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Objective The lifetime risk of maternal mortality, which describes the cumulative loss of life due to maternal deaths over the female life course, is an important summary measure of population health. However, despite its interpretive appeal, the lifetime risk of dying from maternal causes can be defined and calculated in various ways. A clear and concise discussion of both its underlying concept and methods of measurement is badly needed. Methods I define and compare a variety of procedures for calculating the lifetime risk of maternal mortality. I use detailed survey data from Bangladesh in 2001 to illustrate these calculations and compare the properties of the various risk measures. Using official UN estimates of maternal mortality for 2005, I document the differences in lifetime risk derived with the various measures. Findings Taking sub-Saharan Africa as an example, the range of estimates for the 2005 lifetime risk extends from 3.41% to 5.76%, or from 1 in 29 to 1 in 17. The highest value resulted from the method used for producing official UN estimates for the year 2000. The measure recommended here has an intermediate value of 4.47%, or 1 in 22. Conclusion There are strong reasons to consider the calculation method proposed here more accurate and appropriate than earlier procedures. Accordingly, it was adopted for use in producing the 2005 UN estimates of the lifetime risk of maternal mortality. By comparison, the method used for the 2000 UN estimates appears to overestimate this important measure of population health by around 20%. Objectif Le risque de deces maternel sur la duree de vie, qui designe la probabilite de perte de vie due a la maternite en termes cumules sur la duree de vie d'une femme, est une mesure recapitulative importante de la sante des populations. Cependant, malgre son interet interpretatif, le risque de deces au cours de la vie par des causes liees a la maternite se definit et se calcule de diverses facons. Une analyse claire et concise de la notion sous-jacente et des methodes de mesure de ce parametre s'impose donc. Methodes J'ai defini et compare diverses procedures pour calculer le risque de deces maternel sur la duree de vie. J'ai fait appel a des donnees d'enquete detaillees emanant du Bangladesh pour l'annee 2001 pour illustrer ces calculs et comparer les qualites des diverses mesures de ce risque. Jai etaye les differences entre les valeurs du risque sur la duree de vie fournies par les diverses mesures en utilisant les estimations officielles ONU de la mortalite maternelle pour 2005. Resultats D'apres l'exemple de l'Afrique sub-saharienne, les estimations du risque sur la duree de vie pour 2005 se situent entre 3,41% et 5,76% ou entre 1 sur 29 et 1 sur 17. La plus forte valeur de ce risque a ete obtenue par la methode ayant servi a etablir les estimations officielles de l'ONU pour l'annee 2000. Je recommande ici une valeur intermediaire de 4,47 % ou de 1 sur 22. Conclusion Il existe des raisons solides pour considerer la methode de calcul proposee dans cet article comme plus precise et plus appropriee que les procedures anterieures. Cette methode a donc ete adoptee pour produire les estimations ONU du risque de deces maternel sur la duree de vie pour 2005. Par comparaison, la methode employee pour etablir les estimations de l'ONU pour 2000 semble surestimer cette importante mesure de la sante des populations d'environ 20%. Objetivo El riesgo de mortalidad materna a lo largo de la vida, que refleja la perdida acumulada de anos de vida por defunciones maternas a lo largo dei ciclo vital femenino, es un importante indice sintetico de la salud de la poblacion. Sin embargo, pese a su interes como variable interpretativa, ese riesgo de morir por causas maternas a lo largo de la vida puede definirse y calcularse de diversas, maneras. Hay que iniciar cuanto antes un debate claro y conciso tanto sobre el concepto subyacente como sobre los metodos de medicion. Metodos Se describen y comparan aqui diversos procedimientos para calcular el riesgo de mortalidad materna a lo largo de la vida. Se usaron datos encuestales detallados de Bangladesh correspondientes a 2001 para ilustrar esos calculos y comparar las propiedades de las distintas medidas dei riesgo. Usando las estimaciones oficiales de las Naciones Unidas sobre la mortalidad materna en 2005, se documentan las diferencias entre los riesgos a lo largo de la vida obtenidos con las diversas medidas. Resultados Tomando como ejemplo el Africa subsahariana, el intervalo de estimaciones para el riesgo en cuestion en 2005 se situa entre 3,41% y 5,76%, o entre 1/29 y 1/17. El valor superior se debe al metodo utilizado para generar las estimaciones oficiales de las Naciones Unidas para el ano 2000. La medida que aqui se recomienda tiene un valor intermedio: 4,47%, o 1/22. Conclusion Hay razones contundentes para considerar que el metodo de calculo aqui propuesto es mas preciso y adecuado que los procedimientos anteriores. En consecuencia, fue el metodo adoptado para generar las estimaciones de 2005 de las Naciones Unidas sobre el riesgo de mortalidad materna a lo largo de la vida. En comparacion, el metodo utilizado para las estimaciones de 2000 de las Naciones Unidas parece sobrestimar en aproximadamente un 20% esa importante medida de la salud de la poblacion., Introduction The importance of quantifying the loss of life caused by maternal mortality in a population is widely recognized. In 2000, the UN Millennium Declaration identified the improvement of maternal [...]

How Long Can We Live? A Review Essay (*) The quest for a longer, healthier life is the subject of a recent book by Jay Olshansky and Bruce Carnes. Written [...]

It has been widely supposed that human mortality from all causes increases with age nearly exponentially (at a constant rate) through adult ages except for very old ages, and that this exponential increase also holds fairly well for most major causes of death (CODs). However, the present analysis of death registration data for Japan, 1951-1990, reveals that the rate of age-related relative increase in mortality (the life table aging rate) changes with age significantly and systematically for many CODs. Above age 75, the mortality increase decelerates for most CODs; under age 75, it remains at a relatively stable pace for ischemic heart disease, decelerates for most major cancers, and accelerates for diseases related to a declining ability to maintain homeostasis (pneumonia, bronchitis, influenza, gastroenteritis, and heart failure). These results seem to suggest that significantly different types of senescent processes may underlie atherogenesis, oncogenesis, and immunosenescence.

This article summarizes recent findings in a case study of exceptional longevity. CM, a resident of San Rafael, California, was 114 years old in August 1996. He is the first properly verified case of a 114-year-old man in human history (although a few women have been known to live longer). Our investigation of CM continues as we attempt to gather additional information about his life, family history, and current condition. Here, we consider only two aspects of this case: its authenticity and its significance in the history of human longevity. We believe that we have proven that CM's stated age is accurate. Based on the available information, it also seems a reasonable conjecture that he may be the oldest man alive today and perhaps the oldest man who has ever lived. This study documents an extreme example of human longevity and records characteristics of the man's life that may provide clues about the causes of his exceptional survivorship. Key Words: Exceptional longevity, Centenarian, Super-centenarian

Paris: Economica, 1997.440 p. 198 FF (£30.18). Two recent books on demographic methods by French authors illustrate the richness of the field of demography in France. If one wished to [...]

Paris: Presses Universitaires de France and INED, 1994. x + 296 p, 170 FF (£25.92). Two recent books on demographic methods by French authors illustrate the richness of the field [...]

The alleged genetic deterioration of modern populations is the subject of a new book by Richard Lynn, a psychologist who marshals demographic theory and data as he revisits a familiar [...]

David W. E. Smith offers us a sweeping and unusually lucid review on the subject of human longevity. The work provides an impressively detailed discussion of the current state of [...]

With only five years left until the 2015 deadline to achieve the United Nation's Millennium Development Goals (MDGs), slow progress in MDG 5 (Improve maternal health) has been of concern [...]