Selection effects on regional survival differences in Italy

This paper deals with the question whether elderly mortality differences observed in various Italian regions may be linked to different mortality levels at earlier ages and whether this may be explained by different selection or debilitation mechanisms. We applied a statistical model that includes possible selection effects since birth to mortality data by cohort for Italy and four selected regions only available from age 60. Then, after estimating the probabilities of death from age 30 to age 59 for the four regions, we applied a frailty model, fixing the frailty distribution at age 30. Selection is active and predominates possible debilitation events only starting at young-old ages (around age 60). The existence of different regional patterns of selection has been also pinpointed.