of decline

– To match average rate since 1950, overall

– Understood this incorporated deceleration

• Chairperson Alicia Munnell, after TR 2016, said she was glad 

Trustees did not adopt the 1% rate of decline
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 15

Mortality Experience: All Ages

Reductions continue to fall short of expectations

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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 16

Mortality Experience: Ages 65 and Older

Reductions since 2009 continue to fall short of expectations

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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 17

Mortality Experience: Ages Under 65 

Actual increase since 2010

200

250

300

350

400

1990 1995 2000 2005 2010 2015 2020

Age-Sex-Adjusted Death Rates

(Ages Under 65)

2017TR 2018TR 2019TR Actual
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 18

Developing Assumptions by Cause

• 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 similar medium term expectations—

independently

– Trustees’ medium-term rates by cause had not been published 
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 19

Cardiovascular: JHU Less Optimistic than Trustees 

over Age 50 for Next 30 Years

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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 20

Respiratory: JHU More Optimistic under Age 50, Less 

Optimistic over Age 85

-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

-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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 21

Cancer: JHU Very Similar to Trustees’ Expectations

-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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 22

How Future Conditions Might Change

• 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 deceleration
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 23

Trends in Obesity: US 1971-2006 

Sam Preston 2010—must consider cumulative effects and increasing 

duration of obesity for aged in future
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 24

Death Rates Vary by Career Average Earnings Quintile 

Bosley, Morris, Glenn (2018): have the spreads stabilized? At ages 65-69:
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 25

Does Health Spending Affect Mortality?

Note rise, at least through 2009

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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 26

Health Spending Cannot Continue to Rise at Historical Rates

Note Trustees’ deceleration

-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
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 27

Is There an Omega?

It appears we are rectangularizing the survival curve

Survival Curve U.S. Female: Period Data

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

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

1900

1925

1950

1975

2000

2013

Survival Curve U.S. Male: Period Data

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

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

1900

1925

1950

1975

2000

2013
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 28

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 in 2013 to be 

19.0; actual was 19.1
Mortality Projections: A US Perspective on Approaches and Challenges - 17 May 2019 29

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
Thank you

Social Security Administration

Office of the Chief Actuary

410-965-3000

Actuary@ssa.gov