The DOI matches its Crossref record; 142 of the 147 references it cites were found in a registry or an index.
Declining Life Expectancy in the United States: Missing the Trees for the Forest
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Abstract
In recent years, life expectancy in the United States has stagnated, followed by three consecutive years of decline. The decline is small in absolute terms but is unprecedented and has generated considerable research interest and theorizing about potential causes. Recent trends show that the decline has affected nearly all race/ethnic and gender groups, and the proximate causes of the decline are increases in opioid overdose deaths, suicide, homicide, and Alzheimer's disease. A slowdown in the long-term decline in mortality from cardiovascular diseases has also prevented life expectancy from improving further. Although a popular explanation for the decline is the cumulative decline in living standards across generations, recent trends suggest that distinct mechanisms for specific causes of death are more plausible explanations. Interventions to stem the increase in overdose deaths, reduce access to mechanisms that contribute to violent deaths, and decrease cardiovascular risk over the life course are urgently needed to improve mortality in the United States.
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“However, examining the pattern in its totality reveals more of a systemic failure, for which there is no single explanation (49).”
From Insights into US life expectancy stagnation from birth cohort mortality dynamics (2026) · cites this paper as [49]
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Metadata
- Authors
- Harper, S., Riddell, C. A., & King, N. B.
- Affiliations
- Erasmus MC (NL)
- University of California, Berkeley (US)
- McGill University (CA)
- Venue
- Annual Review of Public Health
- Publisher
- Annual Reviews
- Published
- 2021-04-01
- Volume
- 42
- Issue
- 1
- Pages
- 381-403
- ISSN
- 0163-7525 (ISSN-L)
- 1545-2093
- OpenAlex
- W3113152292
- Cited by
- 144
- References
- 147
- Citations by year
- 2026: 18 · 2025: 23 · 2024: 32 · 2023: 33 · 2022: 24 · 2021: 14
- FWCI
- 4.18
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Annual Review of Public Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
- OSF Preprints (OSF Preprints) (submittedVersion)
- 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, opioid overdose deaths, suicide, homicide, Alzheimer's disease, cardiovascular mortality, racial and ethnic disparities, gender disparities, causes of death
- MeSH terms
- Humans, Life Expectancy, United States
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- Harper, S., Riddell, C. A., & King, N. B. (2021). Declining Life Expectancy in the United States: Missing the Trees for the Forest. Annual Review of Public Health. https://doi.org/10.1146/annurev-publhealth-082619-104231
