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

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 Economic Cooperation and Development November 6, 2019 Paris, France

Life Expectancy Gains Since 2010 Men Women 0.70 Annual Change, 2010-Present 0.60 0.50 0.40 0.30 0.20 0.10 0.00 65 70 75 80 85 90 -0.10 Life Expectancy at Birth, 2010 Source : Ho (2019a) 2

Life Expectancy Gains, 2000-2010 Men Women 0.70 0.60 Annual Change, 2000-2010 0.50 0.40 0.30 0.20 0.10 0.00 65 70 75 80 85 90 -0.10 Life Expectancy at Birth, 2010 Source : Ho (2019a) 3

Life Expectancy Gains Since 2010 Men Women 0.70 Annual Change, 2010-Present 0.60 0.50 0.40 0.30 0.20 0.10 0.00 65 70 75 80 85 90 -0.10 Life Expectancy at Birth, 2010 Source : Ho (2019a) 4

Life Expectancy Gains Since 2010, Men 0.50 Luxembourg Lithuania Estonia Annual Change, 2010-Present Slovak Republic 0.40 Latvia Denmark Norway High Poland Switzerland Ireland Hungary Finland 0.30 Slovenia France Japan Czechia Spain Austria Belgium Medium Portugal Iceland Canada 0.20 Netherlands Australia Greece Sweden Germany Israel Low 0.10 United Kingdom Italy New Zealand United States 0.00 66 68 70 72 74 76 78 80 82 -0.10 Life Expectancy at Birth, 2010 5 Source : Ho (2019a)

Life Expectancy Gains Since 2010, Women 0.4 Luxembourg Annual Change, 2010-Present 0.3 Latvia Denmark High Estonia Slovenia Lithuania Switzerland Poland Belgium Japan Portugal 0.2 Czechia Spain Norway Finland Israel Austria Medium Greece Ireland Hungary Germany Canada United Kingdom 0.1 Australia Sweden Iceland France Low New Zealand United States Netherlands Italy 0 76 78 80 82 84 86 88 -0.1 Life Expectancy at Birth, 2010 Source : Ho (2019a) 6

Topics I. Age Groups II. Causes of Death III. Smoking IV. Implications for CVD Monitoring 7

Two Comparisons 1. Between groups, 2010-Present:  High vs. Low  High vs. Medium 2. Within groups across time:  2000-2010 vs. 2010-Present 8

Topics I. Age Groups II. Causes of Death III. Smoking IV. Implications for CVD Monitoring 9

Age Group Contributions, 2010-Present Men Women 85+ 85+ 65-84 65-84 45-64 45-64 High 30-44 30-44 Medium 15-29 15-29 Low 0-14 0-14 0.15 0.10 0.05 0.00 0.00 0.05 0.10 0.15 Contribution to Life Expectancy Gain, 2010-Present Source : Ho (2019a) 10

2000 High Medium Low - 85+ 85+ 85+ 2010 65-84 65-84 65-84 45-64 45-64 45-64 30-44 30-44 30-44 15-29 15-29 15-29 2000-2010 0-14 0-14 0-14 2010-Present 0.00 0.05 0.10 0.15 0.00 0.05 0.10 0.15 0.00 0.05 0.10 0.15 Source : Ho (2019a) Contribution to Life Expectancy Gains 11

2000 High Medium Low - 85+ 85+ 85+ 2010 65-84 65-84 65-84 45-64 45-64 45-64 30-44 30-44 30-44 15-29 15-29 15-29 2000-2010 0-14 0-14 0-14 2010-Present 0.00 0.05 0.10 0.15 0.00 0.05 0.10 0.15 0.00 0.05 0.10 0.15 Source : Ho (2019a) Contribution to Life Expectancy Gains 12

0-14 15-29 30-44 45-64 65-84 85+ 100% 80% 60% 40% 20% 0% -20% Medium Low Medium Low Men Women Source : Ho (2019a) 13

0-14 15-29 30-44 45-64 65-84 85+ 100% 80% 53% 46% 53% 60% 60% 13% 40% 23% 16% 28% 20% 0% -20% Medium Low Medium Low Men Women Source : Ho (2019a) 14

Topics I. Age Groups II. Causes of Death III. Smoking IV. Implications for CVD Monitoring 15

1. Cardiovascular 8. Suicide Disease 9. Motor Vehicle 2. Diabetes Accidents 3. Cancer 10. Other External Decreases Causes 4. Other Respiratory Since 2010 Diseases (Men only) 11. Influenza & Pneumonia 5. Digestive Diseases 12. Infectious Diseases 6. Genitourinary (Men only) Diseases 13. Residual 7. Homicide 16

1. Accidental Poisoning 2. Mental and Nervous System Diseases Increases 3. Other Respiratory Diseases (Women only) Since 2010 4. Perinatal Conditions 5. Infectious Diseases (Women only) 17

Countries Experiencing Mortality Increases CAUSE MEN WOMEN # % # % Accidental Poisoning 14 58% 17 71% Mental and Nervous 23 96% 23 96% System Diseases Other Respiratory 4 17% 15 63% Diseases Perinatal Conditions 10 42% 11 46% Infectious Diseases 9 38% 11 46% 18 Source : Ho (2019a)

1. Diabetes (Men only) 2. Lung Cancer 3. Preventable Cancers (Men only) More 4. Genitourinary Diseases Favorable 5. Homicide Since 2010 vs. 6. Suicide 2000-2010 7. Other External Causes 8. Infectious Diseases 9. Residual 19

1. Cardiovascular 7. Mental and Disease Nervous System Diseases** 2. Diabetes (Women only) 8. Accidental Less Favorable Poisoning** 3. Other Respiratory Since 2010 vs. Diseases* 9. Motor Vehicle Accidents 2000-2010 4. Preventable Cancers (Women 10. Perinatal only) Conditions* 5. Other Cancers 11. Influenza & Pneumonia 6. Digestive Diseases 20

700 Australia Austria Belgium 600 Canada Denmark Finland Age-Standardized CVD Death Rate (p. 100,000) France Trends in CVD 500 Germany Greece Mortality, Iceland 400 Ireland 1995-Present Israel Italy Japan 300 Luxembourg Netherlands Men New Zealand 200 Norway Portugal Spain Sweden 100 Switzerland United Kingdom United States 0 1995 1998 2001 2004 2007 2010 2013 2016 21 Source : Ho (2019a)

100% Australia Austria Belgium 90% Canada Denmark 80% Progress in Finland France 70% Reducing CVD Germany CVD Mortality Level Relative to1995 Greece Mortality Iceland 60% Ireland Relative to 1995 Israel 50% Italy Japan 40% Luxembourg Men Netherlands New Zealand 30% Norway Portugal 20% Spain Sweden 10% Switzerland United Kingdom United States 0% 2000 2005 2010 2015 Present Average Source : Ho (2019a) 22

Cause of Death Contributions to Life Expectancy Changes 2010-Present 23

Low Men Medium High Low Women Medium High -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 24 Source : Ho (2019a)

Low Men Medium High Low Women Medium High -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 25 Source : Ho (2019a)

Low Men Medium High Low Women Medium High -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 26 Source : Ho (2019a)

Low Men Medium High Low Women Medium High -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 27 Source : Ho (2019a)

Low Men Medium High Low Women Medium High -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 28 Source : Ho (2019a)

Low Men Medium High Low Women Medium High -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 29 Source : Ho (2019a)

Cause of Death Contributions to the Slowdown in Life Expectancy Improvements 2000-2010 vs. 2010-Present 30

2000-2010 Men Low 2010-Present 2000-2010 Medium 2010-Present 2000-2010 High 2010-Present -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 31 Source : Ho (2019a)

2000-2010 Men Low 2010-Present 2000-2010 Medium 2010-Present 2000-2010 High 2010-Present -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 32 Source : Ho (2019a)

2000-2010 Women Low 2010-Present 2000-2010 Medium 2010-Present 2000-2010 High 2010-Present -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 33 Source : Ho (2019a)

2000-2010 Women Low 2010-Present 2000-2010 Medium 2010-Present 2000-2010 High 2010-Present -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 34 Source : Ho (2019a)

Topics I. Age Groups II. Causes of Death III. Smoking IV. Implications for CVD Monitoring 35

Deaths Attributable to Smoking, Ages 50+ 36

Deaths Attributable to Smoking, Ages 50+ Men Low Medium High Eastern 30% Percent of Deaths Attributable to Smoking, 25% 20% Ages 50+ 15% 10% 5% 0% 1994 1998 2002 2006 2010 2014 37 Source : Ho (2019a)

Deaths Attributable to Smoking, Ages 50+ Men Women Low Medium High Eastern Low Medium High Eastern 30% 30% Percent of Deaths Attributable to Smoking, Percent of Deaths Attributable to Smoking, Ages 25% 25% 20% 20% Ages 50+ 15% 15% 50+ 10% 10% 5% 5% 0% 0% 1994 1998 2002 2006 2010 2014 1994 1998 2002 2006 2010 2014 38 Source : Ho (2019a)

Reductions in Observed Gain Gain Without Smoking Smoking-Related 0.40 Mortality are 0.35 0.30 Drivers of Gains in Gain in Life Expectancy at Age 50 0.25 Life Expectancy at 0.20 Age 50 0.15 0.10 Men 0.05 2010-Present 0.00 -0.05 Source : Ho (2019a) 39

Increases in Observed Gain Gain Without Smoking Smoking-Related 0.35 Mortality Partly 0.30 0.25 Explain Slowdowns Gain in Life Expectancy at Age 50 0.20 in Life Expectancy 0.15 Gains at Age 50 0.10 0.05 Women 0.00 2010-Present -0.05 -0.10 Source : Ho (2019a) 40

0.40 Gain, 2000-2010 Gain, 2010-Present Without Smoking 0.30 Gain in Life Expectancy at Age 50 0.20 0.10 0.00 Source : Ho (2019a) -0.10 41

0.40 Gain, 2000-2010 Gain, 2010-Present Without Smoking Most Moderate Least 0.30 Gain in Life Expectancy at Age 50 0.20 0.10 0.00 Source : Ho (2019a) -0.10 42