Study: Premature Mortality Rates Rising in the US
In a new study, researchers analyzed trends in premature mortality rates to identify causes-of-death contributing to these trends. Their findings showed reduced premature deaths in black, Hispanic, and Asians and Pacific Islanders, but increases in white, American Indian, and Alaska Native individuals.
“Unlike other high-income countries, age-adjusted mortality in the USA plateaued in 2010 and increased slightly in 2015, possibly because of rising premature mortality,” the researchers wrote.
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Researchers used cause-of-death and demographic data from death certificates from the US National Center for Health Statistics, and used the US Census Bureau to obtain population estimates. Age-period cohort models were used to estimate annual percentage changes in mortality, and age-standardized excess deaths estimated for 2000 to 2014 were calculated as observed deaths minus expected deaths using estimated morality rates from 1999.
Premature mortality between 1999 and 2014 increased in white, American Indian, and Alaskan Native individuals, and the increases were highest in women between 25-30 years of age.
The annual morality increases were 3.2% for 30-year-old white women, 0.6% for 30-year-old white men, 4.3% for 30-year-old American Indian men and women, and 1.9% for 30-year-old Alaskan Native men and women. Accidental deaths, primarily drug poisoning, chronic liver disease and cirrhosis, and suicide were attributed to the increases in premature deaths for white, Alaska Native, and American Indian individuals.
During 2000-2014, An estimated 111,000 excess premature deaths occurred in white individuals from 25 to 49 years of age, and 6600 in American Indians and Alaska Natives.
Conversely, premature mortality decreased up to 3.2% per year in all age groups in Hispanic individuals, up to 3.9% in black individuals, and up to 2.6% in Asians and Pacific Islanders. Reasons for the decreases in premature mortality were attributed to declines in HIV, cancer, and heart disease deaths, with an estimated 112,000 fewer deaths in Hispanic individuals, 311,000 fewer deaths in black individuals, and 34,000 fewer deaths in Asians and Pacific Islanders aged 25-64 years.
From 2011-2014, premature mortality was highest in American Indians and Alaska Natives, followed by black individuals.
According to researchers, while the declines in premature deaths in Hispanic individuals, black individuals, and Asians and Pacific Islanders can be partially attributed to public health successes in smoking cessation and HIV treatment, the continued increases in premature deaths for American Indians, Alaska Natives, and white individuals 25 to 49 years of age from potentially avoidable causes illustrates a need for better public health measures.
“The magnitude of annual mortality increases in the USA is extremely unusual in high-income countries, and a rapid public health response is needed to avert further premature deaths,” the researchers concluded.
—Melissa Weiss
Reference:
Shiels MS, Chernyavskiy P, Anderson WF, et al. Trends in premature mortality in the USA by sex, race, and ethnicity from 1999 to 2014: an analysis of death certificate data [published online January 25, 2017]. The Lancet. doi: http://dx.doi.org/10.1016/S0140-6736(17)30187-3.