长寿时代的理论与对策报告（中英文版，61页）

行业报告下载 2020-09-14 1 管理员

公共卫生条件的改善对死亡率的下降同样扮演着重要的作用，尤其是对传染性疾病的控制。以美国为例，由于通过水和空气传播的传染性疾病得到了有效控制，1900 年至 1940 年美国整体死亡率下降了 40%，预期寿命从 47 岁提升至 63 岁，原来在城市生活死亡率更高的问题也在这一时期消失了。研究发现净水过滤和氯化系统的广泛应用在其中发挥了巨大的作用，为美国带来了这一史无前例、最为快速的死亡率下降（Cutler，2005）。此外，20 世纪 40 年代抗生素类药物的使用进一步降低了传染病的病死率。例如，根据美国疾控中心数据显示，在此期间肺结核的死亡率一下从 1945 年的 39.9/10 万降到了 1955 年的 9.1/10 万。到 20 世纪下半叶，医疗和技术进步与死亡率下降的关系越来越密切。有研究指出美国 20 世纪 50 年代以来死亡率下降更多是得益于医疗进步带来的心脏病、中风等心血管疾病死亡率的降低。1950 年至 2016 年美国预期寿命提升了 11 岁，其中一半以上的增长与 65 岁及以上人群生存率提升有关（Catillon et al.，2018）。此外，欧美发达国家在公共卫生方面的知识和现代医药技术向发展中国家的传播推动了全球死亡率的快速下降。1960~2000 年期间公共卫生基础设施、免疫接种、疾病专项防治等成为带动发展中国家死亡率下降的重要因素。

The Industrial Revolution which broke out in the mid-18th century shattered the constraint of the capacity of agricultural social resources to support the population, and the world’s population began to grow, on an unprecedented, massive scale. Based on research into changes in birth rates and mortality in the population growth process, US demographer Warren Thompson in 1929 first proposed dividing countries into three types based on population growth patterns. On this basis, Frank Notestein in 1945 further summarised the population growth pattern into three categories: incipient decline, transformational growth, and high growth potential. Since then, the description of population growth patterns has gradually developed into the theory of demographic transition. Today, demographic transition is generally divided into four stages, namely a first stage characterised by its high birth rate and mortality, and a lack of change or extremely slow growth in population size; a second stage then introduces a high birth rate but a decline in mortality, and rapid population growth; a third stage then witnesses a decline in the birth rate, low mortality, and a slowing population growth rate; finally, a fourth stage has a low birth rate and mortality, and the population size tends to stabilise. The world is currently rapidly shifting from the third stage of the demographic transition to the fourth stage, but what state will we enter in this fourth stage and thereafter? Here, we would like to propose the concept of an age of longevity, and believe that this will form a new steady state following the demographic transition. This era will bring with it five major characteristics: low mortality, low fertility, continuously increasing life expectancy, a population age structure tending toward a pillar shape, and an ageing population segment which exceeds 1/4 of the total during the plateau period.