scholarly journals Social Determinants of the Recent Decline in US Life Expectancy

2020 ◽  
Author(s):  
Sam Harper ◽  
Corinne Riddell ◽  
Nicholas King
Keyword(s):  
United States ◽  
Life Expectancy ◽  
The United States ◽  
Opioid Overdose ◽  
Recent Trends ◽  
And Gender ◽  
Gender Groups ◽  
The Life Course ◽  
Overdose Deaths

In recent years life expectancy has stagnated in the United States, followed by three consecutive years of decline. The decline is small in absolute terms, but is unprecedented and has generated considerable research interest and theorizing about potential causes. Recent trends show the decline has affected nearly all race-ethnic and gender groups, and the proximate causes of the decline are increases in opioid overdose deaths, suicide, homicide, and Alzheimer’s disease. A slowdown in the long-term decline in mortality from cardiovascular diseases has also prevented life expectancy from further improvements. Although a popular explanation for the decline is the cumulative decline in living standards across generations, recent trends suggest that distinct mechanisms for specific causes of death are more plausible explanations. Interventions to stem the increase in overdose deaths, reduce access to mechanisms that contribute to violent deaths, and decrease cardiovascular risk over the life course are urgently needed to improve mortality in the United States.

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

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Sam Harper ◽  
Corinne A. Riddell ◽  
Nicholas B. King
Keyword(s):  
United States ◽  
Life Expectancy ◽  
The United States ◽  
Annual Review ◽  
Publication Date ◽  
Opioid Overdose ◽  
Recent Trends ◽  
And Gender ◽  
Gender Groups ◽  
Overdose Deaths

In recent years, life expectancy in the United States has stagnated, followed by three consecutive years of decline. The decline is small in absolute terms but is unprecedented and has generated considerable research interest and theorizing about potential causes. Recent trends show that the decline has affected nearly all race/ethnic and gender groups, and the proximate causes of the decline are increases in opioid overdose deaths, suicide, homicide, and Alzheimer's disease. A slowdown in the long-term decline in mortality from cardiovascular diseases has also prevented life expectancy from improving further. Although a popular explanation for the decline is the cumulative decline in living standards across generations, recent trends suggest that distinct mechanisms for specific causes of death are more plausible explanations. Interventions to stem the increase in overdose deaths, reduce access to mechanisms that contribute to violent deaths, and decrease cardiovascular risk over the life course are urgently needed to improve mortality in the United States. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

How Prevalent is Performance-Related Pay in the United States? Current Incidence and Recent Trends

2013 ◽  
Vol 226 ◽  
pp. R4-R16 ◽  
Author(s):  
Maury Gittleman ◽  
Brooks Pierce
Keyword(s):  
United States ◽  
Explanatory Power ◽  
The United States ◽  
High Wage ◽  
Potential Explanation ◽  
Us Economy ◽  
The Us ◽  
Recent Trends ◽  
Current Incidence

We address basic questions about performance-related pay in the US. How widespread is it? What characteristics of employers and jobs are associated with it? What are recent trends in its incidence? What factors are responsible for these trends? Nearly two-fifths of hours worked in the US economy in 2013 were in jobs with performance-related pay, but this share has been declining. We consider several possible causes for this trend and find that they do not have much explanatory power. We do establish, however, that any potential explanation must also account for a long-term shift in the relative incidence of performance-related pay away from low-wage and toward high-wage jobs.

Aging Societies and the Ethical Challenges of Long Life

2018 ◽  
Author(s):  
Allison R. Heid ◽  
Steven H. Zarit
Keyword(s):  
United States ◽  
Life Expectancy ◽  
End Of Life ◽  
The United States ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Older Individuals ◽  
Ethical Challenges ◽  
Chronic Health

Individuals are living longer than they ever have before with average life expectancy at birth estimated at 79 years of age in the United States. A greater proportion of individuals are living to advanced ages of 85 or more and the ratio of individuals 65 and over to individuals of younger age groups is shrinking. Disparities in life expectancy across genders and races are pronounced. Financial challenges of sustaining the older population are substantial in most developed and many developing countries. In the United States in particular, employer-based pension programs are diminishing. Furthermore, Social Security will begin taking in less money than it pays out as early as 2023, and the debate over its future in part entails discussions of equitable distribution of resources for the young in need and the old. Living longer is associated with a greater number of chronic health conditions—over two-thirds of Medicare beneficiaries in the United States have two or more chronic health conditions that require complex self-management regimes partnered with informal and formal care services from family caregivers and institutional long-term services and supports. Caregiver burden and stress is high as are quality care deficiencies in residential long-term care settings. The balance of honoring individuals’ autonomous wishes and providing person-centered care that also addresses the practicalities of safety is an ever-present quandary. Furthermore, complex decisions regarding end-of-life care and treatments plague the medical and social realms, as more money is spent at the end of life than at any other point and individuals’ wishes for less invasive treatment are often not accommodated. Yet, despite these challenges of later life, a large percentage of older individuals are giving financial support, time, and energy to younger generations, who are increasingly strained by economic hardship, the pressures on dual earner parents, and the problems faced by single parenthood. Older individuals’ engagement in society and the help they provide others runs counter to stereotypes that render them helpless and lonely. Overall, the ethical challenges faced by society due to the aging of the population are considerable. Difficult decisions that must be addressed include the sustainability of programs, resources, and social justice in care, as well as how to marshal the resources, talents, and wisdom that older people provide.

Aging Populations, Mortality, and Life Expectancy

2019 ◽  
Vol 45 (1) ◽  
pp. 69-89 ◽  
Author(s):  
Eileen M. Crimmins ◽  
Yuan S. Zhang
Keyword(s):  
Life Expectancy ◽  
White Women ◽  
The United States ◽  
Public Health Programs ◽  
Race And Gender ◽  
Aging Populations ◽  
Recent Trends ◽  
And Gender ◽  
Deaths Of Despair

Life expectancy has long been seen as an indicator of the quality of life as well as the health of a population. Recent trends in US life expectancy show growing inequality in life expectancy for some socioeconomic and geographic groupings but diminishing inequality by race and gender. For example, while African Americans had gains in life expectancy, non-Hispanic white women with low levels of education experienced drops. Overall, the United States continues to fall behind other countries in terms of life expectancy. One reason is our growing mortality in midlife from so-called deaths of despair. Public health programs cannot eliminate these adverse trends if they are not also accompanied by social policies supporting economic opportunity for US families.

scholarly journals Long-Term Exposure to Ozone and Life Expectancy in the United States, 2002 to 2008

Medicine ◽  
2016 ◽  
Vol 95 (7) ◽  
pp. e2474 ◽  
Author(s):  
Chaoyang Li ◽  
Lina S. Balluz ◽  
Ambarish Vaidyanathan ◽  
Xiao-Jun Wen ◽  
Yongping Hao ◽  
...  
Keyword(s):  
United States ◽  
Life Expectancy ◽  
The United States

scholarly journals Mortality among Adults Ages 25-44 in the United States During the COVID-19 Pandemic

2020 ◽  
Author(s):  
Jeremy Samuel Faust ◽  
Harlan M. Krumholz ◽  
Katherine L. Dickerson ◽  
Zhenqiu Lin ◽  
Cleavon Gilman ◽  
...  
Keyword(s):  
United States ◽  
New York ◽  
The United States ◽  
Relative Increase ◽  
Opioid Overdose ◽  
Public Data ◽  
Control And Prevention ◽  
Incident Rate ◽  
Opioid Deaths ◽  
Overdose Deaths

AbstractIntroductionCoronavirus disease-19 (COVID-19) has caused a marked increase in all-cause deaths in the United States, mostly among adults aged 65 and older. Because younger adults have far lower infection fatality rates, less attention has been focused on the mortality burden of COVID-19 in this demographic.MethodsWe performed an observational cohort study using public data from the National Center for Health Statistics at the United States Centers for Disease Control and Prevention, and CDC Wonder. We analyzed all-cause mortality among adults ages 25-44 during the COVID-19 pandemic in the United States. Further, we compared COVID-19-related deaths in this age group during the pandemic period to all drug overdose deaths and opioid-specific overdose deaths in each of the ten Health and Human Services (HHS) regions during the corresponding period of 2018, the most recent year for which data are available.ResultsAs of September 6, 2020, 74,027 all-cause deaths occurred among persons ages 25-44 years during the period from March 1st to July 31st, 2020, 14,155 more than during the same period of 2019, a 23% relative increase (incident rate ratio 1.23; 95% CI 1.21–1.24), with a peak of 30% occurring in May (IRR 1.30; 95% CI 1.27-1.33). In HHS Region 2 (New York, New Jersey), HHS Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas), and HHS Region 9 (Arizona, California, Hawaii, Nevada), COVID-19 deaths exceeded 2018 unintentional opioid overdose deaths during at least one month. Combined, 2,450 COVID-19 deaths were recorded in these three regions during the pandemic period, compared to 2,445 opioid deaths during the same period of 2018.MeaningWe find that COVID-19 has likely become the leading cause of death—surpassing unintentional overdoses—among young adults aged 25-44 in some areas of the United States during substantial COVID-19 outbreaks.NoteThe data presented here have since been updated. As a result, an additional 1,902 all-cause deaths occurring among US adults ages 25-44 during the period of interest are not accounted for in this manuscript.

scholarly journals I NTERNATIONAL WORK-TIME TRENDS: THE EMERGING GAP IN HOURS

Just Labour ◽  
1969 ◽  
Author(s):  
Anders Hayden
Keyword(s):  
United States ◽  
Recent Work ◽  
Time Trends ◽  
Leading Edge ◽  
The United States ◽  
Work Hours ◽  
Work Time ◽  
Recent Trends ◽  
Catch Up

This paper examines historical and recent trends in average annual work hours. The shared long-term decline in annual hours appears to be giving way to a growing divergence among OECD nations, with notable differences between several European nations and the United States. Significant differences among nations exist in annual vacation entitlements and are emerging with regard to the workweek. Competing notions of work-time flexibility held by employers and employees are an important new element in recent work-time debates, as is the related trend toward individualised forms of work-time reduction. Some European countries with pioneering work-time regimes are reviewed. The paper concludes by raising the question of how Canada can resist the American long-hours model and catch up with leading-edge practices.

Educational inequalities in longevity in 18 OECD countries

2021 ◽  
pp. 1-29
Author(s):  
Fabrice Murtin ◽  
Johan P. Mackenbach ◽  
Domantas Jasilionis ◽  
Marco Mira d'Ercole
Keyword(s):  
Life Expectancy ◽  
Cause Of Death ◽  
The United States ◽  
Oecd Countries ◽  
Similar Treatment ◽  
Gender And Education ◽  
First Cause ◽  
And Gender ◽  
Low Educated ◽  
Gender Groups

Abstract This paper assesses inequality in longevity across education and gender groups in 23 OECD countries around 2011. Data on mortality rates by age, gender, educational attainment, and, for 17 countries, cause of death were collected from national sources, with similar treatment applied to all countries in order to derive comparable measures of longevity at age 25 and 65 by gender and education. These estimates show that, on average, the gap in life expectancy between high and low-educated people is 7.6 years for men and 4.8 years for women at age 25 years, and 3.6 years for men and 2.6 years for women at age 65. At the age of 25, the gap in life expectancy between high and low-educated people varies between 4.1 years (in Canada) and 13.9 years (in Hungary) for men, and between 2.5 years (in Italy) and 8.3 years (in Latvia) for women; in the United States, the gap is 10.0 years for men and 7.0 years for women. Cardiovascular diseases are the first cause of death for all gender and education groups after age 65 years, and the first cause of mortality inequality between the high and low-education elderly.

Reframing the Prevention Strategies of the Opioid Crisis: Focusing on Prescription Opioids, Fentanyl, and Heroin Epidemic

2018 ◽  
Vol 1 (21;1) ◽  
pp. 309-326 ◽  
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Epidemic ◽  
Synthetic Opioids ◽  
Opioid Crisis ◽  
Electronic Reporting ◽  
Number Of Patients ◽  
Overdose Deaths

The opioid epidemic has been called the “most consequential preventable public health problem in the United States.” Though there is wide recognition of the role of prescription opioids in the epidemic, evidence has shown that heroin and synthetic opioids contribute to the majority of opioid overdose deaths. It is essential to reframe the preventive strategies in place against the opioid crisis with attention to factors surrounding the illicit use of fentanyl and heroin. Data on opioid overdose deaths shows 42,000 deaths in 2016. Of these, synthetic opioids other than methadone were responsible for over 20,000, heroin for over 15,000, and natural and semisynthetic opioids other than methadone responsible for over 14,000. Fentanyl deaths increased 520% from 2009 to 2016 (increased by 87.7% annually between 2013 and 2016), and heroin deaths increased 533% from 2000 to 2016. Prescription opioid deaths increased by 18% overall between 2009 and 2016. The Drug Enforcement Administration (DEA) mandated reductions in opioid production by 25% in 2017 and 20% in 2018. The number of prescriptions for opioids declined significantly from 252 million in 2013 to 196 million in 2017 (9% annual decline over this period), falling below the number of prescriptions in 2006. In addition, data from 2017 shows significant reductions in the milligram equivalence of morphine by 12.2% and in the number of patients receiving high dose opioids by 16.1%. This manuscript describes the escalation of opioid use in the United States, discussing the roles played by drug manufacturers and distributors, liberalization by the DEA, the Food and Drug Administration (FDA), licensure boards and legislatures, poor science, and misuse of evidencebased medicine. Moreover, we describe how the influence of pharma, improper advocacy by physician groups, and the promotion of literature considered peer-reviewed led to the explosive use of illicit drugs arising from the issues surrounding prescription opioids. This manuscript describes a 3-tier approach presented to Congress. Tier 1 includes an aggressive education campaign geared toward the public, physicians, and patients. Tier 2 includes facilitation of easier access to non-opioid techniques and the establishment of a National All Schedules Prescription Electronic Reporting Act (NASPER). Finally, Tier 3 focuses on making buprenorphine more available for chronic pain management as well as for medication-assisted treatment. Key words: Opioid epidemic, fentanyl and heroin epidemic, prescription opioids, National All Schedules Prescription Electronic Reporting Act (NASPER), Prescription Drug Monitoring Programs (PDMPs)

Abstract 15422: Distribution of 10- and 30-year Predicted Risks for Heart Failure in the United States: NHANES 2015 to 2018

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nilay S Shah ◽  
Hongyan Ning ◽  
Sanjiv J Shah ◽  
Clyde Yancy ◽  
John T Wilkins ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Life Course ◽  
The United States ◽  
Older Individuals ◽  
Middle Aged ◽  
Short And Long Term ◽  
The Life Course ◽  
Predicted Risk

Introduction: Heart failure (HF) poses a significant health burden with prevalence projected to increase by 46% by 2030 in the United States. Targeted implementation and dissemination of clinical and public health preventive measures across the life course will be informed by describing population distributions of short- and long-term predicted HF risk. Methods: Among nonpregnant middle-aged (30-59 years) adults without prevalent CVD from the National Health and Nutrition Examination Surveys 2015-18, continuous 10-year (10Y) and 30-year (30Y) HF risk estimates were calculated using short- and long-term risk equations derived in the Cardiovascular Lifetime Risk Pooling Project. High estimated 10Y risk was classified as ≥5%, and high 30Y risk as ≥20%. Participants were categorized by combined 10Y and 30Y estimated risk categories overall and stratified by sex, race, age, and body mass index. Distributions were compared using chi-square tests. Results: In 1495 NHANES participants (representing 53,022,413 Americans) with mean age 45 years (SE 0.3), median 10Y risk was 0.8% and 30Y risk was 11%. Approximately 4% of individuals were estimated to have high 10Y predicted risk of HF. Of those who were classified as low 10Y risk, 23% had high 30Y predicted risk. Distributions differed significantly by sex, race, age, and BMI (P<0.01, Figure ). Black males more frequently were classified as high 10Y or 30Y risk compared to other race-sex groups. Older individuals and those with BMI ≥30 kg/m 2 had a higher frequency of low 10Y but high 30Y risk. Conclusions: More than one-fourth of middle-aged U.S. adults have elevated short- or long-term predicted risk for HF. While the majority of middle-aged US adults are at low 10Y risk for HF, a large proportion among this subgroup are at high 30Y HF risk. Application of both short- and long-term HF risk prediction may mitigate the growing morbidity and mortality related to HF and identify strategies to target those at-risk earlier in the life course.

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