ObjectivesTo assess whether declines in life expectancy occurred across high income countries during 2014-16, to identify the causes of death contributing to these declines, and to examine the extent to which these declines were driven by shared or differing factors across countries.DesignDemographic analysis using aggregated data.SettingVital statistics systems of 18 member countries of the Organisation for Economic Co-operation and Development.Participants18 countries with high quality all cause and cause specific mortality data available in 2014-16.Main outcome measuresLife expectancy at birth, 0-65 years, and 65 or more years and cause of death contributions to changes in life expectancy at birth.ResultsThe majority of high income countries in the study experienced declines in life expectancy during 2014-15; of the 18 countries, 12 experienced declines in life expectancy among women and 11 experienced declines in life expectancy among men. The average decline was 0.21 years for women and 0.18 years for men. In most countries experiencing declines in life expectancy, these declines were predominantly driven by trends in older age (≥65 years) mortality and in deaths related to respiratory disease, cardiovascular disease, nervous system disease, and mental disorders. In the United States, declines in life expectancy were more concentrated at younger ages (0-65 years), and drug overdose and other external causes of death played important roles in driving these declines.ConclusionsMost of the countries that experienced declines in life expectancy during 2014-15 experienced robust gains in life expectancy during 2015-16 that more than compensated for the declines. However, the United Kingdom and the United States appear to be experiencing stagnating or continued declines in life expectancy, raising questions about future trends in these countries.

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Life expectancy has increased among White men for all education groups and has decreased among White women with less than a high school education, though not to the extent reported in previous studies. The fact that a large proportion of the change in education-specific life expectancy among women is due to the 85+ age group suggests changes in institutionalization may be affecting estimates. Much of the change in education-specific life expectancy and the growth in the educational gradient in life expectancy is due to the shifting distribution of individuals across education categories.

Several recent articles have reported conflicting conclusions about educational differences in life expectancy, and this is partly due to the use of unreliable data subject to a numerator-denominator bias previously reported as ranging from 20 % to 40 %. This article presents estimates of life expectancy and lifespan variation by education in the United States using more reliable data from the National Health Interview Survey. Contrary to prior conclusions in the literature, I find that life expectancy increased or stagnated since 1990 among all education-race-sex groups except for non-Hispanic white women with less than a high school education; there has been a robust increase in life expectancy among white high school graduates and a smaller increase among black female high school graduates; lifespan variation did not increase appreciably among high school graduates; and lifespan variation plays a very limited role in explaining educational gradients in mortality. I also discuss the key role that educational expansion may play in driving future changes in mortality gradients. Because of shifting education distributions, within an education-specific synthetic cohort, older age groups are less negatively select than younger age groups. We could thus expect a greater concentration of mortality at younger ages among people with a high school education or less, which would be reflected in increasing lifespan variability for this group. Future studies of educational gradients in mortality should use more reliable data and should be mindful of the effects of shifting education distributions.