Mortality Under Age 50 Accounts For Much Of The Fact That US Life Expectancy Lags That Of Other High-Income Countries

Abstract

Life expectancy at birth in the United States is among the lowest of all high-income countries. Most recent studies have concentrated on older ages, finding that Americans have a lower life expectancy at age fifty and experience higher levels of disease and disability than do their counterparts in other industrialized nations. Using cross-national mortality data to identify the key age groups and causes of death responsible for these shortfalls, I found that mortality differences below age fifty account for two-thirds of the gap in life expectancy at birth between American males and their counterparts in sixteen comparison countries. Among females, the figure is two-fifths. The major causes of death responsible for the below-fifty trends are unintentional injuries, including drug overdose--a fact that constitutes the most striking finding from this study; noncommunicable diseases; perinatal conditions, such as pregnancy complications and birth trauma; and homicide. In all, this study highlights the importance of focusing on younger ages and on policies both to prevent the major causes of death below age fifty and to reduce social inequalities.

Racial/Ethnic Differences in Early-Life Mortality in the United States

“…Moreover, the U.S. relative mortality disadvantage is increasing: the other 16 high-income countries included in the report outpaced the United States in reducing their early life mortality rates over the past 25 years (NRC/IoM 2013). Given the progress that has been made in other high income countries (see Ho 2013; NRC/IoM 2013), the United States should be able to reduce substantially the 37,894 yearly early life U.S. deaths (Xu et al 2016), increase the pace of mortality reductions over time, reduce variations in life span, and close the widening gap between the United States and peer countries, which would in turn contribute to a brighter future for our children, youth, family and community members, and the nation at large (Fletcher et al 2013; Rogers et al 2008; Song et al 2010). …”

Major Causes of Injury Death and the Life Expectancy Gap Between the United States and Other High-Income Countries

“…We calculated the difference in life expectancy using death rates observed and after removing deaths from the 3 causes of injury. 1 The International Classification of Diseases, Tenth Revision , codes were used to capture the 3 injury causes, which included intentional and unintentional deaths and drug poisonings from illicit and nonillicit drugs. We used Stata (StataCorp), version 13.1, for all analyses.…”

Increasing Disparities in Mortality by Socioeconomic Status

“…Perhaps the restriction of the analysis to older ages could be justified by noting that 94% of all deaths occur at the ages of 50 and over, but the recent research by Case & Deaton (5, 6) highlighting a surge in mortality rates for younger persons weakens that argument. In addition, a paper by Ho finds that two-thirds of the difference in life expectancy at birth between the United States and other high-income countries arises from a higher US mortality rate for those below the age of 50 (20). Because it is determined in midlife, income will always be subject to a greater potential for reverse correlation from health or potential bias from the influence of other covariates.…”