Development, Inequality, Health Care, and Mortality at the Older Ages: A Cross-National Analysis

We examine mortality at ages 50 and above in female populations of 38 countries and control for variation in quality of the mortality data. We find that economic development, economic distributional inequality, and basic primary health care have independent cross-national effects on cause of death structures and that these effects are not uniform across the age intervals of interest. As improvements occur in level of living and health care, age-specific death rates decline except at the oldest ages, at which point they may increase. Our results are interpreted in terms of their relevance for mortality research, theory, and policy.