Jessica Y a Y. Ho Ho University of Southern California Joint - - PowerPoint PPT Presentation

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Jessica Y a Y. Ho Ho University of Southern California Joint - - PowerPoint PPT Presentation

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Causes of uses of Gains s and L d Los osse ses i s in L Life E Expect ectan ancy cy in O OECD CD Co Countries Jessica Y a Y. Ho Ho University of Southern California Joint Workshop of The King's Fund and the Organisation for

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SLIDE 1

Causes of uses of Gains s and L d Los

  • sse

ses i s in L Life E Expect ectan ancy cy in O OECD CD Co Countries

Jessica Y a Y. Ho Ho

University of Southern California Joint Workshop of The King's Fund and the Organisation for Economic Cooperation and Development November 6, 2019 Paris, France

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SLIDE 2

Life Expectancy Gains Since 2010

2

  • 0.10

0.00 0.10 0.20 0.30 0.40 0.50 0.60 0.70 65 70 75 80 85 90 Annual Change, 2010-Present Life Expectancy at Birth, 2010 Men Women Source: Ho (2019a)

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SLIDE 3

Life Expectancy Gains, 2000-2010

3

  • 0.10

0.00 0.10 0.20 0.30 0.40 0.50 0.60 0.70 65 70 75 80 85 90 Annual Change, 2000-2010 Life Expectancy at Birth, 2010 Men Women Source: Ho (2019a)

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SLIDE 4

Life Expectancy Gains Since 2010

4

  • 0.10

0.00 0.10 0.20 0.30 0.40 0.50 0.60 0.70 65 70 75 80 85 90 Annual Change, 2010-Present Life Expectancy at Birth, 2010 Men Women Source: Ho (2019a)

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SLIDE 5

Life Expectancy Gains Since 2010, Men

5

Australia Austria Belgium Canada Czechia Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Israel Italy Japan Latvia Lithuania Luxembourg Netherlands New Zealand Norway Poland Portugal Slovak Republic Slovenia Spain Sweden Switzerland United Kingdom United States

  • 0.10

0.00 0.10 0.20 0.30 0.40 0.50 66 68 70 72 74 76 78 80 82 Annual Change, 2010-Present Life Expectancy at Birth, 2010

High Medium Low

Source: Ho (2019a)

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SLIDE 6

Life Expectancy Gains Since 2010, Women

6

High Medium Low

Australia Austria Belgium Canada Czechia Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Israel Italy Japan Latvia Lithuania Luxembourg Netherlands New Zealand Norway Poland Portugal Slovenia Spain Sweden Switzerland United Kingdom United States

  • 0.1

0.1 0.2 0.3 0.4 76 78 80 82 84 86 88 Annual Change, 2010-Present Life Expectancy at Birth, 2010 Source: Ho (2019a)

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SLIDE 7

Topics

I. Age Groups

  • II. Causes of Death
  • III. Smoking
  • IV. Implications for CVD Monitoring

7

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SLIDE 8

Two Comparisons

  • 1. Between groups, 2010-Present:
  • High vs. Low
  • High vs. Medium
  • 2. Within groups across time:
  • 2000-2010 vs. 2010-Present

8

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SLIDE 9

Topics

I. Age Groups

  • II. Causes of Death
  • III. Smoking
  • IV. Implications for CVD Monitoring

9

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SLIDE 10

Age Group Contributions, 2010-Present

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0.15 0.10 0.05 0.00 0-14 15-29 30-44 45-64 65-84 85+

High Medium Low

0.00 0.05 0.10 0.15 0-14 15-29 30-44 45-64 65-84 85+

Contribution to Life Expectancy Gain, 2010-Present

Women Men

Source: Ho (2019a)

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SLIDE 11

11

0.00 0.05 0.10 0.15 0-14 15-29 30-44 45-64 65-84 85+

2000-2010 2010-Present

0.00 0.05 0.10 0.15 0-14 15-29 30-44 45-64 65-84 85+

2000

  • 2010

0.00 0.05 0.10 0.15 0-14 15-29 30-44 45-64 65-84 85+

Contribution to Life Expectancy Gains

High Medium Low

Source: Ho (2019a)

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SLIDE 12

12

0.00 0.05 0.10 0.15 0-14 15-29 30-44 45-64 65-84 85+

2000-2010 2010-Present

0.00 0.05 0.10 0.15 0-14 15-29 30-44 45-64 65-84 85+

2000

  • 2010

0.00 0.05 0.10 0.15 0-14 15-29 30-44 45-64 65-84 85+

Contribution to Life Expectancy Gains

High Medium Low

Source: Ho (2019a)

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SLIDE 13

13

  • 20%

0% 20% 40% 60% 80% 100% Medium Low Medium Low Men Women 0-14 15-29 30-44 45-64 65-84 85+

Source: Ho (2019a)

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SLIDE 14

14

13% 23% 16% 28% 46% 53% 60% 53%

  • 20%

0% 20% 40% 60% 80% 100% Medium Low Medium Low Men Women 0-14 15-29 30-44 45-64 65-84 85+

Source: Ho (2019a)

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SLIDE 15

Topics

I. Age Groups

  • II. Causes of Death
  • III. Smoking
  • IV. Implications for CVD Monitoring

15

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SLIDE 16

Decreases Since 2010

1. Cardiovascular Disease 2. Diabetes 3. Cancer 4. Other Respiratory Diseases (Men only) 5. Digestive Diseases 6. Genitourinary Diseases 7. Homicide 8. Suicide 9. Motor Vehicle Accidents

  • 10. Other External

Causes

  • 11. Influenza &

Pneumonia

  • 12. Infectious Diseases

(Men only)

  • 13. Residual

16

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SLIDE 17

Increases Since 2010

  • 1. Accidental Poisoning
  • 2. Mental and Nervous System Diseases
  • 3. Other Respiratory Diseases (Women only)
  • 4. Perinatal Conditions
  • 5. Infectious Diseases (Women only)

17

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SLIDE 18

Countries Experiencing Mortality Increases

18

CAUSE MEN WOMEN

# % # % Accidental Poisoning 14 58% 17 71% Mental and Nervous System Diseases 23 96% 23 96% Other Respiratory Diseases 4 17% 15 63% Perinatal Conditions 10 42% 11 46% Infectious Diseases 9 38% 11 46%

Source: Ho (2019a)

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SLIDE 19

More Favorable Since 2010 vs. 2000-2010

1. Diabetes (Men only) 2. Lung Cancer 3. Preventable Cancers (Men only) 4. Genitourinary Diseases 5. Homicide 6. Suicide 7. Other External Causes 8. Infectious Diseases 9. Residual

19

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SLIDE 20

Less Favorable Since 2010 vs. 2000-2010

1. Cardiovascular Disease 2. Diabetes (Women

  • nly)

3. Other Respiratory Diseases* 4. Preventable Cancers (Women

  • nly)

5. Other Cancers 6. Digestive Diseases 7. Mental and Nervous System Diseases** 8. Accidental Poisoning** 9. Motor Vehicle Accidents

  • 10. Perinatal

Conditions*

  • 11. Influenza &

Pneumonia

20

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SLIDE 21

Trends in CVD Mortality, 1995-Present Men

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100 200 300 400 500 600 700 1995 1998 2001 2004 2007 2010 2013 2016 Age-Standardized CVD Death Rate (p. 100,000) Australia Austria Belgium Canada Denmark Finland France Germany Greece Iceland Ireland Israel Italy Japan Luxembourg Netherlands New Zealand Norway Portugal Spain Sweden Switzerland United Kingdom United States

Source: Ho (2019a)

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SLIDE 22

Progress in Reducing CVD Mortality Relative to 1995 Men

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2000 2005 2010 2015 Present CVD Mortality Level Relative to1995 Australia Austria Belgium Canada Denmark Finland France Germany Greece Iceland Ireland Israel Italy Japan Luxembourg Netherlands New Zealand Norway Portugal Spain Sweden Switzerland United Kingdom United States Average

Source: Ho (2019a)

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SLIDE 23

Cause of Death Contributions to Life Expectancy Changes 2010-Present

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SLIDE 24
  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

High Medium Low High Medium Low Women Men

24

Source: Ho (2019a)

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SLIDE 25
  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

High Medium Low High Medium Low Women Men

25

Source: Ho (2019a)

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SLIDE 26
  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

High Medium Low High Medium Low Women Men

26

Source: Ho (2019a)

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SLIDE 27
  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

High Medium Low High Medium Low Women Men

27

Source: Ho (2019a)

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SLIDE 28
  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

High Medium Low High Medium Low Women Men

28

Source: Ho (2019a)

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SLIDE 29
  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

High Medium Low High Medium Low Women Men

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Source: Ho (2019a)

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SLIDE 30

Cause of Death Contributions to the Slowdown in Life Expectancy Improvements 2000-2010 vs. 2010-Present

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SLIDE 31

Men

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  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

2010-Present 2000-2010 2010-Present 2000-2010 2010-Present 2000-2010 High Medium Low

Source: Ho (2019a)

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SLIDE 32

Men

32

  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35

2010-Present 2000-2010 2010-Present 2000-2010 2010-Present 2000-2010 High Medium Low

Source: Ho (2019a)

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SLIDE 33

Women

33

  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25

2010-Present 2000-2010 2010-Present 2000-2010 2010-Present 2000-2010 High Medium Low

Source: Ho (2019a)

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SLIDE 34

Women

34

  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25

2010-Present 2000-2010 2010-Present 2000-2010 2010-Present 2000-2010 High Medium Low

Source: Ho (2019a)

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SLIDE 35

Topics

I. Age Groups

  • II. Causes of Death
  • III. Smoking
  • IV. Implications for CVD Monitoring

35

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SLIDE 36

Deaths Attributable to Smoking, Ages 50+

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SLIDE 37

Deaths Attributable to Smoking, Ages 50+

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0% 5% 10% 15% 20% 25% 30% 1994 1998 2002 2006 2010 2014 Percent of Deaths Attributable to Smoking, Ages 50+ Low Medium High Eastern

Men

Source: Ho (2019a)

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SLIDE 38

0% 5% 10% 15% 20% 25% 30% 1994 1998 2002 2006 2010 2014 Percent of Deaths Attributable to Smoking, Ages 50+ Low Medium High Eastern

Deaths Attributable to Smoking, Ages 50+

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0% 5% 10% 15% 20% 25% 30% 1994 1998 2002 2006 2010 2014 Percent of Deaths Attributable to Smoking, Ages 50+ Low Medium High Eastern

Women Men

Source: Ho (2019a)

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SLIDE 39

Reductions in Smoking-Related Mortality are Drivers of Gains in Life Expectancy at Age 50

Men 2010-Present

39

  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 Gain in Life Expectancy at Age 50

Observed Gain Gain Without Smoking

Source: Ho (2019a)

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SLIDE 40

40

  • 0.10
  • 0.05

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 Gain in Life Expectancy at Age 50

Observed Gain Gain Without Smoking

Increases in Smoking-Related Mortality Partly Explain Slowdowns in Life Expectancy Gains at Age 50

Women 2010-Present

Source: Ho (2019a)

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SLIDE 41

41

  • 0.10

0.00 0.10 0.20 0.30 0.40 Gain in Life Expectancy at Age 50

Gain, 2000-2010 Gain, 2010-Present Without Smoking

Source: Ho (2019a)

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SLIDE 42

42

  • 0.10

0.00 0.10 0.20 0.30 0.40 Gain in Life Expectancy at Age 50

Gain, 2000-2010 Gain, 2010-Present Without Smoking

Least Most Moderate

Source: Ho (2019a)

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SLIDE 43

Topics

I. Age Groups

  • II. Causes of Death
  • III. Smoking
  • IV. Implications for CVD Monitoring

43

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SLIDE 44

Key Points

  • Importance of timely vital statistics data releases
  • Influenza and pneumonia
  • Drug overdose

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SLIDE 45

Influenza & Pneumonia and Cardiovascular Disease

  • Series of bad influenza

years since 2010

  • The majority of high-

income countries experienced life expectancy declines between 2014 and 2015

45

Source: Ho and Hendi (2018)

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SLIDE 46

46

Source: Ho and Hendi (2018)

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SLIDE 47

Influenza & Pneumonia and Cardiovascular Disease

  • Influenza and pneumonia may precipitate cardiovascular events

such as acute myocardial infarction and consequently mortality from cardiovascular disease

  • Individuals with CVD may be more susceptible to dying from

influenza and pneumonia

  • Influenza often goes undetected owing to lack of diagnostic testing
  • Deaths may potentially be coded as due to influenza,

cardiovascular diseases, or other respiratory diseases on death certificates

47

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SLIDE 48

Drug Use and Cardiovascular Disease

  • Cardiovascular disease is a leading cause of death among users of

illicit drugs

  • Illicit drug use increases the risk of several cardiovascular conditions

including:

48

 Atrial fibrillation  Cardiomyopathy  Cerebral infarction  Cardiac arrest and sudden cardiac death  Cardiac arrhythmia  Endocarditis  Myocardial infarction  Stroke

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SLIDE 49

Men

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Source: Ho (2019b)

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SLIDE 50

Women

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Source: Ho (2019b)

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SLIDE 51

Data and Methods

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SLIDE 52

Data

  • Human Mortality Database (HMD)
  • All-cause life table death rates by age, sex, year, and country
  • Supplemented by data from individual countries’ vital statistics

agencies

  • World Health Organization (WHO) Mortality Database
  • Deaths by age, sex, year, and cause of death

52

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SLIDE 53

Methods

I. Combine the HMD all-cause death rates with cause-specific proportions from the WHO to generate death rates by age, sex, year, country, and broad cause of death category

  • II. Arriaga’s decomposition
  • Age and cause of death contributions to changes in life expectancy at

birth between 2010 and Present and 2000 and 2010 for each country III.Indirect estimation of smoking-attributable mortality at ages 50+ (Preston, Glei, and Wilmoth 2010, 2011)

  • Contribution of smoking to changes in life expectancy at age 50

between 2010 and Present for each country

53