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A Twenty-First Century Demographic Challenge: Comparatively Low Life Expectancy in the United States

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Low Fertility Regimes and Demographic and Societal Change

Abstract

The United States is currently characterized by a lower fertility rate and higher life expectancy than most countries around the world. However, overall U.S. life expectancy lags behind that of most low fertility (and high-income) countries. We review trends in U.S. life expectancy, as well as the most prominent causes of death and behavioral factors that contribute to the relatively higher mortality in the United States. Compared to other low fertility, highincome countries, U.S. males and females exhibit the highest age-specific mortality in early life, but average or better age-specific mortality at older ages. High mortality in the United States due to behavioral-related causes—cigarette smoking, obesity, alcohol and drug abuse, risky driving, use of firearms—is in part responsible for the lags in U.S. life expectancy compared to other low fertility, high-income countries. It will take very substantial reductions in U.S. age-specific mortality in the next few decades to achieve the levels of life expectancy already experienced by the vanguard countries of the world. Nevertheless, some trends in the United States appear favorable, and we are guardedly optimistic that the United States will continue to experience gains in U.S. life expectancy over the next few decades.

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References

  • Arias, E. (2014). United States life tables, 2010. National Vital Statistics Reports, 63(7), 1–62.

    Google Scholar 

  • Avendano, M., & Kawachi, I. (2014). Why do Americans have shorter life expectancy and worse health than people in other high income countries? Annual Review of Public Health, 35, 307–325.

    Article  Google Scholar 

  • Bezruchka, S. (2012). The hurrider I go the behinder I get: The deteriorating ranking of U.S. health status. Annual Review of Public Health, 33, 157–173.

    Article  Google Scholar 

  • Bongaarts, J. (2006). How long will we live? Population and Development Review, 32(4), 605–628.

    Article  Google Scholar 

  • Carter, B. D., Abnet, C. C., Feskanich, D., Freedman, N. D., Hartge, P., Lewis, C. E., Ockene, J. K., Prentice, R. L., Speizer, F. E., Thun, M. J., & Jacobs, E. J. (2015). Smoking and mortality—Beyond established causes. The New England Journal of Medicine, 372, 631–640.

    Article  Google Scholar 

  • Centers for Disease Control. (1999). Achievements in public health, 1900–1999 motor-vehicle safety: A 20th century public health achievement. Morbidity and Mortality Weekly Report, 48(18), 369–374.

    Google Scholar 

  • Central Intelligence Agency (CIA). (2013). The world factbook 2013–2014. Washington, DC. https://www.cia.gov/library/publications/the-world-factbook/index.html

  • Crimmins, E. M., Preston, S. H., & Cohen, B. (Eds.). (2011). Explaining divergent levels of longevity in high-income countries. Washington, DC: National Academies.

    Google Scholar 

  • Cutler, D. M., & Meara, E. (2004). Changes in the age distribution of mortality over the twentieth century. In Perspectives on the Economics of Aging (pp. 333–366). Chicago: University of Chicago Press.

    Chapter  Google Scholar 

  • Heron, M. (2013). Deaths: Leading causes for 2010. National Vital Statistics Reports, 62(6), 1–96.

    Google Scholar 

  • Himes, C. L. (2011). Relationships among health behaviors, health, and mortality. In R. G. Rogers & E. M. Crimmins (Eds.), International handbook of adult mortality (pp. 289–310). New York: Springer.

    Chapter  Google Scholar 

  • Ho, J. Y. (2013). Mortality under age 50 account for much of the fact that U.S. life expectancy lags that of other high-income countries. Health Affairs, 32(3), 459–467.

    Article  Google Scholar 

  • Human Mortality Database. (2014). University of California, Berkeley (USA), and Max Planck Institute for Demographic Research (Germany). Available at www.mortality.org. Data downloaded on 12 December, 2014.

  • Jamal, A., Agaku, I. T., O’Connor, E., King, B. A., Kenemer, J. B., & Neff, L. (2014). Current cigarette smoking among adults—United States, 2005–2013. Morbidity and Mortality Weekly Report, 63(47), 1108–1112.

    Google Scholar 

  • Johnson, N. B., Hayes, L. D., Brown, K., Hoo, E. C., & Ethier, K. A. (2014). CDC national health report: Leading causes of morbidity and mortality and associated behavioral risk and protective factors—United States, 2006–2013. Morbidity and Mortality Weekly Report Supplement, 63(4), 3–27.

    Google Scholar 

  • Land, K. C., & Yang, Y. (2006). Morbidity, disability, and mortality. In R. H. Binstock, L. K. George, S. J. Cutler, J. Hendricks, & J. H. Schulz (Eds.), Handbook of aging and the social sciences (6th ed., pp. 41–58). San Diego: Academic.

    Chapter  Google Scholar 

  • Lutz, W., & Butz, W. P. (Eds.). (2014). World population and human capital in the twenty-first century. Oxford: Oxford University Press.

    Google Scholar 

  • MacDorman, M. F., Mathews, T. J., Mohangoo, A. D., & Zeitlin, J. (2014). International comparisons of infant mortality and related factors: United States and Europe, 2010. National Vital Statistics Reports, 63(5), 1–6.

    Google Scholar 

  • Masters, R. K., Hummer, R. A., Powers, D. A., Beck, A., Lin, S., & Finch, B. K. (2014). Long-term trends in adult mortality for U.S. blacks and whites: An examination of period- and cohort-based changes. Demography, 51(6), 2047–2073.

    Article  Google Scholar 

  • Miech, R., Pampel, F., Kim, J., & Rogers, R. G. (2011). The enduring association between education and mortality: The role of widening and narrowing disparities. American Sociological Review, 76(6), 913–934.

    Article  Google Scholar 

  • Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291(10), 1238–1245. doi:10.1001/jama.291.10.1238.

    Article  Google Scholar 

  • National Center for Health Statistics. (2014). Deaths: Final data for 2012. National Vital Statistics Reports, 63(9), 1–85. http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_09.pdf. Accessed 28 Dec 2014.

    Google Scholar 

  • National Research Council and Institute of Medicine. (2013). U.S. health in international perspective: Shorter lives, poorer health. In S. H. Woolf & L. Aron (Eds.), Panel on understanding cross-national health differences among high-income countries. Washington, DC: National Academies.

    Google Scholar 

  • Oeppen, J., & Vaupel, J. W. (2002). Broken limits to life expectancy. Science, 296(5570), 1029–1031.

    Article  Google Scholar 

  • Olshansky, S. J., & Ault, A. B. (1986). The fourth stage of the epidemiologic transition: The age of delayed degenerative diseases. Milbank Quarterly, 64(3), 355–391.

    Article  Google Scholar 

  • Olshansky, S. J., Carnes, B. A., & Cassel, C. (1990). In search of Methuselah—Estimating the upper limits to human longevity. Science, 250(4981), 634–640.

    Article  Google Scholar 

  • Olshansky, S. J., Carnes, B. A., Rogers, R. G., & Smith, L. (1997). New and ancient threats to world health. Population Bulletin, 52(2), 1–52.

    Google Scholar 

  • Omran, A. R. (1971). Epidemiologic transition—Theory of epidemiology of population change. Milbank Memorial Fund Quarterly, 49(4), 509–538.

    Article  Google Scholar 

  • Pampel, F. C. (2005). Forecasting sex differences in mortality in high income nations: The contribution of smoking. Demographic Research, 13, 455–484.

    Article  Google Scholar 

  • Population Reference Bureau. (2014). 2014 world population data sheet. Washington, DC: Population Reference Bureau.

    Google Scholar 

  • Preston, S. H., & Stokes, A. (2011). Contribution of obesity to international differences in life expectancy. American Journal of Public Health, 101(11), 2137–2143.

    Article  Google Scholar 

  • Preston, S. H., Heuveline, P., & Guillot, M. (2001). Demography: Measuring and modeling population processes. Oxford: Blackwell.

    Google Scholar 

  • Preston, S. H., Glei, D. A., & Wilmoth, J. R. (2010). A new method for estimating smoking-attributable mortality in high-income countries. International Journal of Epidemiology, 39(2), 430–438.

    Article  Google Scholar 

  • Preston, S. H., Stokes, A., Mehta, N., & Cao, B. (2014). Projecting the effect of changes in smoking and obesity on future life expectancy in the United States. Demography, 51, 27–49.

    Article  Google Scholar 

  • Reither, E. N., Olshansky, S. J., & Yang, Y. (2011). New forecasting method indicates more diseases and earlier mortality for today’s younger Americans. Health Affairs, 30(8), 1562–1568.

    Article  Google Scholar 

  • Rogers, R. G., & Crimmins, E. M. (Eds.). (2011). International handbook of adult mortality. New York: Springer.

    Google Scholar 

  • Rogers, R. G., & Hackenberg, R. (1987). Extending epidemiologic transition theory: A new stage. Social Biology, 34(3–4), 234–243.

    Google Scholar 

  • Schroeder, S. A. (2007). We can do better—Improving the health of the American people. New England Journal of Medicine, 357(12), 1221–1228.

    Article  Google Scholar 

  • Sickles, R. C., & Taubman, P. (1997). Mortality and morbidity among adults and the elderly. In M. R. Rosenzweig & O. Stark (Eds.), Handbook of population and family economics (Vol. 1A, pp. 559–643). Amsterdam: Elsevier.

    Chapter  Google Scholar 

  • Stewart, S. T., Cutler, D. M., & Rosen, A. B. (2009). Forecasting the effects of obesity and smoking on U.S. life expectancy. The New England Journal of Medicine, 361(23), 2252–2260.

    Article  Google Scholar 

  • U.S. Department of Agriculture and U.S. Department of Health and Human Services. (2010). Dietary guidelines for Americans, 2010 (7th ed.). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • U.S. Department of Health and Human Services. (2014). The health consequences of smoking—50 years of progress (A report of the Surgeon General). Atlanta: U.S. Department of Health and Human Services.

    Google Scholar 

  • U.S. Department of Health, Education, and Welfare. (1964). Smoking and health: Report of the advisory committee to the Surgeon General of the Public Health Service (Public Health Service Publication No. 1103). Washington, DC: U.S. Department of Health, Education, and Welfare.

    Google Scholar 

  • Vallin, J., & Meslé, F. (2009). The segmented trend line of highest life expectancies. Population and Development Review, 35(1), 159–187.

    Article  Google Scholar 

  • Wang, H., & Preston, S. H. (2009). Forecasting United States mortality using cohort smoking histories. Proceedings of the National Academy of Sciences, 106(2), 393–398.

    Article  Google Scholar 

  • World Health Organization. (2014). Global status report on alcohol and health 2014. Geneva: WHO Press. http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_2.pdf?ua=1. Accessed 17 Jan 2015.

  • World Health Organization. 2015. Mortality database. http://apps.who.int/healthinfo/statistics/mortality/whodpms/. Accessed Jan 8, 2015.

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Acknowledgements

We thank the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD grant R01HD082106 and F32 HD 085599) for research support, the NICHD-funded University of Colorado Population Center (Award Number P2CHD066613) and the NICHD-funded Carolina Population Center (Award Number P2CHD050924) for administrative and computing support, and Nancy Mann for editing the manuscript. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of NIH or NICHD.

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Rogers, R.G., Lawrence, E.M., Hummer, R.A. (2018). A Twenty-First Century Demographic Challenge: Comparatively Low Life Expectancy in the United States. In: Poston, Jr., D. (eds) Low Fertility Regimes and Demographic and Societal Change. Springer, Cham. https://doi.org/10.1007/978-3-319-64061-7_4

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