The “double jeopardy” of midlife and old age mortality trends in the United States
Open accessAbstract
Since 2010, US life expectancy growth has stagnated. Much research on US mortality has focused on working-age adults given adverse trends in drug overdose deaths, other external causes of death, and cardiometabolic deaths in midlife. We show that the adverse mortality trend at retirement ages (65+ y) has in fact been more consequential to the US life expectancy stagnation since 2010, as well as excess deaths and years of life lost in 2019, than adverse mortality trends at working ages. These results reveal that the United States is experiencing a “double jeopardy” that is driven by both mid-life and older-age mortality trends, but more so by older-age mortality. Understanding and addressing the causes behind the worsening mortality trend in older ages will be essential to returning to the pace of life expectancy improvements that the United States had experienced for decades.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Recent work demonstrated that mortality trends among those above age 65 have also played a critical role in the US life expectancy stall.
“recent work demonstrated that trends among those above age 65 have also played a critical role (16).”
From Insights into US life expectancy stagnation from birth cohort mortality dynamics (2026) · cites this paper as [16]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
US life expectancy stalls due to cardiovascular disease, not drug deaths
Mehta, N. K., Abrams, L. R., & Myrskylä, M. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1920391117 · Cited by 240 · see citing works
Self-citationHigh and Rising Mortality Rates Among Working-Age Adults
Education, D. O. B. A. S. S. A., & National Academies of Sciences, E. (2021) · National Academies Press eBooks · doi:10.17226/25976 · Cited by 210 · see citing works
Causes of America’s Lagging Life Expectancy: An International Comparative Perspective
Ho, J. Y. (2021) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbab129 · Cited by 156 · see citing works
A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases
Institute of Medicine (2011) · National Academies Press eBooks · doi:10.17226/13145 · Cited by 85 · see citing works
Excess mortality in the United States in the 21st century
Preston, S. H., & Vierboom, Y. C. (2021) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2024850118 · Cited by 62 · see citing works
Elo, I. T., Luck, A. N., Stokes, A. C., Hempstead, K., Xie, W., & Preston, S. H. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.12686 · Cited by 53 · see citing works
Is the US Old‐Age Mortality Advantage Vanishing?
Palloni, A., & Yonker, J. A. (2016) · Population and Development Review · doi:10.1111/j.1728-4457.2016.00157.x · Cited by 16 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Vollset, S. E., Ababneh, H., Abate, Y. H., Abbafati, C., Abbasgholizadeh, R., Abbasian, M., Abbastabar, H., Magied, A. H. A. A. A., ElHafeez, S. A., Abdelkader, A. F. I., et al. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00685-8 · Cited by 1,152 · see citing works
Progress Stalled? The Uncertain Future of Mortality in High‐Income Countries
Dowd, J. B., Polizzi, A., & Tilstra, A. M. (2025) · Population and Development Review · doi:10.1111/padr.12687 · Cited by 21 · see citing works
Health Economics in a World of Uneconomic Growth
Hensher, M., McCartney, G., & Ochodo, E. (2024) · Applied Health Economics and Health Policy · doi:10.1007/s40258-024-00883-3 · Cited by 14 · see citing works
Hrzic, R., & Vogt, T. C. (2024) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2024.101042 · Cited by 14 · see citing works
Mortality Trends Among Early Adults in the United States, 1999-2023
Wrigley-Field, E., Raquib, R. V., Berry, K. M., Morris, K. J., & Stokes, A. C. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.57538 · Cited by 12 · see citing works
Polizzi, A., & Dowd, J. B. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2318276121 · Cited by 12 · see citing works
Abrams, L. R., Brower, N., Myrskylä, M., & Mehta, N. K. (2024) · American Journal of Epidemiology · doi:10.1093/aje/kwae414 · Cited by 5 · see citing works
Self-citationMidlife in crisis? Life course pathways to health at midlife across U.S. cohorts
Gaydosh, L. M., Gutin, I., & Harris, K. M. (2026) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbag138 · Cited by 4 · see citing works
Why is life expectancy in England and Wales falling behind? A cause-of-death decomposition approach.Preprint
Polizzi, A., Tilstra, A. M., Zhang, L., & Dowd, J. B. (2024) · doi:10.31235/osf.io/caswv · Cited by 4 · see citing works
Insights into US life expectancy stagnation from birth cohort mortality dynamics
Abrams, L., Bramajo, O., van Raalte, A., Myrskylä, M., & Mehta, N. K. (2026) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2519356123 · Cited by 6 · see citing works
Self-citationShen, T., van Raalte, A., & Payne, C. (2025) · American Journal of Epidemiology · doi:10.1093/aje/kwaf066 · Cited by 3 · see citing works
Agudelo‐Botero, M., Vogt, T. C., & Giraldo‐Rodríguez, L. (2024) · Archives of Medical Research · doi:10.1016/j.arcmed.2024.103082 · Cited by 1 · see citing works
Shi, J., & Fletcher, J. M. (2025) · Population Studies · doi:10.1080/00324728.2025.2546993 · Cited by 1 · see citing works
Тимонин, С. А., & Cooley, C. C. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2404342121 · Cited by 1 · see citing works
Abrams, L. R., Myrskylä, M., & Mehta, N. K. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2320028121
Self-citationAbrams, L. R., Myrskylä, M., & Mehta, N. K. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2407918121
Self-citationWrigley‐Field, E. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.37355
Bramajo, O. N., O’Grady, B., Chakraborty, M., & Mehta, N. (2026) · PLoS ONE · doi:10.1371/journal.pone.0340694
Self-citationWhy is life expectancy in England & Wales falling behind? A cause-of-death decomposition approach
Polizzi, A., Tilstra, A. M., Zhang, L., & Dowd, J. B. (2026) · Population Studies · doi:10.1080/00324728.2026.2682462
Sicker at all ages? Two decades of changing disease histories and mortality in the United States
Ebeling, M., Mehta, N. K., Abrams, L. R., & Myrskylä, M. (2026) · International Journal of Epidemiology · doi:10.1093/ije/dyag217
Self-citation
- Authors
- Abrams, L. R., Myrskylä, M., & Mehta, N. K.
- Affiliations
- Tufts University (US)
- University of Helsinki (FI)
- The University of Texas Medical Branch at Galveston (US)
- Corresponding author
- Abrams, Leah R.
- Myrskylä, Mikko
- Mehta, Neil K.
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2023-10-09
- Volume
- 120
- Issue
- 42
- Pages
- e2308360120-e2308360120
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC10589701
- OpenAlex
- W4387448477
- Cited by
- 20
- References
- 7
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 11
- FWCI
- 11.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Työväentutkimus Vuosikirja (submittedVersion)
- Funders
- HHS | NIH | National Institute on Aging (R24AG045061 30917-05467-S24, R01AG075208 P30AG024832, R01AG075208)
- AKA | Strategic Research Council (345130 345131)
- Topics
- Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- mortality trends, older adults, midlife mortality, retirement age, excess mortality, years of life lost, drug overdose deaths, external causes of death, United States
- MeSH terms
- Adult, Cause of Death, Humans, Life Expectancy, Mortality, Retirement, United States, Ethical Theory, Drug Overdose
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
