scholarly journals Can we determine whether physical limitations are more prevalent in the US than in countries with comparable life expectancy?

2017 ◽  
Vol 3 ◽  
pp. 808-813 ◽  
Author(s):  
Dana A. Glei ◽  
Noreen Goldman ◽  
Carol D. Ryff ◽  
Maxine Weinstein
Keyword(s):  
Life Expectancy ◽  
The Us ◽  
Physical Limitations

scholarly journals Reductions in US life expectancy from COVID-19 by Race and Ethnicity: Is 2021 a repetition of 2020?

2021 ◽  
Author(s):  
Theresa Andrasfay ◽  
Noreen Goldman
Keyword(s):  
Life Expectancy ◽  
Race And Ethnicity ◽  
Ethnic Disparities ◽  
White Population ◽  
Widespread Distribution ◽  
Life Expectancy At Birth ◽  
The Us ◽  
The Impact ◽  
Racial Ethnic ◽  
Black And Latino

COVID-19 had a huge mortality impact in the US in 2020 and accounted for the majority of the 1.5-year reduction in 2020 life expectancy at birth. There were also substantial racial/ethnic disparities in the mortality impact of COVID-19 in 2020, with the Black and Latino populations experiencing reductions in life expectancy at birth over twice the reduction experienced by the White population. Despite continued vulnerability of the Black and Latino populations, the hope was that widespread distribution of effective vaccines would mitigate the overall impact and reduce racial/ethnic disparities in 2021. In this study, we use cause-deleted life table methods to estimate the impact of COVID-19 mortality on 2021 US period life expectancy. Our partial-year estimates, based on provisional COVID-19 deaths for January-early October 2021 suggest that racial/ethnic disparities have persisted and that life expectancy at birth in 2021 has already declined by 1.2 years from pre-pandemic levels. Our projected full-year estimates, based on projections of COVID-19 deaths through the end of 2021 from the Institute for Health Metrics and Evaluation, suggest a 1.8-year reduction in US life expectancy at birth from pre-pandemic levels, a steeper decline than the estimates produced for 2020. The reductions in life expectancy at birth estimated for the Black and Latino populations are 1.6-2.4 times the impact for the White population.

Life Expectancy At The US-Mexico Border: Evidence Of Disparities By Place, Race, And Ethnicity

2021 ◽  
pp. 10.1377/hlthaff
Author(s):  
Keith P. Gennuso ◽  
Elizabeth A. Pollock ◽  
Anne M. Roubal
Keyword(s):  
Life Expectancy ◽  
Race And Ethnicity ◽  
The Us ◽  
Mexico Border ◽  
Us Mexico Border

scholarly journals Black-white disparities during an epidemic: Life expectancy and lifespan disparity in the US, 1980–2000

2021 ◽  
Vol 40 ◽  
pp. 100937
Author(s):  
José Manuel Aburto ◽  
Frederikke Frehr Kristensen ◽  
Paul Sharp
Keyword(s):  
Life Expectancy ◽  
The Us

scholarly journals Disparities in Disease-Specific Remaining Life Expectancy Among Medicare Beneficiaries in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 276-276
Author(s):  
Bin Yu ◽  
Julia Kravchenko
Keyword(s):  
Heart Disease ◽  
Life Expectancy ◽  
Cerebrovascular Disease ◽  
Cox Model ◽  
The United States ◽  
Medicare Beneficiaries ◽  
Persistent Problem ◽  
Kaplan Meier ◽  
The Us ◽  
Breast And Prostate Cancer

Abstract Racial and geographic disparities in life expectancy (LE) in the US are a persistent problem. We used 5% Medicare Claims for 2000-2017 to investigate the patterns of remaining LE (RLE) in the U.S. with the highest and the lowest LE. RLEs in race-/ethnicity specific populations aged 65+ were calculated in patients with specific diseases and in the total population using the area under the Kaplan-Meier estimator. The Cox model was used to investigate the effect of state-specific residence on total LE and RLE. Between-the-states differences in RLE were most pronounced for cerebrovascular disease, atherosclerotic heart disease, breast and prostate cancer. RLE was the lowest for lung cancer and sepsis, followed by Alzheimer’s disease, dementia, pneumonia, and heart failure. RLE for myocardial infarction and cerebrovascular disease decreased over time, while for renal failure, diabetes, atherosclerotic heart disease, and cancers of breast and prostate RLE increased.

scholarly journals Role of Disease-Specific Incidence and Survival in Disparities in Life Expectancy in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 149-149
Author(s):  
Julia Kravchenko ◽  
Bin Yu ◽  
Igor Akushevich
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Life Expectancy ◽  
Racial Disparities ◽  
Disease Incidence ◽  
The United States ◽  
The State ◽  
The Us ◽  
Race Ethnicity ◽  
Disease Specific

Abstract There are persisting geographic and racial disparities in life expectancy (LE) across the United States (US). We used 5% Medicare Claims data (2000-2017) to investigate how disease incidence and survival contribute to such disparities. Disease-specific hazard ratios (HRs) were calculated for Medicare beneficiaries living in the US states with the lowest LE (the states with the highest LE were used as a reference group), in gender- and race-/ethnicity-specific populations. Analysis of incidence showed that the greatest contribution to between-the-state disparities in LE was due to higher incidence (HRs≥1.30) of atherosclerosis, heart failure, influenza/pneumonia, Alzheimer’s disease, and lung cancer among older adults living in the states with the lowest LE. The list of diseases that contributed most to LE through the differences in their survival substantially differed from the above listed diseases: namely, diabetes, chronic ischemic heart disease, and cerebrovascular disease had HRs≥1.28 for their respective survival rates, with the highest HRs for lung cancer (HR=1.37, in females) and prostate cancer (HR=1.30). Respective race-/ethnicity-specific patterns of incidence and survival HRs were investigated and diseases contributed most to racial disparities in LE were identified. Study showed that when planning the strategies targeting between-the-state differences in LE in the US, it is important to address both 1) primary and secondary prevention for diseases demonstrating substantial differences in contributions of incidence, and 2) treatment choice, adherence to treatment, and comorbidities for diseases contributing to LE disparities predominantly through the differences in survival. Such strategies can be disease-, race-/ethnicity-, and geographic area-specific.

scholarly journals US life expectancy stalls due to cardiovascular disease, not drug deaths

2020 ◽  
Vol 117 (13) ◽  
pp. 6998-7000 ◽  
Author(s):  
Neil K. Mehta ◽  
Leah R. Abrams ◽  
Mikko Myrskylä
Keyword(s):  
Cardiovascular Disease ◽  
Life Expectancy ◽  
Drug Overdose ◽  
Causes Of Death ◽  
High Income ◽  
Death Rates ◽  
Drug Deaths ◽  
The Us ◽  
Main Culprit ◽  
Cvd Mortality

After decades of robust growth, the rise in US life expectancy stalled after 2010. Explanations for the stall have focused on rising drug-related deaths. Here we show that a stagnating decline in cardiovascular disease (CVD) mortality was the main culprit, outpacing and overshadowing the effects of all other causes of death. The CVD stagnation held back the increase of US life expectancy at age 25 y by 1.14 y in women and men, between 2010 and 2017. Rising drug-related deaths had a much smaller effect: 0.1 y in women and 0.4 y in men. Comparisons with other high-income countries reveal that the US CVD stagnation is unusually strong, contributing to a stark mortality divergence between the US and peer nations. Without the aid of CVD mortality declines, future US life expectancy gains must come from other causes—a monumental task given the enormity of earlier declines in CVD death rates. Reversal of the drug overdose epidemic will be beneficial, but insufficient for achieving pre-2010 pace of life expectancy growth.

Long-term survival benefits of docetaxel plus cyclophosphamide compared to doxorubicin plus cyclophosphamide in the adjuvant treatment of operable breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 563-563
Author(s):  
M. Thompson ◽  
B. Seal ◽  
M. Tangirala ◽  
L. Asmar ◽  
S. Jones
Keyword(s):  
Clinical Trial ◽  
Life Expectancy ◽  
Life Time ◽  
Stage I ◽  
Trial Period ◽  
Term Survival ◽  
Life Years ◽  
The Us ◽  
Disease Free

563 Background: The U.S. Oncology Adjuvant Trial 9735 recently demonstrated disease-free survival and overall survival (OS) benefits over 7 years for docetaxel plus cyclophosphamide (TC) compared with doxorubicin plus cyclophosphamide (AC) as adjuvant treatment for women with operable stage I-III invasive breast cancer (BC). The life-time benefits of TC vs. AC, however, are unknown. This analysis aimed to project potential life-time survival benefits of TC vs. AC as adjuvant therapy for operable BC. Methods: The 7-year follow-up results of the 9735 study combined with US average life expectancy were used to project the life-time survival benefits of TC vs. AC. In the base case (scenario 1), it was assumed the survival advantage of TC did not persist beyond the 7-year clinical trial period. Rather, all patients alive and disease-free at 7 years (from the starting age of 51 to the age of 58), regardless of treatment, were assumed to be cured and received the average remaining life expectancy of a 58-year old woman in the US general population. As survival benefits from chemotherapy may persist beyond the clinical trial period, two sensitivity analyses were conducted: 1) greater life expectancy in the TC arm of 1.8 months equivalent to the mean difference in OS between TC and AC within the clinical trial period (scenario 2) and 2) greater life expectancy in the TC arm of 22 months equivalent to the difference in survival at the end of 7 years (scenario 3). The total life years gained (LYs) and quality-adjusted life years gained (QALYs) were then calculated. Results: Per patient LYs gained in scenarios 1, 2, and 3 were 0.850, 0.930, and 1.755, respectively; while QALYs gained were slightly lower at 0.674, 0.736 and 1.383, respectively. Applying this benefit to a cohort of 167,133 women in the US with newly diagnosed stage I-III invasive BC in 2008, the gains were 142,063 LYs and 112,648 QALYS in scenario 1. Conclusions: In addition to survival benefit observed within the clinical trial period, the use of TC is associated with long-term survival benefits compared to AC in patients with stage I-III invasive BC. The results provide additional support of the value of TC in the management of early stage BC. [Table: see text]

scholarly journals Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data

BMJ ◽  
2021 ◽  
pp. n1343 ◽  
Author(s):  
Steven H Woolf ◽  
Ryan K Masters ◽  
Laudan Y Aron
Keyword(s):  
Life Expectancy ◽  
Ethnic Minority ◽  
Race And Ethnicity ◽  
Minority Groups ◽  
High Income ◽  
Mortality Data ◽  
Ethnic Minority Groups ◽  
The Us ◽  
Black Populations ◽  
Racial And Ethnic Minority

Abstract Objective To estimate changes in life expectancy in 2010-18 and during the covid-19 pandemic in 2020 across population groups in the United States and to compare outcomes with peer nations. Design Simulations of provisional mortality data. Setting US and 16 other high income countries in 2010-18 and 2020, by sex, including an analysis of US outcomes by race and ethnicity. Population Data for the US and for 16 other high income countries from the National Center for Health Statistics and the Human Mortality Database, respectively. Main outcome measures Life expectancy at birth, and at ages 25 and 65, by sex, and, in the US only, by race and ethnicity. Analysis excluded 2019 because life table data were not available for many peer countries. Life expectancy in 2020 was estimated by simulating life tables from estimated age specific mortality rates in 2020 and allowing for 10% random error. Estimates for 2020 are reported as medians with fifth and 95th centiles. Results Between 2010 and 2018, the gap in life expectancy between the US and the peer country average increased from 1.88 years (78.66 v 80.54 years, respectively) to 3.05 years (78.74 v 81.78 years). Between 2018 and 2020, life expectancy in the US decreased by 1.87 years (to 76.87 years), 8.5 times the average decrease in peer countries (0.22 years), widening the gap to 4.69 years. Life expectancy in the US decreased disproportionately among racial and ethnic minority groups between 2018 and 2020, declining by 3.88, 3.25, and 1.36 years in Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. In Hispanic and non-Hispanic Black populations, reductions in life expectancy were 18 and 15 times the average in peer countries, respectively. Progress since 2010 in reducing the gap in life expectancy in the US between Black and White people was erased in 2018-20; life expectancy in Black men reached its lowest level since 1998 (67.73 years), and the longstanding Hispanic life expectancy advantage almost disappeared. Conclusions The US had a much larger decrease in life expectancy between 2018 and 2020 than other high income nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. A longstanding and widening US health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism.

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