SELECT – Unfolding the SEcrets of LongEvity: Current Trends and future prospects. A path through morbidity, disability and mortality in Italy and Europe)
Italy is considered one of the countries holding the secrets of high longevity. Evidence of this is provided not only through mortality statistics (OECD, 2017) but also through several studies focusing on the high prevalence of centenarians in some regions (e.g., Poulain et al., 2004). This view is challenged by increasing evidence of “selective” gain in longevity among population and population strata (WHO, 2008;
2015), which could have several cascading effects on disability and on the complex evolution of the mortality curves across time, cohorts, countries, and risk factors. Guillot and Canudas-Romo (2016), for instance, highlight that longevity rankings of countries change substantially if a cohort perspective is taken—e.g., Italy loses ranks. Moreover, if an increase in longevity is not coupled by a parallel decrease in morbidity, a longer life expectancy could result in more years of diseases and disabilities, which means, besides a not pleasant perspective for many of us, a substantial increase in costs for the health systems. Hence, although Italy is of particular interest to unfold some of the secrets of longevity, these considerations motivate also a broader quantitative perspective, which requires comparative studies with other countries as well as more comprehensive analyses of the several processes and determinants associated with mortality, including morbidity, disability, and the related risk factors.
Although the aforementioned aspects are of fundamental interest and have motivated an increasing availability of rich datasets on morbidity, disability, and mortality, there is a current lack of an in-depth and systematic analysis of these data sources to obtain a broader and more accurate quantitative picture of the determinants, mechanisms and future patterns associated with these processes. Indeed, the fast transformations that our society has undergone in the recent years motivate more comprehensive datasets, novel statistical models, increasingly targeted interventions and improved evaluation strategies to keep the same pace of the rapid, heterogeneous and complex changes in the dynamic mechanisms driving morbidity, disability, mortality, and their interactions. A single perspective and a separate analysis of
such complex processes would, in fact, fail to answer the questions associated with current and future longevity.
The goal of this project is to take a relevant step forward in addressing the above problems by relying on a highly interconnected and multidisciplinary team with experience in Demography, Epidemiology,
Social Science and Data Science. More specifically, we aim to:
1. Systematically collect, organize, reconstruct and link available mortality databases, register data, finer scales surveys on morbidity, and indicators of disability to provide richer and more comprehensive data frames that allow joint modeling of morbidity, disability, and mortality, along with their timely prediction and ranking.
2. Develop novel statistical models and learning methods for the above datasets which can provide a joint and broader picture—well beyond separate models—of the complex, possibly causal, interrelations between morbidity, disability, and mortality, along with their changes across countries, causes-of-death, risk factors, vulnerable groups, and their future coevolution.
3. Identify, review, and assess epidemiological theories and current public health intervention strategies in the light of the new datasets, statistical models, and quantitative findings. Such results will be useful also in identifying and evaluating alternative and potentially more effective interventions via novel simulations methods.
Although Italy will be our starting point, a comparative perspective will be essential in this project. These aims will be accomplished via a constant collaboration among the research units and a continuous
interaction with the broader research community through a series of workshops, conferences, summer schools, and meetings. Website, data repositories, and softwares will also be made available in order to stimulate constant discussion, validation and a broader implementation of the advances at each research step, and to adhere to the open-data paradigm as well (see for example the BMJ Campaign www.bmj.com/open-data). Finally, due to the relevance of the addressed topics in the future of our society, the project will be characterized by an active involvement, training and recruiting a network of junior researchers in Demography, Epidemiology, Social Science and Data Science to ensure future advances in this field, well beyond the deadlines of the current project. The project will also benefit by a continuous exchange with national (ISTAT – National Institute of Statistics, Ministry of Health, National Institute for Health) and international (WHO, IUHPE) researchers thanks to the network already available for the research team.
Research area: Why do we age, Age-related diseases
Principal Investigator (PI) and CO-PI: