Estimating the Effects of Smoking and Other Risk Factors on Mortality Slowdowns in Developed Countries

Brian Rostron, National Center for Health Statistics (NCHS), CDC

Attention has been directed recently to slowdowns in life expectancy in the United States, particularly for females at older ages, even as gains have continued to be robust in some other countries. Decomposition of changes in life expectancy by cause suggests that previous smoking exposure contributes to these trends. Use of the indirect method suggested by Peto, et al. to measure the mortality effect of smoking, modified and extended here, indicates that smoking accounts for approximately half of the difference in female life expectancy at age 65 between the U.S. and some other developed countries. For the remaining difference, mixed effects models using longitudinal data suggest that dietary factors, in particular animal fat consumption, are the most easily identifiable cause, a conclusion that is similar to previous findings concerning excess male mortality in a previous period. Finally, economic factors do not appear to account for much of the remaining difference in life expectancy.