Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109.
Max Planck Institute for Demographic Research, Rostock 18057, Germany;
Proc Natl Acad Sci U S A. 2020 Mar 31;117(13):6998-7000. doi: 10.1073/pnas.1920391117. Epub 2020 Mar 16.
After decades of robust growth, the rise in US life expectancy stalled after 2010. Explanations for the stall have focused on rising drug-related deaths. Here we show that a stagnating decline in cardiovascular disease (CVD) mortality was the main culprit, outpacing and overshadowing the effects of all other causes of death. The CVD stagnation held back the increase of US life expectancy at age 25 y by 1.14 y in women and men, between 2010 and 2017. Rising drug-related deaths had a much smaller effect: 0.1 y in women and 0.4 y in men. Comparisons with other high-income countries reveal that the US CVD stagnation is unusually strong, contributing to a stark mortality divergence between the US and peer nations. Without the aid of CVD mortality declines, future US life expectancy gains must come from other causes-a monumental task given the enormity of earlier declines in CVD death rates. Reversal of the drug overdose epidemic will be beneficial, but insufficient for achieving pre-2010 pace of life expectancy growth.
经过几十年的强劲增长，美国的预期寿命增长在 2010 年后停滞不前。对于这种停滞的解释主要集中在与药物相关的死亡人数上升上。在这里，我们表明，心血管疾病（CVD）死亡率的下降停滞不前是主要原因，超过并掩盖了所有其他死因的影响。CVD 停滞使 2010 年至 2017 年间美国 25 岁人群的预期寿命增长减少了 1.14 年，女性和男性均受影响。与药物相关的死亡人数上升的影响要小得多：女性为 0.1 年，男性为 0.4 年。与其他高收入国家的比较表明，美国的 CVD 停滞现象异常严重，导致美国与其他国家之间的死亡率出现明显差异。如果没有 CVD 死亡率下降的帮助，未来美国的预期寿命增长必须来自其他原因——鉴于 CVD 死亡率早期大幅下降，这是一项艰巨的任务。逆转药物过量流行将是有益的，但不足以实现 2010 年前的预期寿命增长速度。
