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Cited by 439Insurance, Mortality, Demography, Risk ManagementHealthcare Systems and Public HealthHealth disparities and outcomes

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

Open access
Ho, Jessica Y, Hendi, Arun S·2018·BMJ
DOI 10.1136/bmj.k2562PMC PMC6092679
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Abstract

OBJECTIVES: To 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. DESIGN: Demographic analysis using aggregated data. SETTING: Vital statistics systems of 18 member countries of the Organisation for Economic Co-operation and Development. PARTICIPANTS: 18 countries with high quality all cause and cause specific mortality data available in 2014-16. MAIN OUTCOME MEASURES: Life expectancy at birth, 0-65 years, and 65 or more years and cause of death contributions to changes in life expectancy at birth. RESULTS: The 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. CONCLUSIONS: Most 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.

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Fig 1 Life expectancy at birth (years) in 18 high income countries for women and men during 2010-16 and 1990-2015. Data for Canada are not available in 2016. See supplementary figure A1 for all countries identified. AUS=Australia; JPN=Japan; SWI=Switzerland; USA=United States
Fig 1 Life expectancy at birth (years) in 18 high income countries for women and men during 2010-16 and 1990-2015. Data for Canada are not available in 2016. See supplementary figure A1 for all countries identified. AUS=Australia; JPN=Japan; SWI=Switzerland; USA=United StatesCC BY-NC · PubMed Central
Fig 2 Changes in life expectancy for women at birth, 0-65 years, and 65 or more years during 2014-15 in 18 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest gain to largest decline. See table 1 and supplementary table A4 for corresponding values
Fig 2 Changes in life expectancy for women at birth, 0-65 years, and 65 or more years during 2014-15 in 18 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest gain to largest decline. See table 1 and supplementary table A4 for corresponding valuesCC BY-NC · PubMed Central
Fig 3 Changes in life expectancy for men at birth, 0-65 years, and 65 or more years during 2014-15 in 18 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest gain to largest decline. See table 1 and supplementary table A4 for corresponding values
Fig 3 Changes in life expectancy for men at birth, 0-65 years, and 65 or more years during 2014-15 in 18 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest gain to largest decline. See table 1 and supplementary table A4 for corresponding valuesCC BY-NC · PubMed Central
Fig 4 Contribution of broad cause of death categories to changes in life expectancy at birth for women during 2014-15 in 17 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest decline to largest gain. Countries to left of dashed line experienced a decline in life expectancy during 2014-15, and countries to right of dashed line experienced a life expectancy gain during 2014-15. Cause of death categories for Portugal differ from those for the other countries (see supplementary table A2). See supplementary figure A2 for a more detailed version of this figure with 22 cause of death categories
Fig 4 Contribution of broad cause of death categories to changes in life expectancy at birth for women during 2014-15 in 17 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest decline to largest gain. Countries to left of dashed line experienced a decline in life expectancy during 2014-15, and countries to right of dashed line experienced a life expectancy gain during 2014-15. Cause of death categories for Portugal differ from those for the other countries (see supplementary table A2). See supplementary figure A2 for a more detailed version of this figure with 22 cause of death categoriesCC BY-NC · PubMed Central
Fig 5 Contribution of broad cause of death categories to changes in life expectancy at birth for men during 2014-15 in 17 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest decline to largest gain. Countries to left of dashed line experienced a decline in life expectancy during 2014-15, and countries to right of dashed line experienced a life expectancy gain during 2014-15. Cause of death categories for Portugal differ from those for the other countries (see supplementary table A2). See supplementary figure A2 for a more detailed version of this figure with 22 cause of death categories
Fig 5 Contribution of broad cause of death categories to changes in life expectancy at birth for men during 2014-15 in 17 high income countries. Countries are ordered by change in life expectancy at birth during 2014-15, from largest decline to largest gain. Countries to left of dashed line experienced a decline in life expectancy during 2014-15, and countries to right of dashed line experienced a life expectancy gain during 2014-15. Cause of death categories for Portugal differ from those for the other countries (see supplementary table A2). See supplementary figure A2 for a more detailed version of this figure with 22 cause of death categoriesCC BY-NC · PubMed Central

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Research works printed but not linked: 1

  1. [8]Woolf SH Aron L, eds. Institute of Medicine and National Research Council. U.S. Health in International Perspective: Shorter Lives, Poorer Health. National Academies Press, 2013. 24006554

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Metadata

Authors
Ho, J. Y., & Hendi, A. S.
Affiliations
  • University of Southern California (US)
  • Princeton University (US)
Corresponding author
Ho, Jessica Y
ORCID
Venue
BMJ
Publisher
BMJ
Published
2018-08-15
Volume
362
Pages
k2562
ISSN
  • 1756-1833 (ISSN-L)
  • 0959-8138
DOI
10.1136/bmj.k2562
PMC
PMC6092679
OpenAlex
W2887239822
Cited by
439
References
50
Citations by year
2026: 17 · 2025: 36 · 2024: 62 · 2023: 66 · 2022: 66 · 2021: 66 · 2020: 59 · 2019: 57 · 2018: 10
FWCI
99.22
Type
journal article
Language
en
Update notices
correction (2018-08-22)
Open access
Licence
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R00HD083519, P2CHD047879)
Topics
  • Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
  • Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
  • Social Sciences › Health › Health disparities and outcomes
Keywords
life expectancy decline, high-income countries, cause-specific mortality, drug overdose, respiratory mortality, cardiovascular mortality, sex differences in longevity, United States, United Kingdom, mortality trends
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Life Expectancy, Male, Middle Aged, Mortality, Retrospective Studies, Developed Countries, Young Adult

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