Longitudinal Gompertzian analysis of emphysema mortality in the US, 1962-1987: the differing basis for evolving mortality patterns in men and women.

Age-specific mortality rates for emphysema in the United States from 1962 through 1987 were subjected to longitudinal Gompertzian analysis, a method that can be used to identify and distinguish aggregate genetic, environmental, and competitive influences upon mortality. Annual crude emphysema mortality rates (per 100,000) among men increased from 11.77 in 1962 to 20.94 in 1968, and then fell to 7.74 in 1987. The basis for this rise and fall is shown to be the corresponding changes in environmental influences upon emphysema mortality in men. Between 1962 and 1987, the annual crude emphysema mortality rates among women increased from 1.71 to 4.25. The basis for the increase of emphysema mortality in women, on the other hand, is shown to be an enhancement of the competitiveness of emphysema as a cause of mortality in women, and not the result of worsening environmental influences. The capability to distinguish between environmental and competitive influences upon evolving human mortality patterns could have a significant impact upon public health policy.