The slowdown in mortality improvement rates 2011–2017: a multi-country analysis

Djeundje, Viani B.; Haberman, Steven; Bajekal, Madhavi; Lu, J. L. C.

doi:10.1007/s13385-022-00318-0

Cited by 17 publications

(16 citation statements)

References 46 publications

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“…Visual inspection showed that a second order polynomial usually gave the best estimate for the 'average' or 'baseline' deaths in 2019although in most instances the actual differences are minor. This is consistent with the observation that there was a break point in international mortality improvement from 2011 onward [44]. Exceptions include infants in the first year of life where population-adjusted male and female mortality was constant between 2013 and 2019.…”

Section: Estimation Of Year Of Age Baseline For Deaths In England And...supporting

confidence: 90%

“…These two sources were used to cross-check each other, and the full detail is given in the Supplementary Materials S2-S5 [38][39][40][41][42][43][44][45][46][47][48][49][50][51].…”

Section: Validation Of Deaths 'Due To' Covid-19 and Methods For Adjus...mentioning

confidence: 99%

“…Firstly, raw deaths between 2011 ̶ 2018 (from [28]) were converted to a 2019 equivalent by multiplying by the 2019 mid-year year of age estimated population divided by that in each of the years 2011 ̶ 2018. Given that human mortality is changing over time [44], both linear and a second order polynomial regression was applied to these adjusted deaths to give the most likely average for 2019 which will be relatively free of both Poisson and systematic variation. Visual inspection showed that a second order polynomial usually gave the best estimate for the 'average' or 'baseline' deaths in 2019although in most instances the actual differences are minor.…”

Section: Estimation Of Year Of Age Baseline For Deaths In England And...mentioning

confidence: 99%

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Age Profiles for SARS-CoV-2 Variants in England and Wales and States of the USA (2020 to 2022): Impact on All-Cause Mor-Tality

Jones¹,

Ponomarenko²

2023

Preprint

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Since 2020 COVID-19 has caused serious mortality around the world. Given the ambiguity in es-tablishing COVID-19 as the direct cause of death we first investigate the effects of age and sex upon all-cause mortality during 2020 and 2021 in England and Wales. Since infectious agents have their own unique age profile for death, we explore several methods to adjust single year of age deaths in England and Wales during 2019 (the pre-COVID-19 base year) to a pathogen-neutral single year of age baseline. This adjusted base year is then used to confirm the widely reported higher deaths in males for most ages above 43 years in both 2020 and 2021. During 2020 (+ COVID-19 but no vac-cination) both male and female population-adjusted deaths were significantly increased above age 35. A significant reduction in all-cause mortality among both males and females aged 75+ could be demonstrated in 2021 during widespread COVID–19 vaccination, however, below age 75 deaths progressively increased. This finding arises from a mix of vaccination and year of age profiles of deaths for the different SARS-CoV-2 variants. In addition, specific effects for age around puberty were demonstrated where females had higher deaths rather than males. There is evidence that year-of-birth cohorts may also be involved, indicating that immune priming to specific pathogen outbreaks in the past may lead to lower deaths for some birth cohorts. To specifically identify the age profile for the COVID-19 variants in 2020 to 2023, we employ the proportion of total deaths at each age which are potentially due to or ‘with’ COVID-19. The original Wuhan strain, and the Alpha variant show somewhat limited divergence in the age profile with the Alpha variant shifted to a moderately higher proportion of deaths below age 84. The Delta variant specifically targeted persons below age 65. The Omicron variants showed significantly lower proportion of overall mortality, with markedly higher relative proportion of deaths above age 65 steeply increasing with age to a maximum around 100 years of age. A similar age profile for the variants can be seen in the age-banded deaths in US states – although slightly obscured by using age bands rather than single year of age. However, the US data shows that higher male deaths are greatly dependent on age and the COVID-variant. Deaths determined as ‘due to’ COVID-19 (as opposed to ‘involving’ COVID-19) in England and Wales were especially over-estimated in 2021 relative to the change in all-cause mortality. This arose as a by-product of an increase in COVID-19 testing capacity in late 2020. Potential structure-function mechanisms for the year of age specificity of SARS-CoV-2 var-iants are discussed. The question is posed as to whether vaccines based on different variants carry the specific age profile through into the vaccine.

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Section: Estimation Of Year Of Age Baseline For Deaths In England And...supporting

confidence: 90%

“…These two sources were used to cross-check each other, and the full detail is given in the Supplementary Materials S2-S5 [38][39][40][41][42][43][44][45][46][47][48][49][50][51].…”

Section: Validation Of Deaths 'Due To' Covid-19 and Methods For Adjus...mentioning

confidence: 99%

Section: Estimation Of Year Of Age Baseline For Deaths In England And...mentioning

confidence: 99%

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Age Profiles for SARS-CoV-2 Variants in England and Wales and States of the USA (2020 to 2022): Impact on All-Cause Mor-Tality

Jones¹,

Ponomarenko²

2023

Preprint

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“…Global life expectancy has shown a dramatic increase over the last century in most high-income countries (HICs) even though these mortality declines have not been universal between and within populations. 1 In the years preceding the Covid-19 pandemic, there were observed slowdowns in longevity improvements or even mortality reversals in some HICs [2][3][4][5][6] corresponding to warning signs for both longstanding and emerging health problems. 7 The Covid-19 pandemic has had a further dramatic impact on longevity globally including in HICs.…”

Section: Introductionmentioning

confidence: 99%

Faltering mortality improvements at young-middle ages in high-income English-speaking countries

Timonin,

Leon,

Banks

et al. 2023

Preprint

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ObjectiveTo quantify mortality trends in six high-income English-speaking countries (Australia, Canada, Ireland, New Zealand, UK, USA) - including by age, sex, period, cohort and major cause - and compare them with other high-income countries (HICs).DesignPeriod and cohort analysis using population-level demographic data.Setting6 high-income Anglophone countries and the average for 14 other HICs.ParticipantsAll-cause mortality data from the Human Mortality Database (1970-2021) and cause-specific death counts from the WHO Mortality Database (2017-19), disaggregated by sex, age group and major cause of death.Main outcome measuresTrends in longevity measures (period life expectancy at birth, 0-50 years, and at age 50 years) and lifespan inequality were estimated for 1970-2021. The contribution of causes of death was measured by calculating life-years lost and decomposing differences in life expectancy between each Anglophone country and the average for other HICs in the pre-pandemic period. The impact of differential cohort survival on current differences in longevity was assessed by calculating the gap in truncated cross-sectional average length of life.ResultsHaving improved consistently from the 1970s, life expectancy in all English-speaking countries except Ireland stalled in the pre-pandemic decade, mainly due to stagnating or increasing mortality at young-middle ages. Relative to other HICs, those born in Anglophone countries since the 1970s experienced relative mortality disadvantage, largely attributable to injuries, including suicides, substance-related and cardiovascular mortality. In contrast, older cohorts enjoyed advantages for females in Australia and Canada and for males in all Anglophone countries except the USA.ConclusionsThe striking disadvantage of young adults in English-speaking countries relative to other HICs should be seen as an emerging and avoidable threat to efforts to improve health equity. Population health policies should be adapted to meet this challenge. Post-pandemic mortality and life expectancy trends in Anglophone countries require further monitoring.WHAT IS ALREADY KNOWN ON THIS TOPICIn the decade before the Covid-19 pandemic, many high-income countries (HICs) experienced a slowdown in longevity improvements.The UK and especially the US have seen some of the most unfavourable trends in life expectancy in recent times.Socio-economic inequalities and the impact of austerity policies, the high prevalence of obesity and long-term cohort effects of smoking, together with an ongoing epidemic of opioid overdose mortality, are identified as the possible determinants of the adverse mortality trends in individual countries.WHAT THIS STUDY ADDSEach of the English-speaking countries, except for men in Ireland, has experienced a marked mortality disadvantage for those under 50 years (born since the early 1970s) relative to the average of other HICs.In 2017-19, losses in life expectancy at birth due to elevated mortality at younger ages relative to other HICs ranged from 0.15 years for Australian women to 2.06 years for US men.This contrasts with the generally better performance of the English-speaking countries at older ages, particularly for men.

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“…Life expectancy is an objective measure of a population´s health and relies on a complex variety of individual, social, economic and regional factors [ 1 – 5 ]. Although the life span with the interruption of World War II has risen globally over the last 100 years, the decline in mortality has recently slowed down in developed countries despite major increases in health expenditure [ 6 – 8 ]. Also, there is robust evidence from European countries that the overall gain in life span appears to be dearly bought by an increase in disabled years [ 9 ].…”

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confidence: 99%