This is a multi–essay dissertation in the area of mortality risk management. The first essay investigates natural hedging between life insurance and annuities and then proposes a mortality swap between a life insurer and an annuity insurer. Compared with reinsurance, capital markets have a greater capacity to absorb insurance shocks, and they may offer more flexibility to meet insurers’ needs. Therefore, my second essay studies securitization of mortality risks in life annuities. Specifically I design a mortality bond to transfer longevity risks inherent in annuities or pension plans to financial markets. By explicitly taking into account the jumps in mortality stochastic processes, my third essay fills a gap in the mortality securitization modeling literature by pricing mortality securities in an incomplete market framework. Using the Survey of Consumer Finances, my fourth essay creates a new financial vulnerability index to examine a household’s life cycle demand for different types of life insurance.

Alzheimer'€™s disease (AD) is the fifth leading cause of death among the elderly. This study uses National Center for Health Statistics (NCHS) Multiple Cause of Death data for the United States for the years 1998 to 2002, examining the 9.5 million death records of all decedents of age 60 and over, and determines their incidence of AD. Seven independent variables are used: age, sex, race, ethnicity, marital status, education level and whether or not they lived in a metropolitan area. This study uses logistic regression, modeling five nested models, to determine the likelihood of mortality by AD and the direction of the relationship between AD and each of the variables. A Bayesian analysis, used to determine the best fit model, found that the full model was the best fit. The major findings of the study are that the incidence of AD increases significantly with increasing age in decedents aged 60-90. However, this peaks for decedents aged 85-89. Those who survive past age 90 begin to have a lesser likelihood of mortality by AD. With the exceptions of marital status and education, the hypotheses were supported. Females are more likely to die of AD than males. NonHispanic Whites are more likely to die of AD than Hispanics and NonHispanic Blacks. There is an increased risk of dying in a nursing home if one dies of AD. Future research as outlined above is needed to learn further about this fifth leading cause of mortality of those over age 60.

This study utilized a multi-level model to examine the impact of religion as an occupation on mortality. Death certificate data were used to examine clergy mortality and compares them to census categorized professionals, counseling professionals and unmarried clergy. Individuals mortality exist in, and is influenced by the state they resided and died in. Because of this, they are not only examined on the individual level, they are also nested in their respective state of death. A series of hierarchical linear models were estimated in order to determine the effects of the different influence levels (individual and state). Findings suggest that clergy have a significant life advantage over professionals and counseling professionals. Married clergy have significant years of life disadvantage when compared to unmarried clergy. Implications of this research are discussed and considerations for future research are presented.

Thesis (M.S.)--West Virginia University, 2001. / Title from document title page. Document formatted into pages; contains v, 104 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 48-54).

Thesis--Catholic University of America. / Bibliography: p. 81-85.

Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Deborah Frank, Florida State University, School of Nursing. Title and description from dissertation home page (viewed 6/16/04). Includes bibliographical references.

Objective The objective of the present study is to explore the associations of health expenditures and cause-specific mortality among countries at different stages of economic development. Methodology Scatter plot and simple linear regression were used to estimate whether there was an association between health expenditures and cause-specific mortality. The statistical significance levels were set at p < 0.05. Mortalities due to all causes, and three specific causes of the global burden of disease (GBD) were used. The three kinds of cause-specific mortalities were: communicable, maternal, perinatal and nutritional conditions (CMPN), non-communicable disease and injuries. Countries were grouped into four income groups according to the standard issued by World Bank in 2012. Result This study suggested general government expenditure on health, as a percentage of total government expenditure, was inversely associated with the three cause-specific mortalities, especially in high income group. Conclusion: This study showed an inverse association between healthcare expenditure and cause-specific mortalities. The Law of Health Transition has been once again evidenced. In developed countries, non-communicable diseases contributed to more deaths compared with mortality from communicable, maternal, perinatal and nutritional conditions (CMPN). While in less-developed countries, they were facing higher mortalities; CMPN was still a major cause of death, especially among children. / published_or_final_version / Public Health / Master / Master of Public Health

Background: India as one of the rapidly developing economies where health challenges are myriad at the population level has the highest number of maternal death in the world. Understanding risk factors for maternal mortality is paramount because maternal health is the basic indicator for the overall adequacy of healthcare of a country. This study was conducted to review on the various risk factors of maternal mortality and the multifarious challenges for maternal health in India. Methods: A literature search was conducted with PubMed and Google scholar using the key words of (“risk factors” AND (“maternal mortality” OR “maternal death”) AND India) for articles published from 1970 to May 2014. PubMed was primarily used for the systematic search. Findings: Twelve studies were identified for the final review of which six were case series studies, three were case studies and three were case control studies. Most of the studies were conducted in institutional settings from the five regions (North, South, West, Central and East) of India with different range of Maternal Mortality Rate (MMR) estimates. Previous literature had highlighted socio economic disadvantages as important determinants for maternal mortality. The current review shows a complex interplay of four factors in general in India: social, obstetrical, behavioural and medical factors. Variables of both social demographic and economic factors such as median age of the women at childbirth, literacy rate of the female population and area of residences are put together in the social factors of this study. Compared to the causes, descriptions on behavioural risk factors were rather limited and so the requisite to examine the risk factors affecting maternal mortality is justified. Intervention strategies include conditional cash transfer scheme, voucher scheme, training of village health volunteers and training of auxiliary mid wives’. Conclusions: India has a unique social system of diversity and stratification. The pattern of maternal mortality in India is different and varied widely in zones or regions. The variations of challenges should be highlighted so as to give a clear grasp of the inequalities of maternal health as well as also help in reducing the MMR substantially. / published_or_final_version / Public Health / Master / Master of Public Health

Background Influenza is an infectious respiratory illness which causes not only mild illness but also severe illness and death, responsible for about 250,000 to 500,000 deaths worldwide every year. Excess mortality usually had been used to estimate the actually recorded number of deaths that exceeded the number expected on the basis of past seasonal experience so as to assess the influenza related mortality. Previous studies reporting the association with environmental factors, such as ambient temperature and influenza related mortality, varied in different cities. Therefore, the association between environmental factors and excess mortality of influenza is still controversial and inconclusive, particularly in subtropical regions. Furthermore, whether there exists heterogeneity in the influenza disease burden and effect magnitude among different cities in the same subtropic region has been seldom documented so far. Objective The primary aim of this study is to critically assess the association between environmental factors especially weather conditions such as temperature, precipitation and relative humidity and the influenza‐associated mortality via systematic review and quantative analysis. The secondary aim is to compare the effect magnitude of environmental factors on influenza associated mortality between the southern cities of Mainland China and Hong Kong. Method Because influenza disease is difficult to detect or measure, influenza associated excess mortality which includes all cause deaths associated with influenza, respiratory and cardiovascular diseases (R&C) and pneumonia and influenza (P&I) has been used to measure the influenza. Eiligible studies up to February 2013 have been searched in Pubmed, EMBASE database and reference lists of previous reviews. All observational studies including ecological studies which assessed the assoicaitons between environmental factors and influenza‐associated mortality were included. Related excess mortality which had been deal with Poisson model in Hong Kong and related excess mortality which had been deal with negative binomial model in these Mainland southern cities had been collected from the secondary data. Meteorological data in Hong Kong had been collected from the historical data in meteorological observation stations, while the meteorological data in the southern cities of China was collected from China Meteorological Data Sharing Service System. Pearson correlation and linear regression have been used to examine the association between environmental factors and influenza associated mortality. Last, a pooled analysis was conducted by including city*environmental factors (temperature) as an interaction term in the model to detect the effect magnitude in the two kinds of cities. All tests were two‐sided and p values < 0.05 were considered statistically significant. Results A total of 14 papers were included in the critic review. Negative association between environmental fctors and influenza had been reported in many studies, although inconsistent results had also been reported. The excess mortality of pneumonia and influenza disease in the five southern Mainland cities is significant higher than the the one in Hong Kong (P=0.010). No significant difference was observed in all‐cause excess mortalities and cardiovascular and respiratory disease excess mortality between the two regions (P=0.991, P=0.109). In the five Mainland southern cities, there was significant association between temperature and influenza related all‐cause excess mortality, and the significant association was also found between temperature and cardiovascular and respiratory disease excess mortality (r = ‐0.475, P=0.016 and r = ‐0.673, P=0.007, respectively). Moreover, no significant association was found between precipitation and excess mortality in Mainland. While in Hong Kong, the only two significant associations were found between environmental factors, temperature and relative humidity, and P&I excess mortality (r = ‐0.763, P=0.003 and r =‐0.804, P=0.005, respectively). In the pooled analysis, the influence of temperature on R&C and all cause excess mortality was significantly different between Hong Kong and the five southern Mainland cities. With the increasing of the temperature, the excess mortalities reduced in the two counterparts. However, tempereture had a greater effect on the excess mortality in Mainland China cities than in Hong Kong. / published_or_final_version / Public Health / Master / Master of Public Health

Using standard procedures of demographic methodology, analysts working with mortality data are faced with a choice between large, unwieldy arrays of age-specific rates (or equivalent sets of life table entries), or one or more of a summary measures set, such as life expectancies and standardized rates, which does not retain all of the available information. This dissertation describes the development and preliminary testing of a mathematical model derived from elementary considerations of mortality mechanisms in the life table population. The model as developed postulates a Gompertz specification to account for mortality rates increasing with age among adults. Also, a proportion of the population was posited to be subject to a competing constant risk, to account for the declining mortality rates in early childhood. The motivation for this model is that its parameters, estimated for particular populations via nonlinear regression procedures, might be used as more efficient mortality summaries than those routinely used, without loss of conceptual interpretability. In testing life tables for male and female populations of 47 selected nations during the 1960s, the model was shown to be substantially more efficient for reproducing the original life tables than were any of the traditional measures considered.