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New report describes which Americans are living longer

Robin Wulffson MD's picture
longevity, mortality rate, racial disparity, gender disparity

People in the U.S. are living much longer notes a National Center for Health Statistics Data Brief, which was published online on March 13. The report notes that in the last 75 years, the nation's age-adjusted mortality rate has plummeted 60%; it has dropped in all age groups, with the most significant decline occurring in ages one through four. The death rate for that group has dropped an astounding 94%.

The report was written by Donna L. Hoyert, PhD, a health scientist at the Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Vital Statistics, Mortality Branch, Hyattsville, Maryland. Data was derived from the National Vital Statistics System, which revealed the marked increased in longevity, which were not apparent from earlier studies. Data was reviewed from 1935 to 2010; however, the 2010 statistics are preliminary.

Dr. Hovert wrote: "Although there were year to year exceptions, the last 75 years witnessed sustained declines in the risk of dying in the United States. The report noted that the total number of deaths increased in those years to 2.5 million, which was a 1.1 million increase. However, the unadjusted risk for death dropped 27% in those 75 years; it fell from 1,094.5 deaths for every 100,000 individuals to 798.7 for every 100,000. When the effect of increasing survival in an aging population was factored in, the mortality rate decreased from 1,860.1 per 100,000 individuals in 1935 to 746.2 per 100,000 in 2010, marking a 60% decline.

Death rates decreased by more than 50% for all but the very oldest individuals (aged 85 years and older). However, even in that age group, the mortality rated decreased significantly (38%). For seniors aged 65 to 74 years, the mortality rate dropped 62%; for seniors aged 75 to 84 years, the rate dropped 58%. The decline in mortality rate was even more pronounced among children, particularly those aged one to four years; the death rate plummeted 94%, from 440.9 deaths per 100,000 to 26.6 per 100,000.

A visit to any senior facility today will reveal significantly more women than men. Throughout the survey, males died at a higher rate than females. The peak occurred from 1975 to 1985 when the ratio of male to female deaths was 1.7; during that period, age-adjusted male death rates were 65% higher than the rate for females. In 2010, the rate of male deaths was 40% higher; the male to female ratio was 1.4. The death rate that year was 886.2 per 100,000 for males and 634.3 per 100,000 for females.

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Although the death rate declined in all ethnic groups during the 75 years, racial disparities were found. African Americans continued to experience a higher death rate than Caucasians. The gap was widest between 1988 and 1996; during that period, the ratio of African American to Caucasian deaths was 1.4. Previous studies did not clarify this disparity because up until 1960, African Americans were included in the category "all other races." This inclusion was made despite the fact that African Americans comprised 96% of that group. Using age-adjusted data, between 1935 and 1942, the ratio of deaths in the "all other races" category to deaths among Caucasians was 1.3; from 1943 to 1959 it was 1.2. In 1960, the first year data for African Americans was compiled separately, the ratio of African American to Caucasian deaths was 1.2; from 1988 to 1996, it increased to 1.4. Since 2008, the ratio has remained at 1.2. In 2010, the age-adjusted death rate among African Americans was 897.7 per 100,000; the rate for Caucasians was 741.0 per 100,000.

The report also examined the leading causes of death. Not surprisingly, heart disease, cancer, and stroke were among the five leading causes of death in every survey year. In 1946, accidents rose to become one of the top five reasons for death; in 1979, chronic lower respiratory disease became a constant member of the top five. Other causes have fluctuated in and out of the top five. For example, certain diseases of infancy (not specifically identified in the report) were among the top five causes of death from 1949 to 1962; these diseases resurfaced in 1964. Until 1948, kidney disease was among the top five. Influenza and pneumonia were among the top killers between 1935 and 1945, in 1963, and between 1965 and 1978.

The report also revealed cultural and medical trends over the 75 year period. For example, the 30% decrease in mortality from 1935 to 1954 is most likely due to the emergence of antibiotics and other life-saving medications. The increase in the use of tobacco since the mid-20th Century probably explains the 12-year-long slump in decreasing death rates from 1955 to 1968; during that period the mortality rate decreased by only 2%. It is well established that tobacco use increases the risk of cancer, respiratory disease, and cardiovascular disease.

A 41% decreased in the death rate was found from 1969 to 2010; this finding may reflect improved prevention, diagnosis, and treatment of cardiovascular disease (both medical and surgical). Treatment for cancer and respiratory disease has also improved in recent decades.

Take Home Message: This report documents the fact that Americans are living longer; however, those individuals who will benefit the most from this phenomenon are those that adopt a healthy life style.

Reference: National Center for Health Statistics