We propose a method to decompose the young adult mortality hump by cause of death. This method is based on a flexible shape decomposition of mortality rates that separates cause-of-death contributions to the hump from senescent mortality. We apply the method to U.S. males and females from 1959 to 2015. Results show divergence between time trends of hump and observed deaths, both for all-cause and cause-specific mortality. The study of the hump shape reveals age, period, and cohort effects, suggesting that it is formed by a complex combination of different forces of biological and socioeconomic nature. Male and female humps share some traits in all-cause shape and trend, but they also differ by their overall magnitude and cause-specific contributions. Notably, among males, the contributions of traffic and other accidents were progressively replaced by those of suicides, homicides, and poisonings; among females, traffic accidents remained the major contributor to the hump.Electronic supplementary materialThe online version of this article (10.1007/s13524-018-0680-9) contains supplementary material, which is available to authorized users.
ObjectivesThe ability to translate increases in life expectancy into additional years in good health is a crucial challenge for public health policies. We question the success of these policies in Switzerland, a forerunner of longevity, through the evolution of healthy life expectancy (HLE) across socioeconomic groups.MethodsEducation-specific HLE conditioning on surviving to age 30 was computed for 5-year periods from the Swiss National Cohort, a mortality follow-up of the entire resident population, and the Swiss Health Interview Survey, reporting self-rated health. We compare time trends and decompose them into health, mortality and education components.ResultsBetween 1990 and 2015, comparable gains in LE (males: 5.02 years; females: 3.09 years) and HLE (males: 4.52 years; females: 3.09 years) were observed. People with compulsory education, however, experienced morbidity expansion, while those with middle and high education experienced morbidity compression.ConclusionsDivergence of morbid years by educational levels may reflect unequal access to preventive care due to high out-of-pockets contributions in the healthcare system. This growing gap and the exhaustion of the educational dividend jeopardize future increases in HLE.Electronic supplementary materialThe online version of this article (10.1007/s00038-019-01290-5) contains supplementary material, which is available to authorized users.
We propose a method to decompose the young adult mortality hump by cause of death. This method is based on a flexible shape-decomposition of mortality rates that separates cause-of-death contributions to the hump from senescent mortality. We apply the method to US males and females from 1959 to 2010. Results show divergences between time trends of hump and observed deaths, both for all-cause and cause-specific mortality. The study of the hump shape reveals age, period and cohort effects, suggesting that it is formed by a complex combination of different forces of biological and socioeconomic nature. Male and female humps share some traits in all-cause shape and trend, but also differ by their overall magnitude and cause-specific contributions. Notably, among males the contributions of traffic and other accidents were progressively replaced by those of suicides, homicides and poisonings, whereas among females traffic accidents remained the major contributor to the hump.Correspondence adrien.remund@unige.ch, +41.22.379.89.23
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