Losses of Expected Lifetime in the United States and Other Developed Countries: Methods and Empirical Analyses
Losses of Expected Lifetime in the United States and Other Developed Countries: Methods and Empirical Analyses
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DOI：
10.1007/s13524-011-0015-6
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发表时间：
2011-02-01
期刊：
影响因子：
3.5
通讯作者：
Vaupel, James W.
中科院分区：
文献类型：
--
作者：
Shkolnikov, Vladimir M.;Andreev, Evgeny M.;Vaupel, James W.
死亡年龄的多样性模式是使用e(匕首)检验的，e(匕首)是一种离散度测量，等于死亡时平均预期寿命损失。我们应用两种方法来分解e(匕首)中的差异。第一种方法估计平均死亡率水平和死亡率年龄结构的贡献。第二种(也是新开发的)方法返回年龄和原因特定死亡率之间的差异产生的成分。美国在平均预期寿命方面接近英格兰和威尔士，但预期寿命损失更高，而且没有死亡率压缩。这种差异是由死亡年龄结构决定的，而死亡率水平的作用很小。这与美国65岁以下因各种原因导致的死亡率过高有关。对17个国家序列的回归表明，e(匕首)与各国之间的收入不平等有关，但不是跨时间的。这一结果可以归因于时间死亡率下降和国家间死亡率变化的年龄和死因结构的不同。它还表明，与其他国家相比，影响总体死亡率下降的因素与美国造成额外终身损失的因素不同。后者可能与卫生系统的薄弱和其他因素有关，这些因素导致心脏病、应受责备的原因、事故和暴力导致过早死亡。
Patterns of diversity in age at death are examined using e(dagger), a dispersion measure that equals the average expected lifetime lost at death. We apply two methods for decomposing differences in e(dagger). The first method estimates the contributions of average levels of mortality and mortality age structures. The second (and newly developed) method returns components produced by differences between age-and cause-specific mortality rates. The United States is close to England and Wales in mean life expectancy but has higher life expectancy losses and lacks mortality compression. The difference is determined by mortality age structures, whereas the role of mortality levels is minor. This is related to excess mortality at ages under 65 from various causes in the United States. Regression on 17 country-series suggests that e(dagger) correlates with income inequality across countries but not across time. This result can be attributed to dissimilarity between the age- and cause-of-death structures of temporal mortality reduction and intercountry mortality variation. It also suggests that factors affecting overall mortality decrease differ from those responsible for excess lifetime losses in the United States compared with other countries. The latter can be related to weaknesses of health system and other factors resulting in premature death from heart diseases, amenable causes, accidents and violence.