Declining Life Expectancy in the United States: Missing the Trees for the Forest

Harper, Sam; Riddell, Chris; King, Nicholas B.

doi:10.1146/annurev-publhealth-082619-104231

Cited by 86 publications

(63 citation statements)

References 132 publications

(141 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The causes that contributed most to reductions in the gap were, in order of importance, so called “deaths of despair” ( 43 ) (16.18%; this category includes suicide, overdoses, and cirrhosis), cancer (15.96%), homicide (12.51%), deaths from causes originating in the fetal or infant period (11.05%), and HIV (9.89%). The importance of overdose deaths ( 44 ), homicide, and HIV in explaining racial differences in life expectancy has been previously noted ( 3 – 5 , 45 – 48 ). However, it is notable in light of previous work that over the period we analyze, changes in mortality due to cardiovascular disease explain relatively little of the changing gap.…”

Section: Resultsmentioning

confidence: 84%

Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018

Schwandt

Currie

Bär

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Although there is a large gap between Black and White American life expectancies, the gap fell 48.9% between 1990 and 2018, mainly due to mortality declines among Black Americans. We examine age-specific mortality trends and racial gaps in life expectancy in high- and low-income US areas and with reference to six European countries. Inequalities in life expectancy are starker in the United States than in Europe. In 1990, White Americans and Europeans in high-income areas had similar overall life expectancy, while life expectancy for White Americans in low-income areas was lower. However, since then, even high-income White Americans have lost ground relative to Europeans. Meanwhile, the gap in life expectancy between Black Americans and Europeans decreased by 8.3%. Black American life expectancy increased more than White American life expectancy in all US areas, but improvements in lower-income areas had the greatest impact on the racial life expectancy gap. The causes that contributed the most to Black Americans’ mortality reductions included cancer, homicide, HIV, and causes originating in the fetal or infant period. Life expectancy for both Black and White Americans plateaued or slightly declined after 2012, but this stalling was most evident among Black Americans even prior to the COVID-19 pandemic. If improvements had continued at the 1990 to 2012 rate, the racial gap in life expectancy would have closed by 2036. European life expectancy also stalled after 2014. Still, the comparison with Europe suggests that mortality rates of both Black and White Americans could fall much further across all ages and in both high-income and low-income areas.

show abstract

Section: Resultsmentioning

confidence: 84%

Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018

Schwandt

Currie

Bär

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

show abstract

“…For an individual in the United States born in 2018, life expectancy is 76 and 81 years of age for men and women, respectively. 7 , 8 …”

Section: Advanced Age Enhances the Risk For Human Diseasementioning

confidence: 99%

Glioblastoma as an age-related neurological disorder in adults

Kim

Ladomersky

Mozny

et al. 2021

Neuro-Oncology Advances

View full text Add to dashboard Cite

Background Advanced age is a major risk factor for the development of many diseases including those affecting the central nervous system (CNS). Wild-type isocitrate dehydrogenase glioblastoma (IDH wt GBM) is the most common primary brain cancer and accounts for ≥90% of all adult GBM diagnoses. Patients with IDH wt GBM have a median age of diagnosis at 68-70 years of age and increasing age is associated with an increasingly worse prognosis for patients with this type of GBM. Methods SEER, TCGA, and CGGA databases were analyzed for mortality indices. Meta-analysis of 80 clinical trials were evaluated for log-hazard ratio for aging to tumor survivorship. Results Despite significant advances in the understanding of intratumoral genetic alterations, molecular characteristics of tumor microenvironments, and relationships between tumor molecular characteristics and the use of targeted therapeutics, life expectancy for older adults with GBM has yet to improve. Conclusions Based upon the results of our analysis, we propose that age-dependent factors that are yet to be fully elucidated, contribute to IDH wt GBM patient outcomes.

show abstract

“…During the early 2000s, the United States experienced a stagnation in life expectancy, followed by a decline in 2015 ( Harper et al, 2021 ). This decline was attributed to an increase in deaths among middle-aged white communities without a college degree due to suicide, drug overdose (opioids in particular) and alcohol-related liver disease (ALD) mortality, collectively known as ‘deaths of despair’ ( Case & Deaton, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Racial disparities in alcohol-related liver disease mortality in a 75 year follow-up study of Michigan autoworkers

Allouch

Chen

Lutzker

et al. 2021

SSM - Population Health

View full text Add to dashboard Cite

Background Suicide, drug overdose, and alcohol-related liver disease (ALD) mortality have been rising in the United States. While suicide and overdose have received a great deal of attention, far less public health concern has focused on chronic ALD. To address this gap, we examine ALD mortality rates, by race, in a cohort of autoworkers to describe trends over the past 75 years, from the peak in automobile manufacturing employment through its decline. Methods Based on the United Autoworkers-General Motors (UAW-GM) cohort we estimated temporal trends in age-adjusted ALD mortality rates from 1941 through 2015 at three automobile manufacturing plants in Michigan. We compared these rates to county, state, and U.S. rates, directly standardized to the 2000 U.S. census, to assess the roles of race and employment on ALD mortality. Results The overall age-adjusted ALD mortality rate among 41,097 male autoworkers peaked at 46.1 per 100,000 in the 1970s, followed by a gradual decline and a recent rise. Rates were slightly higher for black than white men until early 2000s, when rates increased only for white men. ALD mortality rates in the study cohort tracked national, state, and county rates for white men until the most recent time period, but were lower throughout the study period for black men, especially in the 1970s and 1980s. Conclusions Employment in automobile manufacturing may have offered some protection against death from ALD for black men, and loss of those manufacturing jobs may have impacted white men without a college degree more in recent decades.

show abstract

Declining Life Expectancy in the United States: Missing the Trees for the Forest

Cited by 86 publications

References 132 publications

Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018

Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018

Glioblastoma as an age-related neurological disorder in adults

Racial disparities in alcohol-related liver disease mortality in a 75 year follow-up study of Michigan autoworkers

Contact Info

Product

Resources

About