Literature DB >> 32182263

Subjective length of life of European individuals at older ages: Temporal and gender distinctions.

Dimiter Philipov1, Sergei Scherbov1,2,3.   

Abstract

This paper examines how older individuals living in 9 European countries evaluate their chances of survival. We use survey data for the years 2004 and 2015 to construct population-level gender-specific subjective length of life (or subjective life expectancy) in people between 60 and 90 years of age. Using a specially designed statistical approach based on survival analysis, we compare people's estimated subjective life expectancies with those actually observed. We find subjective life expectancies to be lower than actual life expectancies for both genders in 2004. In 2015 men become more realistic in the sense that their subjective life expectancy is close to what was actually observed, while women retain their subjective expectations of a shorter than actual life expectancy. These results help to better understand how people might construct diverse decisions related to their remaining life course.

Entities:  

Year:  2020        PMID: 32182263      PMCID: PMC7077847          DOI: 10.1371/journal.pone.0229975

Source DB:  PubMed          Journal:  PLoS One        ISSN: 1932-6203            Impact factor:   3.240


Introduction

Older individuals construct expectations about their remaining length of life with respect to where they live, their health, their life style, their family history, and other factors. They organize their remaining life course and take a wide range of crucial decisions based on these expectations, for example: distribution of savings and properties; changes in employment status and retirement; family issues and living arrangements; bequests; personal health; and care provision. Personal expectations about remaining life years are innately probabilistic because individuals are unaware of what their actual longevity will be. Scientists explore these expectations with survey data which they use to estimate diverse indicators of survival. An important issue is the extent to which subjective measures of survival reflect actual survival. A mismatch between subjective expectations and the actual length of remaining life can lead to biased decision-making related to the remaining life course. There may be undesired consequences if planned life course episodes and events occur at the "wrong" time, which can increase frustration, anxiety, and stress. Such issues demonstrate the need for analyses of potential deviations of subjective measures of longevity from their objective equivalents. This topic has received less attention than analyses of subjective survival, particularly with regard to the elderly population. Path-breaking research [1] based on survey data compares subjective survival probabilities and corresponding life expectancies for males in the United States with those actually observed at the time of survey. The findings show that subjective life expectancies are slightly higher than actual ones. Comparisons of subjective with actual survival plummeted when data from the Health and Retirement Survey (HRS) started being used. One study [2] reports that survey measures of subjective survival probabilities aggregate well to the corresponding population probabilities; another study [3] based on four waves of HRS data reports that subjective longevity expectations are consistent with individuals’ observed survival patterns. A comparison of subjective and actual probabilities using longitudinal HRS data arrived at similar conclusions [4]. However, differences in hazards corresponding to subjective and actual survival curves estimated based on longitudinal HRS data show that both men and women overestimate their remaining life expectancy [5]. Several studies discuss this validation for the elderly in Europe using data from Survey of Health, Ageing and Retirement in Europe (SHARE). Above the age of 60, both men and women overestimate their subjective survival probabilities, with men being less accurate [6]; analysis for 11 countries based on a longitudinal dimension of 2 years (the period between Wave 1 and Wave 2 of SHARE) showed that subjective life expectancy corresponds to actual life expectancy” [7]; a study of 9 countries concluded that male subjective survival probabilities are close to the probabilities computed from cohort life tables, whereas female subjective probabilities are lower [8]. Other studies based on different data sets report different conclusions. Analysis of longitudinal data from the Berlin Ageing Study collected over 16 years shows that individuals aged 70 and over have relatively accurate perceptions of their nearness to death [9]. An exploration of the German SAVE panel (Sparen und Altersvorsorge in Deutschland) over the 25–60 age span inferred that men and women underestimate their longevity in a cohort perspective by 6–7 years [10]. Survey data for France came to similar conclusions [11]; in this survey each respondent stated his or her chances of survival to several different ages, which enabled individual survival curves and relevant individual life expectancies to be estimated. The findings show that respondents over 60 underestimate their subjective life expectancy relative to life table life expectancy, and that this gap is larger for women. The two studies show that lower subjective life expectancies relative to actual life expectancy are observed for both genders. This brief outline shows that while studies based on HRS data for the United States report a satisfactory match between subjective and actual survival rates, studies in Europe are not as unified; some report a good match, while others show that respondents, and particularly women, underestimate their potential longevity. Differences in data, measurement, and methods of estimation are the main reasons for diversity in the findings. Some surveys are longitudinal and provide individual-level data suitable for comparisons of an individual's expectation of survival to a certain age with the actual survival of the same individual. Other surveys are cross-sectional, where the integration of data provides survival rates related to the study of a population. Survey questions also differ and may refer to the measurement of different indicators of longevity. Accordingly, methods of research should comply with each specific data set and measurement. This overall diversity hinders comparisons of findings, as each finding is valid within its own scope of data, measurement, and method. This paper contributes to research based on the use of subjective life expectancies. Although these are derived from survival probabilities, we prefer them because they serve as an integrated indicator of longevity that is easy to understand, easy to communicate, and easy to use for comparisons across time, space, and gender. Research on the health status of the elderly supports our choice, as healthy and unhealthy life expectancies estimated using respondents’ subjective views of their health are routinely used as indicators [12,13]. These remarks are intended to raise awareness of the following topics of research which we consider to be insufficiently covered in the literature: International comparisons can help to ascertain whether deviations are systematic or not. Temporal analyses may indicate whether a fit remains stable in time or whether a misfit increases or decreases with time. Differences between the two genders need to be the subject of further deliberations. We deal with these research topics at the macro level with a focus on the over-60 population. We develop a method to estimate population-level subjective life expectancies based on observed individual subjective survival probabilities and compare them with actually observed life expectancies. The next section describes data and methods. It is followed by a description of estimated results; a discussion of these can be found in the final section.

Data and methods

We use SHARE data from Wave 1 (2004) and Wave 6 (2015) from which we selected men and women aged 60 to 80 years. The upper age boundary was chosen because institutionalization increases in the over-80 population. Subjective survival probabilities are observed with responses to one question: “What are the chances that you will live to be age T or more?” The target age T depends on the age of the respondent as indicated in Table 1.
Table 1

Target ages (T) in the SHARE question about chances for survival to age T.

Age of the respondentTarget age T
60 to 6575
66 to 7080
71 to 7585
76 to 8090
As this question may seem difficult to respondents, they were introduced to the issue of “chances” with an example. They were asked to answer the question: “What do you think are the chances that it will be sunny tomorrow?” with answers from 0 to 100. We selected 9 countries where data were available in both waves: Austria, Belgium (Wave 1 in 2005), France, Germany, Greece, Italy, Sweden, Spain, and Switzerland. The number of “no response” to the question about survival chances was low and is not expected to influence our results. However, the answer “don’t know” to the same question accounted for about 9 percent of all respondents eligible for our study in Wave 1 and for 7 percent in Wave 6. The proportion of "don't knows" is higher in France, Greece, Italy, and Spain in both waves. We compared these answers to those about limited abilities versus non-limited abilities during the 6 months prior to the survey, measured with the Global Activity Limitation Indicator (GALI) [12-14]. The answer “don’t know” to chances of survival was prevalent among respondents who declared having limited abilities. We assume that people with limited abilities will state lower survival probabilities compared to those with non-limited abilities; hence, if respondents had answered with their chance of survival, instead of selecting “don’t know,” survival at the population level would decline. Answers to the question could be any number between 0 and 100; 0 reflects the respondent’s expectation that he/she will certainly not live to the target age, and a value of 100 reflects full certainty of survival to this age. A significant proportion of the answers are clustered around some focal points, with the majority at value 50 (around 26 percent of our selection of respondents); this answer reflects “epistemic uncertainty” [15]. Another large focal point is 100 (around 15 percent). In contrast to other methods of estimation, focal points do not constitute important problems for the method of estimation used in this paper. When the answer is divided by 100, the question measures the probability Sx,i(T) of an individual i aged x years at the time of the survey surviving to age T or higher. By definition, it is analogous to the corresponding life table function, but differs in two respects: the probability Sx,i(T) relates to an individual and reflects subjective views expressed at the time of the survey; the life table probability refers to a population and reflects the probability of actual survival. We assume that a population defined by a specified country, gender, and year pertains to one life table based on actual observations. Pulling together values of individual Sx,i(T) leads to a subjective life table of the same study population. We aim to compare life expectancies estimated in actual and subjective life tables. These comparisons are used for analyses of our research topics. The issue is how to pull together values of the subjective Sx,i(T) into a survival function of one life table. A preferred approach reported in the literature is to consider each response as a draw from a particular distribution that describes the corresponding population’s life table survival function. Gompertz and Weibull distributions are most frequently used in this regard (for example [5] and [16]). Other distributions are also applied, for example, the beta distribution [17] and the logistic distribution [4]. Application of statistical methods such as non-linear programming or maximum likelihood can provide estimates of the parameters of these distributions. Preferences point to the Gompertz function with its long-time applications for the study of mortality. The Gompertz function for survival from age 0 to age x is: with parameters α and β. The following life table equality links the observed survival probabilities Sx(T) with S0(x): Sx(T) = S0(T)/S0(x). The estimated survival probabilities can be used to compute life expectancies. When non-linear regression is applied, confidence intervals of parameter estimates cannot be directly applied to estimating confidence intervals of life expectancies; additional modeling and additional assumptions are required. We prefer a different approach. As the task of pulling together individual survival probabilities belongs to survival analysis, methods developed within this statistical field are preferable. Hence, it is possible to make use of the probabilistic nature of the individuals’ responses about their chances of survival because each response is a draw from an unknown subjective probability distribution (a general discussion on subjective probability distributions is available in [18]). We developed a model approach that comprises the steps included in Table 2.
Table 2

Algorithm of the model applied for the estimation of subjective life expectancies.

Step 1For each respondent i, one number Ji is drawn from the uniform distribution [0,1].

Step 2

Each respondent’s subjective Sx,i(T) is compared with this number. If Sx,i(T)> = Ji the person is supposed to have survived to age T; if Sx,i(T)<Ji, the person is supposed to have died at an unknown age in the interval [X, T). This survival outcome is probabilistic and in line with the probabilistic nature of Sx,i(T).

Step 3

A dichotomous variable Z is constructed which denotes survivals to age T as 1 and deaths in the interval (X,T) as 0.

Step 4

Survival analysis is applied for interval-censored data assuming a Gompertz distribution of survival, using a maximum-likelihood estimator for the parameters of the Gompertz function. At this step we applied weights as available in the survey.

Step 5

A life table Sx(T) is estimated using the Gompertz function specified with the received parameters. The life expectancy of 60-year olds is estimated following conventional formulas in a life table, in the 60–90 year age interval.

Step 6

The procedure is repeated from Step 1 to Step 5 to obtain another value for the life expectancy.

Step 2 Each respondent’s subjective Sx,i(T) is compared with this number. If Sx,i(T)> = Ji the person is supposed to have survived to age T; if Sx,i(T)person is supposed to have died at an unknown age in the interval [X, T). This survival outcome is probabilistic and in line with the probabilistic nature of Sx,i(T). Step 3 A dichotomous variable Z is constructed which denotes survivals to age T as 1 and deaths in the interval (X,T) as 0. Step 4 Survival analysis is applied for interval-censored data assuming a Gompertz distribution of survival, using a maximum-likelihood estimator for the parameters of the Gompertz function. At this step we applied weights as available in the survey. Step 5 A life table Sx(T) is estimated using the Gompertz function specified with the received parameters. The life expectancy of 60-year olds is estimated following conventional formulas in a life table, in the 60–90 year age interval. Step 6 The procedure is repeated from Step 1 to Step 5 to obtain another value for the life expectancy. Our choice of the ages 60–80 for the respondents and 60–90 for the life expectancies needs clarification. We restrict the respondents’ upper age to 80 because the proportion of institutionalized persons rises significantly above this age, and they are not included in the survey samples. Estimates of subjective life expectancies refer to the age interval 60–90 because answers about subjective survival to target age 90 were given by respondents aged 76–80. The life expectancies thus estimated are the sum of person-years lived in the age interval between 60 and 90; we refer to them as segmented to differentiate them from the classical equivalents which are not limited by an upper survival age. In this procedure, the value of the (subjective) life expectancy depends on random numbers Ji. Hence, its value is also random and is a draw from an unknown distribution. We construct the latter empirically, repeating 1000 times the execution of steps 1 to 5. Fig 1 gives the form of this distribution for German males, Wave 1 (2004).
Fig 1

Empirical distribution of 1000 segmented subjective life expectancies in the age interval 60–90 estimated with 1000 draws, German males, 2004 SHARE Wave 1 data; values ordered from low to high.

If the draws were a different number, such as 500 or 2000, the distribution would display essentially the same shape. The mean of all 1000 life expectancies is an estimate of the “true” one; for German males in 2004 it is equal to 18.2 years. It is inappropriate to estimate standard errors and construct confidence intervals around the mean based on this empirical distribution, as the sample size, 1000 in this case, depends on the researcher's decision. Instead of working with standard errors and confidence intervals, we preferred to use 2.5 and 97.5 percent percentiles to define intervals for the estimated mean of the life expectancy similar to the confidence intervals; for German males in 2004 these are 17.4 and 18.9 years. We compare subjective life expectancy to age 90 with actual life expectancy for the whole population estimated from observed data for the age interval 60–90. The actual life expectancy is thus also segmented. These life expectancies were estimated using data from the Human Mortality Database (HMD) [19] for the years 2004 (Belgium 2005 to fit the year of Wave 1) and 2015 (last available data in Greece were for 2013 and in Italy for 2014).

Results

This section displays the results from the estimation procedures. They are considered in the discussion in the next section. We report subjective and observed life expectancies for males and females, segmented over the 60–90 age interval for the years 2004 and 2015 (we skip further the specification “segmented” for life expectancy; all life expectancies in this paper are segmented). We report percentiles of the distribution of estimated subjective life expectancies and use them to elucidate the statistical significance of differences among life expectancies (LE). When an actual LE is outside the range defined by the two percentiles of the corresponding subjective LE, we can reject the hypothesis that the actual and the subjective LE do not differ. We first display results for the year 2004, then for 2015, followed by the results for temporal change and gender differences.

Results for 2004

Table 3A shows that for males the average subjective LE for nine countries is lower than the actual one by slightly over one year. At the country level, the highest subjective LE is observed in Switzerland where the actual LE is also highest of the 9 countries. Subjective LE is also high in southern Europe, specifically in Spain, Italy, and Greece but this observation does not hold for the actual LE. Differences between subjective and actual LE are displayed in the far right-hand column of the table, statistically evaluated using percentiles. Numbers in bold indicate where the difference is beyond the percentile interval. It is worth noting that statistically significant values are greater than one year, and differences cannot be accepted as significant when they are less than one year.
Table 3

a) Segmented subjective and actual life expectancy (LE) and percentiles of the subjective LE, males, 9 European countries, 2004.

 Subjective LEActual LEActual–Subj.
MeanPercentiles
  0.0250.975  
A
Austria18.717.519.920.11.4
Belgium18.317.419.219.81.5
Switzerland20.518.722.121.30.8
Germany18.217.31919.71.5
Spain20.218.921.520.50.3
France18.717.419.820.72
Greece19.718.520.920.30.6
Italy2018.921.120.70.7
Sweden19.218.32020.81.6
Average19.318.120.420.41.2
B
  0.0250.975  
Austria18.217.119.423.45.1
Belgium18.617.619.523.34.7
Switzerland20.418.721.924.23.9
Germany18.117.21923.25
Spain19.818.620.924.34.5
France18.817.719.824.65.8
Greece18.417.219.623.24.9
Italy19.518.420.524.14.7
Sweden19.618.820.523.53.9
Average1917.920.1234.7

Source: Authors’ estimates based on SHARE data, Wave 1, 2004 (Belgium 2005), and Human Mortality Database. In bold observations where the actual LE is outside the boundaries of the two percentiles. Segmented LE refer to the age interval 60–90.

Source: Authors’ estimates based on SHARE data, Wave 1, 2004 (Belgium 2005), and Human Mortality Database. In bold observations where the actual LE is outside the boundaries of the two percentiles. Segmented LE refer to the age interval 60–90. We find that in 2004, males in Switzerland and southern Europe had a realistic view about perspectives of their remaining life years. In the remaining five countries—Austria, Belgium, France, Germany, and Sweden—men’s views about the length of their life show them to be biased downwards: French men appear more downwardly biased, as their expectations about length of life differ from the actual length of life by two years. We can also ignore confidence intervals because differences displayed in the far right-hand column of the table are not as low and could be substantively meaningful. One dominant feature then emerges: men in all 9 countries underestimate their length of life by at least half of one year, and men in Spain by 0.3 of one year. Table 3B gives similar data for women. An obvious inference can be made from the results: women in all countries exhibit a downward bias, as the length of life they expect is nearly 5 years lower than their actual lifespan. Downward bias is particularly strong among French women where the subjective LE is nearly 6 years lower than the actual. Women in Austria and Germany also underestimated their length of life.

Results for 2015

Next, we examine results observed in 2015. These are displayed in Table 4A for males and Table 4B for females.
Table 4

a) Segmented subjective and actual life expectancy (LE) and percentiles of the subjective LE, males, 9 European countries, 2015.

 Subjective LEActual LEActual–Subj.
MeanPercentiles
  0.0250.975  
A
Austria22.621.623.521.3-1.3
Belgium2019.220.721.11.2
Switzerland22.421.423.322.50.2
Germany21.120.421.920.8-0.4
Spain21.820.622.921.90.1
France20.219.22121.91.7
Greece20.619.721.321.20.6
Italy21.720.922.622.20.4
Sweden22.321.62322.2-0.1
Average21.420.522.221.70.3
B
  0.0250.975  
Austria22.82223.524.11.3
Belgium20.519.821.223.93.4
Switzerland2221.222.824.92.9
Germany21.320.52223.82.5
Spain21.220.122.225.24
France20.619.721.525.24.6
Greece19.618.820.424.24.6
Italy20.619.821.324.94.2
Sweden22.72223.424.21.4
Average21.320.42224.53.2

Source: Authors’ estimates based on SHARE data, Wave 6, 2015, and Human Mortality Database for 2015 (last available HMD data: Italy 2014, Greece 2013). In bold observations where the actual LE is outside the boundaries of the two percentiles. Segmented LE refer to the age interval 60–90.

Source: Authors’ estimates based on SHARE data, Wave 6, 2015, and Human Mortality Database for 2015 (last available HMD data: Italy 2014, Greece 2013). In bold observations where the actual LE is outside the boundaries of the two percentiles. Segmented LE refer to the age interval 60–90. Compared to 2004, males in Switzerland and southern Europe maintained their realistic expectations in 2015, while men in Belgium and France retained their downward bias. German and Swedish males changed their previous downward bias to a realistic view. Men in Austria changed their downward bias to an upward bias, but this change needs additional study beyond the scope of this paper. Downward bias continued to have total prevalence among women in 2015. It is most pronounced in southern European countries plus France. On average, women’s overall bias is lower by about 1.5 years in 2015 than in 2004, and is considerably decreased in Austria.

Temporal change

Table 5 shows the results for temporal change. From 2004 to 2015, actual LE increased by about 1.2 years for males and 0.7 years for females. In the same period, subjective LE increased on average by 2.1 years for males and 2.2 years for females which is twice that of actual LE: subjective estimates of LE increased at a higher pace than actual LE.
Table 5

Temporal change in subjective and actual life expectancy from 2004 to 2015 (values in 2015 minus values in 2004), males and females.

MalesFemales
Est.ActualEst.Actual
Austria3.91.04.60.7
Belgium1.61.31.90.6
Switzerland1.91.21.70.6
Germany3.01.13.10.6
Spain1.61.31.40.9
France1.51.21.80.6
Greece0.80.91.21.0
Italy1.71.41.20.7
Sweden3.11.33.10.7
Average2.11.22.20.7

Source: Tables 2 and 3

Source: Tables 2 and 3 We evaluate the statistical significance of differences in subjective LE as follows. Consider, for example, Greek males. The value for 2015 is 20.6 (Table 4A) and lies outside the interval defined by the two percentiles for 2004, namely, 17.2 and 19.6 (Table 3A). We thus conclude that the difference of 0.8 of one year (Table 5) is statistically significant. The same inference holds for all other differences between subjective LE in Table 5, and for this reason it is not shown in the table. At the country level a large increase in subjective LE is notable in the two German-speaking countries, Austria and Germany, and also in Sweden, with more than 3 years for both men and women. In the southern European countries and in Belgium, France, and Switzerland, the increase is under two years for both genders. Values of between 2 and 3 years could be noted only for the averages across the 9 countries. Fig 2 gives a visual presentation of the increase in subjective LE based on the example of German males. The figure displays the two sets of 1000 subjective LE estimated with data from Wave 1 and Wave 6. The increase is around 3 years, and the lowest value estimated with Wave 6 data is higher than the highest value estimated with data from Wave 1.
Fig 2

Subjective LE: 1000 values estimated with data from Wave 1 and 1000 values estimated with data from Wave 6 (exact procedure of estimation described in the previous section).

Values for each wave are ordered from low to high.

Subjective LE: 1000 values estimated with data from Wave 1 and 1000 values estimated with data from Wave 6 (exact procedure of estimation described in the previous section).

Values for each wave are ordered from low to high.

Gender comparisons

The last topic in this section concerns gender comparisons. Averages in Table 6 show that actual LE was around 3 years lower for men than for women in 2004 and in 2015. For subjective LE the observation was different, with the averages for men and women being about equal, and the differences not being greater than 0.2 of one year in 2004 and in 2015. Substantively, in the context of our discussion, 3 years is a significant difference, while 0.2 of one year is not. A check for statistical significance as described in the previous sub-sections leads to an analogous conclusion. We conclude that gender differentials did not change much over time.
Table 6

Gender differences in estimated and actual life expectancy (men’s minus women’s), 2004 and 2015.

20042015
Est.ActualEst.Actual
Austria0.5-3.3-0.2-3.0
Belgium-0.3-3.5-0.5-2.8
Switzerland0.1-3.00.4-2.5
Germany0.0-3.5-0.1-3.0
Spain0.4-3.80.6-3.4
France-0.1-3.9-0.5-3.3
Greece1.4-2.90.9-3.0
Italy0.6-3.41.1-2.7
Sweden-0.4-2.6-0.4-2.0
Average0.2-3.30.1-2.9

Source: Tables 2 and 3

Source: Tables 2 and 3 Some of the differences seen at the country level could be on the edge of substantive significance, for example, the value of 0.5 of one year observed for Austria in 2004. The difference, however, is statistically insignificant. Statistical significance holds for differences shown in Greece (2004), and in Greece and Italy (2015). In Italy in 2004, and to some extent in Spain in both years, the differences can be accepted as substantively important. In these three southern European countries, there was greater downward bias regarding survival on the part of women than of men in 2004 and in 2015. In a figure with two graphs for men and women, similar to Fig 1, the two curves would be hard to distinguish, even for Greece where the largest differences were observed. For this reason, the figure has not been included here.

Discussion

In this paper we advocate the use of subjective life expectancy as an aggregate measure of subjective probabilities of survival. This indicator is familiar from life table theories and it has important advantages vis-à-vis other measures of survival, such as hazards or rates. Life expectancy, when segmented for a closed age interval, is also much easier to understand and use in analyses. We applied it for cross-country analyses as well as for gender and temporal comparisons. We developed and applied a new method of estimation within the framework of survival analyses. In this framework, we consider the reported subjective probabilities of survival as draws from a probability distribution. We generated 1000 trials for simulated survival, and for each trial we estimated a subjective life expectancy using a Gompertz survival curve. Percentile levels of a distribution based on these trials served as confidence intervals. We understand subjective probabilities of survival as being personal expectations that reflect a respondent’s perception of survival at the time of survey. We consider it unlikely that respondents are able to forecast their personal survival for the next 10–15 years. For this reason, we prefer the application of period life tables; moreover, construction of cohort life tables over an age span of 30 years requires the use of assumptions and relevant estimation procedures. Yet, if cohort life tables were considered, then the differences between subjective and actual life expectancy would be even larger because the cohort actual life expectancy would be higher than its period counterpart, in other words, a cohort approach would reinforce our inferences. We find that in 2004 underestimated views about length of life dominated in all 9 countries studied here. Women underestimate their length of life by nearly 5 years within the age interval 60–90 years when compared with the actual life expectancy, while men’s underestimation is lower. These results are consistent with those previously reported for Germany [10] and for France [11], and also with those reported in [8], although these three reports rely on the cohort approach. During the 11 years between 2004 and 2015, subjective life expectancies increased at a higher pace than actual ones. Gender differences did not change. Underestimation decreased for both genders, and men had become much less unbiased in 2015, unlike women. It is important to see how this tendency will develop in the future. If it continues during the next 5–10 years, men may become upwardly biased while women may closely approach realism. If it does not change much for the men, then they will have reached steady realism about life length. Clearly, though, rigorous conclusions would be crucial as a basis for social and economic policies related to the life course of the elderly. Specific studies that include the influence of health, education, income and many other personal traits and societal characteristics are required to substantiate our findings. We expect that personal health status will be a central issue with a direct impact on survival expectations. Other issues such as education are also influential in terms of chances for survival, mainly due to their impact on health [20]. There are different reasons why there may be a decline in the downward bias over time. Some are related to the spread of healthy life styles with good diets, an active life, a decline in smoking and alcohol consumption, and other issues related to active aging. Expectations about improved health, and hence about a longer life, are expected to increase. Other reasons would be population composition effects, such as an increase in the proportion of the elderly with higher education who are more meticulous about keeping up a healthy life style. This increase is documented in statistical data at the population level, and it should have been reflected in survey samples (we discuss this issue below). Hence, there is an increase in the proportion of people with better than average health. Improvements in health care are a further reason why there may be a rise in expected subjective length of life. Rigorous conclusions would be valuable for the evaluation and improvement of pertinent social policies. Our results revealed that men and women have about equal expectations of length of life: around 19 years in 2004 and 21 years in 2015. This result is unexpected because women's actual length of life is longer. Analogous outcomes have been reported for healthy life expectancy measured with subjective statements of survey respondents, for example with GALI. Numerous studies show that women report significantly worse health than men, and their proportion of healthy life is considerably lower than that of men. This is an unexpected outcome because women live longer and hence are expected to be in better health than men. This has led to what is known as the male–female health-survival paradox [21,22]. It is likely that unhealthy persons will report lower probabilities of survival; hence the pronounced downward bias of women, relative to men, is consistent with their worse health status. Our findings reflect a similar paradox: a male–female subjective survival paradox. Comparing subjective with healthy life expectancies reveals a crucial advantage for the former. The validity of the comparisons can be tested with evaluations of objectively observed actual life expectancies. Healthy life expectancies do not have an exact population-level statistical observation and hence do not have an anchor for validation. Only indirect validation is feasible, for example, comparing women’s health with men's. The fact that male–female comparisons of healthy life expectancies and subjective life expectancies resemble each other indicates that they are subject to similar explanations. This topic requires further research. At the country level we find that our main inferences hold in all 9 countries: downward bias for men and women in 2004, downward bias for women in 2015, larger bias for women than for men. We conclude that our inferences are systematic and not a result of some peculiarity. Some country-specific observations require deeper attention. Notably men in the three southern European countries reveal expectations of longevity in 2004 that are close to realistic, and downward bias dominates in France for both genders and in both years. Our study is not free of caveats. Survey data are usually problematic with respect to how well they represent the population of study, in this case men and women aged 60 to 80 years. The SHARE data have been found to be non-representative regarding educational attainment: persons with higher education are over-represented in our list of countries [23]. Due to this sample bias, estimated subjective life expectancies are higher than those of the study population. If samples were representative for education, subjective life expectancies would be lower and therefore our results would be reinforced, as downward bias would increase. An open question remains with respect to men’s realism in 2015; it could turn out that men were biased downwards in 2015 as well. To check the effect of non-representativeness by education we used crudely constructed weights by education for Austrian men in 2015 using their distribution by three levels of education [23,24]. We found that the subjective life of these men would be a fraction of one year lower (i.e., 0.2) than the one displayed in Table 4A. We thus do not expect that non-representativeness by education harms our inferences. To conclude, we raise some policy implications that refer to the life course of the elderly. Men and women who underestimate their length of life are likely to construct their life course over a span that will be shorter than the actual. Later in life they may be confronted with undesirable situations related to savings, investment, bequests, and living arrangements. Hence, we need more information about the prevalence of this kind underestimation and its effect on introducing bias into life course decisions. The underestimation may induce other negative aspects, for example, increased stress and anxiety. Last but not least, differences between men and women may also indicate that unisex policies might lead to gender inequalities among the elderly. 18 Dec 2019 PONE-D-19-30019 Subjective Length of Life of European Individuals at Older Ages: Temporal and Gender Distinctions PLOS ONE Dear Dr. Sherbov, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses all the points raised during the review process. We would appreciate receiving your revised manuscript by Feb 01 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Gianluigi Forloni Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements: Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Yes ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know Reviewer #2: I Don't Know ********** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: No Reviewer #2: Yes ********** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: 1. This is an interesting paper in terms of its approach yet it strikes me as a preliminary step for a more comprehensive and detailed analysis of the SHARE Ware 1 and 6 data. Review of the original data suggest it would be feasible to perform analyses of social, economic, health, and mental health results that might account for differences in perceived chances of survival: this holds for gender differences, country differences, and temporal differences or similarities. 2. The Introduction could be condenses and better organized. Similarities and differences in published studies could be summarized more succinctly. 3. The data and methods section is more detailed than it needs to be and might be better as a Table. 4. I am a medical scientist and we would not employ terms like optimism or pessimism but frame our descriptions in terms of realistic or more accurate perceptions. There are data in Wave 1 and 6 survey that actually could be used to address "pessimism". 5. I find glibly excluding (the Danish data because it is difficult to account for in the model problematic. Does it point to problems with the model and its principles? 6. The main findings could be summarized in a more parsimonious fashion. That being said, there should be a more thoughtful discussion of: a. the reasons for certain patterns of discrepancies between perception of life expectancy and actual life expectancy b. the profound gender differences c. what could account for some of the profound temporal data shifts such as in Austria, Germany, and Sweden. Reviewer #2: Authors analysed data from the SHARE surveys Waves 1 and 6 in order to explore subjective life expectancy (LE) and compare with actual LE, based on Human Mortality Database. The paper has several strength, eg. analysis of several countries in parallel, comparing results of the same survey in two time points and comparing genders. However, I think there are some weak points as well. In the SHARE database respondents are asked about probabilities, ie (Page6 Line 114): 'What are your chances that you will live to be age T or more?' Given the low statistical literacy level of the populations (please see studies by Gigerenzer G. et al) the responses are probably biased in a significant number of cases. Most people can often say the exact age they think they will reach if they are asked in asimple direct way (eg. https://www.ncbi.nlm.nih.gov/pubmed/26077549 ). Howveer, this question forces them to translate this idea first to a specific age (which is either over or below or equal to their subjctive LE). Then, in order to respond this question they have to express that in percentages. This methodology is my major concern regarding the whole study. I understand, of course, that the SHARE data is a given source and Authrs tend to make good use of it, however I am still doubtful about the validity and applicability of these responses to subjective LE estimates. I suggest, therefore, to test the validity of this question at least in a small sample. My second concern is related to the comparison with actual LE. Sociodemographic status is a major determinant of LE. Was the SHARE sample matched to the controll sample (actual LE) by main socioeconomic characteristics, such as educational and income level? For instance, slight differences in educational level between the two may result in differences between subjective and actual LE without any real under- or overestimation. More educated people will express a longer subjective LE and in fact their actual LE is higher than of the average population, hence their subjective LE is realistic and the observed gap is artificial. Overall, Authors do not provide enough infomation about the SHARE data sampling and characteristics of the sample which makes the interpretation of the results challenging for someone who is not very familiar with SHARE. On Page7Line131 Author refer to 'limited abilities'. Is it the GALI question from the MEHM? Analysis of determinants of over- and underestimation (regression) would increase substantially the scientific content of the study. ********** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. 6 Feb 2020 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Yes ________________________________________ 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: I Don't Know Reviewer #2: I Don't Know ________________________________________ 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ________________________________________ 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: No Reviewer #2: Yes The submitted manuscript was language-edited. ________________________________________ 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) We thank the reviewers for their useful comments. Following the recommendations of the reviewers we introduced significant changes in the paper and considerably improved it. While applying the changes, we keep the focus of the paper on trends and observations of subjective life expectancies that have not been published elsewhere. The major changes include: - The introduction is shortened. - We entered a new table in the section on data and methods. - We extended the Discussions. We elaborate more extensively the effect of important issues such as health and level of education. We also discuss non-representativeness of samples by education and find that it does not harm our inferences. - We excluded Denmark where non-representativeness by education is particularly large. Reviewer #1: 1. This is an interesting paper in terms of its approach yet it strikes me as a preliminary step for a more comprehensive and detailed analysis of the SHARE Ware 1 and 6 data. Review of the original data suggest it would be feasible to perform analyses of social, economic, health, and mental health results that might account for differences in perceived chances of survival: this holds for gender differences, country differences, and temporal differences or similarities. We agree with the reviewer that the paper is a preliminary step towards more comprehensive analyses. Our paper explores trends and observations related to subjective life expectancies that have not been published elsewhere. Explanations of such trends and observations can be research topics in subsequent papers. Yet in this paper we consider the effects of health and education, while rigorous analyses of these effects can be topics of separate papers. 2. The Introduction could be condenses and better organized. Similarities and differences in published studies could be summarized more succinctly. The introduction is by about half a page shorter which also improved the clarity. 3. The data and methods section is more detailed than it needs to be and might be better as a Table. Done; Table 2 was added. 4. I am a medical scientist and we would not employ terms like optimism or pessimism but frame our descriptions in terms of realistic or more accurate perceptions. There are data in Wave 1 and 6 survey that actually could be used to address "pessimism". These terms were replaced with others such as upward bias and downward bias. 5. I find glibly excluding (the Danish data because it is difficult to account for in the model problematic. Does it point to problems with the model and its principles? The Danish sample strongly over-represents people with higher education. The country is occupying exceptional positions in other international comparisons, such as for healthy life (for example in references 12, 13, 22). We excluded Denmark from our analysis as it cannot make a meaningful contribution. 6. The main findings could be summarized in a more parsimonious fashion. That being said, there should be a more thoughtful discussion of: a. the reasons for certain patterns of discrepancies between perception of life expectancy and actual life expectancy b. the profound gender differences c. what could account for some of the profound temporal data shifts such as in Austria, Germany, and Sweden. With respect to points a. and b., similar issues have been extensively analyzed with respect to healthy and unhealthy life elsewhere. Given that there is no research for the same issues for subjective life expectancies, we decided to be careful and consider the issues in the Discussion. There, ee refer to the “male-female survival paradox” that seems similar to the gender difference which we found, and speculate that explanations could be correspondingly very similar. As for point c., we are restricted with respect to country-specific discussion which needs more detailed and thorough analyses of country-specific idiosyncrasy. Reviewer #2: Authors analysed data from the SHARE surveys Waves 1 and 6 in order to explore subjective life expectancy (LE) and compare with actual LE, based on Human Mortality Database. The paper has several strength, eg. analysis of several countries in parallel, comparing results of the same survey in two time points and comparing genders. However, I think there are some weak points as well. In the SHARE database respondents are asked about probabilities, ie (Page6 Line 114): 'What are your chances that you will live to be age T or more?' Given the low statistical literacy level of the populations (please see studies by Gigerenzer G. et al) the responses are probably biased in a significant number of cases. Most people can often say the exact age they think they will reach if they are asked in asimple direct way (eg. https://www.ncbi.nlm.nih.gov/pubmed/26077549 ). Howveer, this question forces them to translate this idea first to a specific age (which is either over or below or equal to their subjctive LE). Then, in order to respond this question they have to express that in percentages. This methodology is my major concern regarding the whole study. I understand, of course, that the SHARE data is a given source and Authrs tend to make good use of it, however I am still doubtful about the validity and applicability of these responses to subjective LE estimates. I suggest, therefore, to test the validity of this question at least in a small sample. This point is extremely important, and we have responded to it in the section on data and methods. The organizers have included a special question designed with the specific purpose to help respondents to evaluate chances of an event. The question is added in the text. For clarity we include it also here: As this question may seem difficult to respondents, they were introduced to the issue of “chances” with an example. They were asked to answer the question: “What do you think are the chances that it will be sunny tomorrow?” with answers from 0 to 100. My second concern is related to the comparison with actual LE. Sociodemographic status is a major determinant of LE. Was the SHARE sample matched to the controll sample (actual LE) by main socioeconomic characteristics, such as educational and income level? For instance, slight differences in educational level between the two may result in differences between subjective and actual LE without any real under- or overestimation. More educated people will express a longer subjective LE and in fact their actual LE is higher than of the average population, hence their subjective LE is realistic and the observed gap is artificial. Overall, Authors do not provide enough infomation about the SHARE data sampling and characteristics of the sample which makes the interpretation of the results challenging for someone who is not very familiar with SHARE. Below is the paragraph from the discussion section where we address the issue: “Our study is not free of caveats. Survey data are usually problematic with respect to how well they represent the population of study, in this case men and women aged 60 to 80 years. The SHARE data have been found to be non-representative regarding educational attainment: persons with higher education are over-represented in our list of countries (23). Due to this sample bias, estimated subjective life expectancies are higher than those of the study population. If samples were representative for education, subjective life expectancies would be lower and therefore our results would be reinforced, as downward bias would increase. An open question remains with respect to men’s realism in 2015; it could turn out that men were biased downwards in 2015 as well. To check the effect of non-representativeness by education we used crudely constructed weights by education for Austrian men in 2015 using their distribution by three levels of education (23,24). We found that the subjective life of these men would be a fraction of one year lower (i.e., 0.2) than the one displayed in Table 4a. We thus do not expect that non-representativeness by education harms our inferences. “ On Page7Line131 Author refer to 'limited abilities'. Is it the GALI question from the MEHM? Analysis of determinants of over- and underestimation (regression) would increase substantially the scientific content of the study. It is indeed the GALI question. The question is cited in the section on data and methods. Analyses of determinants is crucially important, yet it can be a subject of a range of research topics and papers. In this paper we expose newly established main trends and observations on subjective life expectancies, and we hope they will attach attention among researchers. ________________________________________ 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. Submitted filename: PONE-D-19-30019_Responses_to_reviewers.docx Click here for additional data file. 20 Feb 2020 Subjective Length of Life of European Individuals at Older Ages: Temporal and Gender Distinctions PONE-D-19-30019R1 Dear Dr. Scherbov, We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements. Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication. Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. With kind regards, Gianluigi Forloni Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ********** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ********** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ********** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors did a reasonable job being responsive to the review. I do worry that excluding Denmark is a form of cherry picking. ********** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No 27 Feb 2020 PONE-D-19-30019R1 Subjective Length of Life of European Individuals at Older Ages: Temporal and Gender Distinctions Dear Dr. Scherbov: I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. For any other questions or concerns, please email plosone@plos.org. Thank you for submitting your work to PLOS ONE. With kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Gianluigi Forloni Academic Editor PLOS ONE
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Authors:  Jean-Marie Robine; Carol Jagger
Journal:  Eur J Public Health       Date:  2003-09       Impact factor: 3.367

2.  Individual survival curves comparing subjective and observed mortality risks.

Authors:  Luc Bissonnette; Michael D Hurd; Pierre-Carl Michaud
Journal:  Health Econ       Date:  2017-05-15       Impact factor: 3.046

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Journal:  Demography       Date:  2011-11

4.  Predicting one's own death: the relationship between subjective and objective nearness to death in very old age.

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Journal:  Eur J Ageing       Date:  2010-10-02

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Authors:  Carol Jagger; Claire Weston; Emmanuelle Cambois; Herman Van Oyen; Wilma Nusselder; Gabriele Doblhammer; Jitka Rychtarikova; Jean-Marie Robine
Journal:  J Epidemiol Community Health       Date:  2011-04-06       Impact factor: 3.710

6.  The male-female health-survival paradox: a survey and register study of the impact of sex-specific selection and information bias.

Authors:  Anna Oksuzyan; Inge Petersen; Henrik Stovring; Paul Bingley; James W Vaupel; Kaare Christensen
Journal:  Ann Epidemiol       Date:  2009-05-19       Impact factor: 3.797

7.  Using subjective expectations to forecast longevity: do survey respondents know something we don't know?

Authors:  Maria Perozek
Journal:  Demography       Date:  2008-02

8.  Individual Uncertainty About Longevity.

Authors:  Brigitte Dormont; Anne-Laure Samson; Marc Fleurbaey; Stéphane Luchini; Erik Schokkaert
Journal:  Demography       Date:  2018-10

9.  Gender differences in healthy life years within the EU: an exploration of the "health-survival" paradox.

Authors:  Herman Van Oyen; Wilma Nusselder; Carol Jagger; Petra Kolip; Emmanuelle Cambois; Jean-Marie Robine
Journal:  Int J Public Health       Date:  2012-05-22       Impact factor: 3.380

10.  Biases in health expectancies due to educational differences in survey participation of older Europeans: It's worth weighting for.

Authors:  Sonja Spitzer
Journal:  Eur J Health Econ       Date:  2020-01-27
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Authors:  Zhishui Chen; Dawei Zhu; Xingyu Hu; Guangying Gao
Journal:  Qual Life Res       Date:  2021-01-19       Impact factor: 4.147

2.  The effect of subjective life expectancy on the participation in commercial pension insurance of Chinese elderly.

Authors:  Mei Zhou; Yingyi Wang; Yunjia Liang; Ruonan Shi; Shaoyang Zhao
Journal:  Front Psychol       Date:  2022-08-22

3.  Comparing actuarial and subjective healthy life expectancy estimates: A cross-sectional survey among the general population in Hungary.

Authors:  Zsombor Zrubka; Áron Kincses; Tamás Ferenci; Levente Kovács; László Gulácsi; Márta Péntek
Journal:  PLoS One       Date:  2022-03-10       Impact factor: 3.240

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