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PubMed1992

Changes in life expectancy 1900-1990.

Life expectancy at birth has risen in all industrialized countries during the last 100 years, but mortality improvements by gender and region often have proceeded at very different rates. Although some countries have experienced increases in overall mortality during recent decades, the levels of life expectancy gains in countries such as Japan have confounded demographic predictions and have led to renewed research and debate over future mortality decline and the limits to human life. This paper reviews levels of and changes in life expectancy at birth and at older ages in industrialized countries during the 20th century. Trends in mortality and morbidity at older ages are summarized in the context of the historic epidemiological disease transition from infectious to chronic. Cause-specific and active/inactive decompositions of life expectancy are examined, as are initial attempts to correlate life expectancy with physical attributes that may reflect differential nutritional status.

Cause of Death↗
PubMed1990

Life expectancy for a class of life distributions having the "setting the clock back to zero" property.

It is demonstrated that the expression for the life expectancy of an individual in biomedical investigations can be greatly simplified if the class of life distributions possesses what has been called the "setting the clock back to zero" property, studied previously by Raja Rao and Talwalker. It is shown that the Gompertzian growth process, Krane's family of life distributions, and the linear hazard exponential distribution have this property. To illustrate the use of this property, an individual's life expectancy is tabulated for several choices of the parameter values when the individual's life distribution belongs to a Gompertzian growth process. In addition, it is shown that a new survival model considered by Chiang and Conforti for the estimation of time to tumor has the "setting the clock back to zero" property. Its life expectancy is evaluated at any given time chi 0 using this property.

Humans↗
PubMed1977

Estimated life expectancy of diabetics.

Life expectancy among diabetics in Iowa was estimated by using mortality data for the state. The Iowa general population had a higher life expectancy than the diabetic population at every age, except at ages 80 and over for men and ages 75 and over for women. The estimated life expectancy of 59.7 years at birth for diabetic males and of 69.8 years for diabetic females was lower than that for the Iowa general population by 9.1 years among males and 6.7 years among females. This difference narrowed with increasing age. The Iowa figures were similar to the estimates of life expectancy for the diabetic popullation of Pennsylvania.

Adult↗
PubMedDate not supplied

Record high life expectancy.

Expectation of life at birth in the United States rose to a record high of 75.7 years in 1992. Life expectancy for newborn boys and girls also established new peaks, namely 72.2 years and 79.1 years, respectively. Just as noteworthy has been the recent marked reduction in the racial longevity gap. The narrowing in the expectation of life differential between whites and nonwhites resulted from the larger gains among people of color. Also encouraging is the continued decline in infant mortality--it fell to its lowest level ever (8.5 per 1,000 births). However, the outlook for AIDS mortality is disconcerting. Because of the mounting toll of these deaths, there will be a negative impact on expectation of life sometime in the near future.

Acquired Immunodeficiency Syndrome↗
PubMed1976

Life expectancy of mentally retarded persons in Canadian institutions.

Data obtained from Statistics Canada were presented on the mortality level and expectancy of life for profoundly retarded and severely and moderately retarded persons in Canadian institutions for the years 1966 through 1968. Previous studies of mortality statistics were reported in mortality rates, average age at death, and crude death rates which are affected by the age distribution of the population involved. The very young and the very old are underrepresented in institutions, and thus these measures are not as accurate as life expectancy tables, which present the number of years expected to live, are independent of age distribution, and provide a reliable statistical measure for future replication and international comparisons. Retarded persons in institutions are living longer than previously, but their life expectancy does not meet that of the general population. Estimates of life expectancy for this population are vital for planning purposes.

Adolescent↗
PubMed2005

Blood pressure in adulthood and life expectancy with cardiovascular disease in men and women: life course analysis.

Limited information exists about the consequences of hypertension during adulthood on residual life expectancy with cardiovascular disease. We aimed to analyze the life course of people with high blood pressure levels at age 50 in terms of total life expectancy and life expectancy with and without cardiovascular disease compared with normotensives. We constructed multistate life tables for cardiovascular disease, myocardial infarction, and stroke using data from 3128 participants of the Framingham Heart Study who had their 50th birthday while enrolled in the study. For the life table calculations, we used hazard ratios for 3 transitions (healthy to death, healthy to disease, and disease to death) by categories of blood pressure level and adjusted by age, sex, and confounders. Irrespective of sex, 50-year-old hypertensives compared with normotensives had a shorter life expectancy, a shorter life expectancy free of cardiovascular disease, myocardial infarction, and stroke, and a longer life expectancy lived with these diseases. Normotensive men (22% of men) survived 7.2 years (95% confidence interval, 5.6 to 9.0) longer without cardiovascular disease compared with hypertensives and spent 2.1 (0.9 to 3.4) fewer years of life with cardiovascular disease. Similar differences were observed in women. Compared with hypertensives, total life expectancy was 5.1 and 4.9 years longer for normotensive men and women, respectively. Increased blood pressure in adulthood is associated with large reductions in life expectancy and more years lived with cardiovascular disease. This effect is larger than estimated previously and affects both sexes similarly. Our findings underline the tremendous importance of preventing high blood pressure and its consequences in the population.

Adult↗
PubMed1991

Mortality trend in a rapidly developing economy in Taiwan. Part II: Life expectancy and "potential years of life lost".

Taiwan has made remarkable economic progress in the last 30 years. The life expectancy of its population improved steadily during this period. A male child born in 1983 could look forward to 70.4 years of life and a female child to 75.3 years, gains of 17.5 years and 19.0 years, respectively, since 1950. The potential gains in life expectancy of the Taiwan population are also examined if the five leading causes of death are reduced or eliminated. In addition, this paper discusses the concept of potential productive years of life lost (PYLL), examines the leading causes of premature death and shows how this measure can be used to target prevention programs and health care planning.

Adolescent↗
PubMed1998

Causes of declining life expectancy in Russia.

CONTEXT: Russian life expectancy has fallen sharply in the 1990s, but the impact of the major causes of death on that decline has not been measured. OBJECTIVE: To assess the contribution of selected causes of death to the dramatic decline in life expectancy in Russia in the years following the breakup of the Soviet Union. DESIGN: Mortality and natality data from the vital statistics systems of Russia and the United States. SETTING: Russia, 1990-1994. POPULATION: Entire population of Russia. MAIN OUTCOME VARIABLES: Mortality rates, life expectancy, and contribution to change in life expectancy. METHODS: Application of standard life-table methods to calculate life expectancy by year, and a partitioning method to assess the contribution of specific causes of death and age groups to the overall decline in life expectancy. United States data presented for comparative purposes. RESULTS: Age-adjusted mortality in Russia rose by almost 33% between 1990 and 1994. During that period, life expectancy for Russian men and women declined dramatically from 63.8 and 74.4 years to 57.7 and 71.2 years, respectively, while in the United States, life expectancy increased for both men and women from 71.8 and 78.8 years to 72.4 and 79.0 years, respectively. More than 75% of the decline in life expectancy was due to increased mortality rates for ages 25 to 64 years. Overall, cardiovascular diseases (heart disease and stroke) and injuries accounted for 65% of the decline in life expectancy while infectious diseases, including pneumonia and influenza, accounted for 5.8%, chronic liver diseases and cirrhosis for 2.4%, other alcohol-related causes for 9.6%, and cancer for 0.7%. Increases in cardiovascular mortality accounted for 41.6% of the decline in life expectancy for women and 33.4% for men, while increases in mortality from injuries (eg, falls, occupational injuries, motor vehicle crashes, suicides, and homicides) accounted for 32.8% of the decline in life expectancy for men and 21.8% for women. CONCLUSION: The striking rise in Russian mortality is beyond the peacetime experience of industrialized countries, with a 5-year decline in life expectancy in 4 years' time. Many factors appear to be operating simultaneously, including economic and social instability, high rates of tobacco and alcohol consumption, poor nutrition, depression, and deterioration of the health care system. Problems in data quality and reporting appear unable to account for these findings. These results clearly demonstrate that major declines in health and life expectancy can take place rapidly.

Adolescent↗
PubMed1978

Smoking and life expectancy among U.S. veterans.

Life expectancies were estimated for selected groups of smokers, ex-smokers, and nonsmokers based on the results of a 16-year mortality follow-up of 198,820 U.S. veterans. Life expectancy varied inversely with number of cigarettes smoked per day. The most pronounced differences were between nonsmokers and heavy cigarette smokers (40+ per day). These differences in life expectancy were greatest at the younger ages--nearly 9 years at ages 35 and 40. Life expectancies for cigarette smokers varied directly with age began smoking. For all ages, differences in life expectancy between nonsmokers and ex-cigarette smokers who stopped for other than doctor's orders were less than those between nonsmokers and current cigarette smokers. Results in the present study clearly confirmed Hammond's earlier findings.

Adult↗
PubMed1999

Potential gains in life expectancy or years of potential life lost: impact of competing risks of death.

BACKGROUND: Measuring the impact of competing risks of death on society is important for setting public health policy and allocating resources. However, various indicators may result in inconsistent conclusions. The potential gains in life expectancy (PGLE) by elimination of deaths from HIV/AIDS, diseases of the heart and malignant neoplasms were compared to the years of potential life lost (YPLL) due to these causes in measuring the impact of premature death for the US population of working age (15-64 years). METHODS: The PGLE and the YPLL were computed from mortality reports (1987-1992) by race and gender group for deaths from HIV/AIDS, diseases of the heart and malignant neoplasms for the US population of working age. RESULTS: The YPLL overestimated the importance of premature deaths from HIV/AIDS compared to the PGLE. For the total US population and total US white population of working age, the YPLL were about 20-30% higher than the PGLE. However, the YPLL were about 20-30% lower than the PGLE for the US black population of working age. Furthermore the relative importance of the impact of death from various diseases may be interchanged by these two indicators. For example, for US black males of working age, the impact of deaths from HIV/AIDS by PGLE in 1992 was higher than that from malignant neoplasms and lower than that from diseases of the heart, but by using YPLL, the impact of premature deaths from HIV/AIDS was higher than that from both diseases of the heart and malignant neoplasms. CONCLUSIONS: The PGLE by elimination of deaths from diseases takes into account the competing risks on the population and it can be compared easily across populations. The YPLL is an index that does not take into account competing risks and it is also heavily influenced by the age structure and total population size. Although there are several standardization techniques proposed to improve the comparability of the YPLL across different populations, the YPLL fails to address the central issue of competing risks operating on the population. For this reason, we prefer the PGLE to the YPLL in measuring the impact of premature deaths on a population.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Reproductive longevity and increased life expectancy.

BACKGROUND: Female life expectancy in developed countries has increased by 30 years in the twentieth century. AIM: To determine if there has been an increase in reproductive longevity. METHODS: We analysed age-specific fertility data from birth statistics for the USA, Canada, Japan, France, Sweden, the UK and Australia. RESULTS: Since 1940, birth rates for women aged 35 and over have declined. Among women aged 50 years and older, there has been no increase in births. Fertility rates in 1990 were 0.0 to 0.044 per 1000 women, with total numbers ranging from 0 to 60 births. CONCLUSION: The fertile years have not been prolonged in the cohort of women whose life expectancy has increased so dramatically this century. This suggests that reproductive senescence is tightly controlled and not extended by factors that enhance female longevity. Other physiological mechanisms may also be fixed within narrow age limits.

Adult↗
PubMed1995

Formulas expressing life expectancy, survival probability and death rate in life table at various ages in US adults.

The National Center for Health Statistics (Monthly Vital Statistics Report, 41 (1993) 1-36; Pediatrics, 92 (1993) 743-754) reported the life table for the total population of the United States, 1992, on the basis of vital statistics. The life table shows life expectancy, survival and death rate at various ages. Formulas expressing death rate, survival probability and life expectancy at various ages in US adults are constructed from the data of the National Center for Health Statistics (NCHS). A mathematical model of the 'probacent'-probability equation previously published by the author is employed in this study. Analysis of the computer-assisted predicted values and the data reported by the NCHS indicates that the formulas are accurate and reliable with a close agreement in expressing death rate, survival probability and life expectancy at various ages in US adults of 25 years of age and older. The formulas can determine the relationship between the age and the death rate, the survival probability or the life expectancy and may be of value for epidemiologic evaluation of US adults.

Adult↗
PubMedDate not supplied

A multistate analysis of active life expectancy.

With today's lower mortality rates, longer expectations of life, and new medical technologies, the nation's health policy focus has shifted from emphasis on individual survival to emphasis on personal health and independent living. Using longitudinal data sets and new methodological techniques, researchers have begun to assess active life expectancies, estimating not only how long a subpopulation can expect to live beyond each age, but what fractions of the expected remaining lifetime will be lived as independent, dependent, or institutionalized. New ideas are addressed, applying recently developed multistate life table methods to Waves One and Two of the Massachusetts Health Care Panel Study. Expectations of active life are presented for those 65 and older who initially are in one of two functional states of well-being. Included are expectations of life, for those, for example, who were independent and remained so, or those who were dependent and became independent. Although public health officials are concerned about the number of elderly who cease being independent, preliminary analysis shows that a significant number of the dependent elderly regain their independence, a situation which needs to be addressed in health care planning.

Activities of Daily Living↗
PubMed2003

Regional differences in healthy life expectancy in The Netherlands.

BACKGROUND: Healthy life expectancy has mainly been studied at the level of healthcare systems rather than at regional level within healthcare systems. In this article, healthy life expectancy at birth and at 65 years of age for men and women in the Netherlands has been described, and factors related to these regional variations have been explored. METHODS: Ecological study of 27 healthcare regions (hospital catchment areas). Life expectancy and healthy life expectancy were calculated using 1995 mortality data and pooled health interview survey data (1992-1997) from Statistics Netherlands. RESULTS: Healthy life expectancy shows a regional pattern, slightly different from that found in life expectancy and self-reported health. The regional distribution of male and female healthy life expectancy is different, especially at 65 years. Healthy life expectancy of women aged 65 years is independent of their total life expectancy. Social conditions and lifestyle differences between regions are negatively associated with healthy life expectancy in Dutch regions. Healthcare supply variables show no clear relationship. CONCLUSION: Although the Netherlands is a small, homogeneous country, substantial differences were found in healthy life expectancy.

Aged↗