High and Rising Mortality Rates Among Working-Age Adults (2021) / Chapter Skim
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2 U.S. Mortality in an International Context
2 U.S. Mortality in an International Context
Pages 33-54
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From page 33... ...
. This chapter extends those prior analyses to consider differences in life expectancy between the United States and peer countries over the period 1950–2016.
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From page 34... ...
The chapter presents five sets of international analyses presented in four sections, each intended to help illustrate the growing gap between mortality in the United States and other peer countries and to clarify the rationale for the committee's focus on mortality rates at working ages: • The first section compares the countries on an overall measure of longevity -- life expectancy at birth -- spanning the period 1950– 2016. This long-term comparison of the United States with other countries helps clarify when the United States began to diverge from its peers, and whether the current gap is consistent with his torical trends or marks a new point of divergence.
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. In the first decades of this period, the slower growth in life expectancy within the United States relative to the peer average was heavily influenced by the rapid growth in life expectancy that occurred within those peer countries that were recovering from the effects of World War II.
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Hispanics. In all four panels, the gray lines plot the respective life expectancies for each peer country, and the blue solid lines show average female and male life expectancies across the 16 peer countries.
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. The gap began to take shape early; as early as 1970, the United States had a survival disadvantage compared with its peer countries in all age groups between 10 and 65.
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. They show the specific contributions of ages <1 year, 1–4 years, and all 5-year age groups from 5–9 through 95–99 (deaths above age 100 do not contribute to the life expectancy differences between the United States and peer countries in all years)
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U.S. Mortality Relative to International Peers by Age Comparing mortality rates in the United States and the peer countries highlights how long the United States has experienced higher mortality rates at midlife and younger ages, and this U.S.
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females dying at age 25 was about 40 percent higher in the United States than in the peer countries in 1970 but rose to more than 150 percent higher by 2016. INTERNATIONAL TRENDS IN WORKING-AGE MORTALITY The above discussion demonstrates that the United States has long faced higher mortality among working-age adults compared with the peer country average, but the gap has grown dramatically since 2000, contributing to widening differences in life expectancy between the United States and its peers.
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From page 41... ...
The figure shows the specific contributions of ages <1 year, 1–4 years, and all 5-year age groups from 5–9 through 95–99 (deaths above age 100 do not contribute to the life expectancy differences between the United States and peer countries in all years)
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From page 42... ...
U.S. MORTALITY BY CAUSE OF DEATH IN INTERNATIONAL PERSPECTIVE To provide insight into the underlying causes of death that drive the higher mortality rates in the United States compared with the peer countries, this section compares cause-specific mortality rates -- for the United States and peer country averages -- for selected causes of death in 2000, 2008, and
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From page 43... ...
In these panels, the red line shows the mortality risk in the United States, the gray lines plot the respective mortality risk for each peer country, and the blue solid lines show the average mortality risk across the 16 peer countries. The bottom two panels show the relative positions of the United States and the 16 peer countries.
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From page 44... ...
mortality disadvantage. Finally, mortality for several causes of death -- including intentional self-harm and diseases of the endocrine system among males and intentional self-harm, diseases of the digestive system, and mental health and alcohol use among females -- increased in the United States but not in the peer countries.
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rate-peer rate >3. Green highlights indicate U.S.
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From page 46... ...
In addition, the table shows how the gap in mortality between the United States and peer countries changed between 2000 and 2015. A positive change in the difference indicates that the United States fared worse than its peers over the period because it experienced either a smaller decrease or a more rapid increase in mortality relative to the peer countries.
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From page 47... ...
Compared with the peer countries, the United States experienced a faster decrease in mortality from HIV/AIDS and colorectal cancer; female mortality due to breast cancer; and male mortality from lung cancer, prostate cancer, and diseases of the genitourinary system. Female mortality from lung cancer and diseases of the genitourinary system decreased in the United States but rose in peer countries.
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mortality disadvantage may have worsened because the United States failed to contain the virus as effectively as did the 16 peer countries (Johns Hopkins University, 2020)
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It is organized by research teams in the United States at the University of California, Berkeley and the Max Planck Institute for Demographic Research in Germany, with scientific contributions from researchers from many countries, and is supported by research grants and financial contributions from governmental and private sources. The HMD data include calculated mortality rates and life tables, as well as the original data underlying these calculations.
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The first section compares life expectancy at birth by sex in the United States and the 16 peer countries. Life expectancy in the United
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From page 51... ...
Life Expectancy at Birth Life expectancy at birth for each country was not directly calculated but drawn from outside data sources. Life expectancy for the 16 peer countries was calculated by the HMD using standard life table construction methods detailed more extensively in the online documentation located on the HMD website.2 Life expectancy at birth for the United States was drawn directly from Table 19 of the NVSRs.
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From page 52... ...
female life expectancy was .33 years lower than the average female life expectancy in peer countries. This overall .33-year life expectancy difference can be decomposed into age-specific differences between the United States and peer countries: • a .23-year disadvantage for U.S.
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From page 53... ...
As with the Arriaga decompositions, the analysis focused on the specific contributions of ages <1 year, ages 1–4 years, and all 5-year age groups from 5–9 through 95–99. When possible, these age-specific probabilities were drawn directly from the NVSRs (United States)
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