Recent trends in life expectancy across high income countries: retrospective observational study

Abstract

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.

Stalling life expectancy in the UK

“…Several high income countries have seen a slowdown in longevity improvements since 2010 89. As in the UK, the slowdown is greater at older ages, especially among women, and is driven by some similar causes of death (although the contribution of opioids to falling life expectancy in 2015 and 2016 is so far unique to the US) 8.…”

Reversals in life expectancy in high income countries?

“…Two linked studies in The BMJ make important contributions to debates about the sustainability of improvements in life expectancy in high income countries 12…”

“…Ho and colleagues (doi:10.1136/bmj.k2562) report the significant decreases in life expectancy that occurred simultaneously in many high income countries, usually in 2015 1. This universal spike in mortality has often been attributed to the direct and indirect effects of severe flu epidemics, particularly among older people 34.…”

“…Despite a strong recovery observed in many countries in 2016, it is too early to conclude that similar fluctuations or more long lasting increases in mortality will not occur in the nearest future 1. Evidence suggests that discontinuities in secular trends can lead to prolonged health crises—they are warning signs of fundamental and longstanding societal and health problems.…”

“…But this is not possible without recent and reliable data—a challenge even for some high income countries 1. National mortality data are often published after substantial delays.…”