The Demography and Epidemiology of Human Health and Aging

Book Preface

Health demography and its companion, the epidemiology of aging, are not well defined fields among the academic areas of study. A subdiscipline of demography labeled health demography has been identified and it essentially applies the materials, methods, and perspectives of demography to the study of health. Health demography overlaps greatly with the epidemiology of aging, and the distinction mainly reflects the difference in the academic training of the analyst. This book tries to set forth the basic materials of this area of study and to give it more formal definition and scope.

Health demography and the epidemiology of aging incorporate materials from a number of established disciplines, mainly sociology, demography, epidemiology, public health, gerontology, and actuarial science, but also bioethics, genetics, biostatistics, biology, medicine, geography, and computer science. Although the list above is long, the natural home of the subject is in departments of gerontology, demography, and epidemiology. The scope of the subject, as I envision it, is suggested by the Table of Contents of the book. It is apparent that I cover a broad area. The field ranges from the highly theoretical to the very practical. I deal with the theories regarding human aging and longevity, derived from molecular and evolutionary biology and biodemography, as well as with the issues involved in the expansion of hospital facilities in a city by local health administrators, derived from applied demography and spatial epidemiology. I consider the range of theories regarding the question of how long humans can live, and I consider the practical problems of how to bring demographic and epidemiological methods, materials, and perspectives to serve the health needs of local communities.

The book describes the latest sources of data on mortality and population health and presents the principal research findings based on these sources. It brings together the latest methods of measuring population health phenomena, including those for mortality, morbidity, and combinations of measures of mortality and morbidity. In this connection it considers such varied measures as the many types of life tables, the design of health surveys, and geographic information systems for health research and administration. While maintaining a primary focus on the demographic and epidemiological aspects of the subjects treated, the book covers socioeconomic variations in mortality and health, reproductive health, the health determinants and consequences of migration, health policy and administration, and selected bioethical issues. The measures described are often illustrated with examples in the form of calculation paradigms, so that the reader has a model for replicating the measures, and I suggest software packages for implementing some of the more elaborate methods described.

The geographic scope of the text, the tabular material, and the references and suggested readings relate to both the national and international area. The health demography of the less developed countries is given a substantial share of attention, in deference to the size and distinctive character of their populations and the extent and complexity of their health problems. At the same time, primary attention is given to the population health of the industrialized countries, especially the United States, where most of the readers of this volume work or will work as professional demographers, gerontologists, or epidemiologists. If no other geographic reference is given, the reader may assume that the area referred to is the United States. Nevertheless, readers from other countries and students of international comparative population epidemiology will find much in it of interest for them.