Understanding the Rise in Life Expectancy Inequality

Abstract We provide a novel decomposition of changing gaps in life expectancy between rich and poor into differential changes in age-specific mortality rates and differences in “survivability”. Declining age-specific mortality rates increases life expectancy, but the gain is small if the likelihood of living to this age is small (ex-ante survivability) or if the expected remaining lifetime is short (ex-post survivability). Lower survivability of the poor explains half of the recent rise in inequality in the US and the entire rise in Denmark. Declines in cardiovascular mortality benefited rich and poor, but inequality increased because of differences in lifestyle-related survivability.

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Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000–2010

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz145 ◽

2019 ◽

Author(s):

Phillip Cantu ◽

Connor M Sheehan ◽

Isaac Sasson ◽

Mark D Hayward

Keyword(s):

Life Expectancy ◽

Activities Of Daily Living ◽

Daily Living ◽

White Men ◽

Mortality Rates ◽

Healthy Life ◽

Men And Women ◽

Specific Mortality ◽

Disability Prevalence ◽

College Educated

Abstract Objectives To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less educated white Americans during the first decade of the 21st century. Method This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (1) change in age-specific mortality rates; and (2) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Results Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. By contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. Discussion Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

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Asthma Mortality in Canada, 1946 to 1990

Canadian Respiratory Journal ◽

10.1155/1995/921501 ◽

1995 ◽

Vol 2 (1) ◽

pp. 61-66 ◽

Cited By ~ 7

Author(s):

Robert S Hogg ◽

Martin T Schechter ◽

Julio SG Montaner ◽

James C Hogg

Keyword(s):

Life Expectancy ◽

Mortality Rates ◽

Population Based ◽

Years Of Life Lost ◽

Population Based Study ◽

Specific Mortality ◽

Statistics Canada ◽

Standardized Mortality Ratios ◽

The Impact ◽

Asthma Mortality

OBJECTIVE: To assess the impact of asthma on Canadian mortality rates over a 45-year period.DESIGN: A descriptive, population-based study.SETTING: Canada.SUBJECTS: All persons who died from asthma in Canada from 1946 to 1990 as reported to Statistics Canada in Ottawa.MAIN OUTCOME MEASURES: Standardized mortality ratios, age-specific patterns of death, potential years of life lost (PYLL) and life expectancy lost.RESULTS: A total of 12,010 male and 8486 female asthma deaths were recorded in Canada from 1946 to 1990. Mortality rates for both sexes declined from a high of between three to six deaths in 1951 to 1955 to approximately two deaths per 100,000 in 1986 to 1990, with the decline in rates being greater for males than females. Age-specific mortality rates were highest al all ages in 1951 to 1955, except for 15 to 24 years when deaths rates for the 1981 to 1985 period were greater. PYLL exhibit the same pattern as mortality, peaking in 1951 to 1955 and subsequently declining with each period. Loss in life expectancy due to asthma was about one month (not significant) in all time periods.CONCLUSIONS: Asthma mortality rates have declined significantly over the study period. This decline appears to be linked with the convergence of sex-specific rates and with changes in the patterning or age-specific mortality. The impact of asthma on the life expectancy of Canadians is small.

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A first analysis of excess mortality in Switzerland in 2020

PLoS ONE ◽

10.1371/journal.pone.0253505 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253505

Author(s):

Isabella Locatelli ◽

Valentin Rousson

Keyword(s):

Life Expectancy ◽

Excess Mortality ◽

The Elderly ◽

Mortality Rates ◽

Loss Of Life ◽

Key Indicator ◽

All Cause Mortality ◽

Specific Mortality ◽

Standardized Mortality Rate ◽

Official Data

Objective To quantify excess all-cause mortality in Switzerland in 2020, a key indicator for assessing direct and indirect consequences of the COVID-19 pandemic. Methods Using official data on deaths in Switzerland, all-cause mortality in 2020 was compared with that of previous years using directly standardized mortality rates, age- and sex-specific mortality rates, and life expectancy. Results The standardized mortality rate was 8.8% higher in 2020 than in 2019, returning to the level observed 5–6 years before, around the year 2015. This increase was greater for men (10.6%) than for women (7.2%) and was statistically significant only for men over 70 years of age, and for women over 75 years of age. The decrease in life expectancy in 2020 compared to 2019 was 0.7%, with a loss of 9.7 months for men and 5.3 months for women. Conclusions There was an excess mortality in Switzerland in 2020, linked to the COVID-19 pandemic. However, as this excess only concerned the elderly, the resulting loss of life expectancy was restricted to a few months, bringing the mortality level back to 2015.

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Integrating ESG Analysis into Smart Beta Strategies

Sustainability ◽

10.3390/su12229351 ◽

2020 ◽

Vol 12 (22) ◽

pp. 9351

Author(s):

Federica Ielasi ◽

Paolo Ceccherini ◽

Pietro Zito

Keyword(s):

Investment Analysis ◽

The Other ◽

Portfolio Rebalancing ◽

A Value ◽

Ex Post ◽

The Us ◽

Ex Ante ◽

The Impact ◽

Smart Beta ◽

Increase In Risk

Smart beta strategy is an increasingly frequent approach to investment analysis for portfolio selection and optimization and it can be combined with environmental, social, and governance (ESG) considerations. In order to verify the impact of the integration between ESG and smart beta analysis, first we apply a portfolio rebalancing based on ESG scores on securities selected according to different smart beta strategies (ex-post ESG rebalancing approach). Secondly, we apply different smart beta approaches to sustainable portfolios, screened according to the issuers’ ESG scores (ex-ante ESG screening approach). We find that ESG rebalancing and screening are able to impact both on return and risk statistics, but with a different level of efficiency for each smart beta strategy. ESG rebalancing proves to be particularly efficient when it is applied to a “Value” portfolio. On the other hand, when smart beta is applied to ESG-screened portfolios, “Growth” is the strategy which shows the highest increase in risk-adjusted performance, particularly in the US. Minimum volatility proves to be the most efficient smart beta strategy for sustainable portfolios. In general, the increase in the level of sustainability does not deteriorate the risk-adjusted performances of most smart beta strategies.

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Abstract P060: Reduction of Cardiovascular Mortality in the United States Population, 1988-2004: A Larger Contribution of Declining Exposures to Cadmium and Lead Compared to Traditional Cardiovascular Risk Factors

Circulation ◽

10.1161/circ.133.suppl_1.p060 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Adrian Ruiz-Hernandez ◽

Ana Navas-Acien ◽

Roberto Pastor-Barriuso ◽

Josep Redon ◽

Eliseo Guallar ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Mortality ◽

Blood Lead ◽

Mortality Rates ◽

Lead And Cadmium ◽

The Us ◽

Urine Cadmium ◽

Cadmium And Lead ◽

Cvd Mortality

Introduction: Lead and cadmium exposures have markedly declined in the US following the banning of lead in gasoline and the implementation of tobacco control, air pollution reduction, and hazardous waste remediation policies since the mid 1970s. While lead and cadmium have been proposed as cardiovascular disease risk factors, little is known about their potential contribution to the decline in cardiovascular mortality in US adults. Hypothesis: We assessed the hypothesis that lead and cadmium exposure reductions partly explain the decreasing trend in cardiovascular mortality that occurred in the US from 1988-1994 to 1999-2004, after controlling for traditional cardiovascular risk factors including smoking, obesity, physical inactivity, hypertension, diabetes, chronic kidney disease, and dyslipidemia. Methods: Cohort study of 15,421 men and women ≥40 years old participating in the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2004. We implemented a mediation approach with additive hazard models to estimate the reductions in cardiovascular disease (CVD) mortality rates over time explained through changes in urine cadmium and blood lead concentrations. Results: After adjusting for age, sex, race and smoking, urine cadmium and blood lead concentrations decreased by 20.4 and 38.2%, respectively, between 1988-1934 and 1999-2004. Age-adjusted CVD mortality rates in the US decreased from 712.0 to 356.8 /100.000 person-years comparing 1988-1994 to 1999-2004. Changes in traditional CVD risk factors explained 16% of this decline. The observed reductions in urine cadmium and blood lead levels explained an additional 27.6% of this decline. Conclusions: The net impact of declining cadmium and lead exposures on mortality changes in the US was larger compared to traditional risk factors. These findings support that reducing cadmium and lead exposures resulted in a major public health achievement. The general population, however, remains exposed to cadmium and lead at concentrations that have been associated to CVD in the US population. Preventive strategies to enable additional reductions in exposure to cadmium and lead are needed.

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Abstract P052: Coronary Heart Disease Mortality Declines in the United States From 1980 through 2011: Evidence for Stagnation in Young Adults, Especially Women

Circulation ◽

10.1161/circ.131.suppl_1.p052 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Kobina A Wilmot ◽

Martin O’Flaherty ◽

Simon Capewell ◽

Earl S Ford ◽

Viola Vaccarino

Keyword(s):

Coronary Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Young Women ◽

Cardiovascular Mortality ◽

Young Men ◽

Mortality Rates ◽

Men And Women ◽

The Us ◽

Age And Sex

Background: Cardiovascular mortality rates have fallen dramatically over the past four decades. However, recent unfavorable trends in coronary heart disease (CHD) risk factors among young adults (obesity, diabetes, and tobacco use) raise concerns about their subsequent impact on CHD mortality. Furthermore, recent data from the US and other countries suggest a worsening of CHD incidence and mortality among young women. We therefore examined recent trends in CHD mortality rates in the US according to age and sex. Methods: We used mortality data between 1980 and 2011 from US adults ≥ 25 years. We calculated age-specific CHD mortality rates and estimated annual percentage change (EAPC) for US adults, and compared three decades of data (1980-1989, 1990-1999, and 2000-2011). We also used Joinpoint regression modeling to assess changes in trends over time, based on inflection points of the mortality distribution. Results: Young men and women (aged<55 years) showed a robust decline in CHD mortality from 1980 until 1989 (EAPC -5.5% in men and -4.6% in women). However, the two subsequent decades saw stagnation with minimal improvement (Table). This was particularly true for young women who had no improvements between 1990 and 1999 (EAPC +0.1%), and only -1% EAPC since 2000. In contrast, older adults (65+years) showed steep annual declines since 2000, approximately doubled compared with the previous period (women, -5.0% and men, -4.4%). Jointpoint analyses provided consistent results. Conclusions: The dramatic declines in cardiovascular mortality since 1980 conceals major heterogeneities. CHD death rates in older groups are now falling steeply. However, young men and women have enjoyed small decreases in CHD mortality rates since 1990. The drivers of these major differences in CHD mortality trends by age and sex needs urgent study.

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6129Temporal trends and patterns in cause-specific mortality and hospitalisations after incident heart failure: a longitudinal analysis of 86,000 individuals

European Heart Journal ◽

10.1093/eurheartj/ehz746.0155 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

N Conrad ◽

A Judge ◽

D Canoy ◽

J G Cleland ◽

J J V McMurray ◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Mortality ◽

Causes Of Death ◽

Mortality Rates ◽

Failure Diagnosis ◽

The Past ◽

Specific Mortality ◽

Heart Failure Diagnosis ◽

Respiratory Conditions ◽

Overall Mortality

Abstract Background The past two decades have brought considerable improvements in heart failure care. Clinical trials have demonstrated effectiveness of several different treatments in reducing mortality and hospitalisations, and observational studies have shown that these treatments are increasingly being used in many countries. Little is known about whether these changes have been reflected in patient outcomes in routine clinical settings. Methods We used anonymised electronic health records that link information from primary care, secondary care, and the national death registry to investigate 86,000 individuals with newly diagnosed heart failure between 2002 and 2013 in the UK. We computed all-cause and cause-specific mortality rates and number of hospitalisations in the first year following diagnosis. We used Poisson regression models to calculate category-specific rate ratios and 95% confidence intervals, adjusting for patients' age, sex, region, socioeconomic status and 17 major comorbidities. Findings One year after initial heart failure diagnosis, all-cause mortality rates were high (32%) and did not change significantly over the period of study (adjusted rate ratio (RR) 2013 vs 2002: 0.94 [0.88, 1]). Overall rates masked diverging trends in cause-specific outcomes: a decline in cardiovascular mortality (RR: 0.74 [0.68, 0.81]) was offset by an increase in non-cardiovascular mortality (RR: 1.28 [1.17, 1.39]), largely due to infections and chronic respiratory conditions. Sub-group analyses further showed that overall mortality declined among patients under 80 years of age (RR 2013 vs 2002: 0.79 [0.71, 0.88]), although not in older age groups (RR 2013 vs 2002: 0.97 [0.9, 1.06]). After cardiovascular causes (43%), the major causes of death identified in 2013 were neoplasms (15%), respiratory conditions (12%), and infections (11%). Hospital admissions within a year of heart failure diagnosis were common (1.15 hospitalisations per patient-year at risk), changed little over time (RR: 0.96 [0.92, 0.99]), and were largely (60%) due to non-cardiovascular causes. Interpretation Despite increased use of life-saving interventions, overall mortality and hospitalisations following a new diagnosis of heart failure have changed little over the past decade. Improved prognosis among young and middle-aged patients marks an important achievement and attests of complex barriers to progress in elderly patients. The shift from cardiovascular to non-cardiovascular causes of death suggest that management of associated comorbidities might offer additional opportunities to improve patients' prognosis. Acknowledgement/Funding British Heart Foundation, National Institute for Health Research, UK Research and Innovation.

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Mortality Inequality: The Good News from a County-Level Approach

The Journal of Economic Perspectives ◽

10.1257/jep.30.2.29 ◽

2016 ◽

Vol 30 (2) ◽

pp. 29-52 ◽

Cited By ~ 32

Author(s):

Janet Currie ◽

Hannes Schwandt

Keyword(s):

Life Expectancy ◽

Mortality Rates ◽

Good News ◽

County Level ◽

Life Expectancy At Birth ◽

Specific Mortality ◽

Smoking Patterns ◽

The Subject ◽

Over Time ◽

Mortality Inequality

In this essay, we ask whether the distributions of life expectancy and mortality have become generally more unequal, as many seem to believe, and we report some good news. Focusing on groups of counties ranked by their poverty rates, we show that gains in life expectancy at birth have actually been relatively equally distributed between rich and poor areas. Analysts who have concluded that inequality in life expectancy is increasing have generally focused on life expectancy at age 40 to 50. This observation suggests that it is important to examine trends in mortality for younger and older ages separately. Turning to an analysis of age-specific mortality rates, we show that among adults age 50 and over, mortality has declined more quickly in richer areas than in poorer ones, resulting in increased inequality in mortality. This finding is consistent with previous research on the subject. However, among children, mortality has been falling more quickly in poorer areas with the result that inequality in mortality has fallen substantially over time. We also show that there have been stunning declines in mortality rates for African Americans between 1990 and 2010, especially for black men. Finally we offer some hypotheses about causes for the results we see, including a discussion of differential smoking patterns by age and socioeconomic status.

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Mortality rates and life expectancy improvements among malaysian elderlies

Indonesian Journal of Electrical Engineering and Computer Science ◽

10.11591/ijeecs.v19.i1.pp134-139 ◽

2020 ◽

Vol 19 (1) ◽

pp. 134

Author(s):

Nur Shatikah Mohamad Ibrahim ◽

Syazreen Niza Shair ◽

Aida Yuzi Yusof

Keyword(s):

Life Expectancy ◽

Life Table ◽

Age Groups ◽

Mortality Rates ◽

Linear Pattern ◽

Elderly Males ◽

Specific Mortality ◽

Different Types ◽

Males And Females ◽

Almost All

<p>This paper presents a study on mortality rates and life expectancy improvements among elderly people in Malaysia. The central age-specific mortality rates will be analyzed according to genders. The expectation of future lifetime of these old age people will be estimated using the actuarial life table approach. Two different types of life table will be developed, including life table for males and females--- to compare the results of mortality rates and life expectancies between genders. Results show that, mortality rates of Malaysian elderly, for both males and females are increasing almost in linear pattern by age, and this trend is consistent from 1950 to 2015. Comparison between genders shows that mortality of elderly females is generally lower than males at almost all ages. Nonetheless, mortality rates of Malaysian elderly males are declining faster than Malaysian elderly females. Life expentancies of females are higher than males for age groups 60 to 70, and lower than males for age 75 and above. Results also indicate that Malaysian elderly popultion is aging faster from previous generation in which elderly males age 85+ in 2010-2015 can live longer by 123% than thise in 1950-1955.</p>

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The predictability of COVID-19 mortality rates based on ex-ante economic, health and social indicators

Acta Oeconomica ◽

10.1556/032.2021.00029 ◽

2021 ◽

Vol 71 (S1) ◽

pp. 53-71

Keyword(s):

Social Indicators ◽

Mortality Rates ◽

Healthcare Systems ◽

European Countries ◽

Regression Equations ◽

Independent Variables ◽

Ex Post ◽

Ex Ante ◽

Economic Health ◽

High Level

Abstract The paper analyses the differences of COVID-19 mortality rates (MR) in 24 European countries. We explain MRs on the available, reliable ex-ante economic, health and social indicators pertaining to the year 2019 – i.e., before the outbreak of the pandemic. Using simple regression equations, we received statistically significant results for 11 such variables out of 28 attempts. Our best model with two ex-ante independent variables explains 0.76 of the variability of our ex-post dependent variable, the logarithm of Cumulative COVID Deaths. The estimated coefficient for the variable Density of Nurses shows that having one more nurse per 1,000 of population decreases cumulative COVID deaths by almost 15%. Similarly, one more unit Consumption of Non-Prescribed Medicine decreases cumulative deaths by 5%. It seems that until now those European countries were successful in minimising the fatalities where the population had a high level of health literacy, people pursue healthier lifestyle and the healthcare systems worked with a relatively large nursing force already prior to the COVID pandemic.

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