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Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
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Explaining Divergent Levels of Longevity in High-Income Countries

Eileen M. Crimmins, Samuel H. Preston, and Barney Cohen, Editors

Panel on Understanding Divergent Trends in Longevity in High-Income Countries

Committee on Population

Division of Behavioral and Social Sciences and Education

NATIONAL RESEARCH COUNCIL
OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
×

THE NATIONAL ACADEMIES PRESS
500 Fifth Street, NW
Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by the National Institute on Aging’s Division of Behavioral and Social Research through Contract No. NO1-OD-4-2139, TO#194 between the National Academy of Sciences and the U.S. Department of Health and Human Services. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organization or agencies that provided support for the project.

Library of Congress Cataloging-in-Publication Data

Explaining divergent levels of longevity in high-income countries / Eileen M. Crimmins, Samuel H. Preston, and Barney Cohen, editors.

p. cm.

“Panel on Understanding Divergent Trends in Longevity in High-Income Countries, Committee on Population, Division of Behavioral and Social Sciences and Education, National Research Council of the National Academies.”

Includes bibliographical references.

ISBN 978-0-309-18640-7 (pbk.) — ISBN 978-0-309-18641-4 (pdf)

1. Life expectancy. 2. Longevity. 3. Life expectancy—United States. 4. Longevity—United States. I. Crimmins, Eileen M. II. Preston, Samuel H. III. Cohen, Barney, 1959- IV. National Research Council (U.S.). Panel on Understanding Divergent Trends in Longevity in High-Income Countries.

HB1322.3.E97 2011

304.6’45—dc23

2011017452

Additional copies of this report are available from the

National Academies Press,

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Copyright 2011 by the National Academy of Sciences. All rights reserved.

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Suggested citation: National Research Council. (2011). Explaining Divergent Levels of Longevity in High-Income Countries. E.M. Crimmins, S.H. Preston, and B. Cohen, Eds. Panel on Understanding Divergent Trends in Longevity in High-Income Countries. Committee on Population, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine


The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.


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The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.


www.national-academies.org

Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
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Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
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PANEL ON UNDERSTANDING DIVERGENT TRENDS IN LONGEVITY IN HIGH-INCOME COUNTRIES

EILEEN M. CRIMMINS (Cochair),

Davis School of Gerontology, University of Southern California

SAMUEL H. PRESTON (Cochair),

Department of Sociology, University of Pennsylvania

JAMES BANKS,

Department of Economics, University of Manchester, and Institute for Fiscal Studies, England

LISA F. BERKMAN,

Department of Society, Human Development, and Health, Harvard University School of Public Health

DANA A. GLEI,

Center for Population and Health, Georgetown University

NOREEN GOLDMAN,

Office of Population Research and Woodrow Wilson School, Princeton University

ALAN D. LOPEZ,

School of Population Health, University of Queensland, Australia

JOHAN P. MACKENBACH,

Department of Public Health, Erasmus University, Rotterdam, The Netherlands

MICHAEL G. MARMOT,

Department of Epidemiology and Public Health, University College London, England

DAVID MECHANIC,

Institute for Health, Health Care Policy, and Aging Research, Rutgers University

CHRISTOPHER J.L. MURRAY,

School of Public Health, University of Washington

JAMES P. SMITH,

RAND Corporation, Santa Monica, California

JACQUES VALLIN,

Institut National d’Études Démographiques, Paris, France

JAMES W. VAUPEL,

Max Planck Institute for Demographic Research, Rostock, Germany

JOHN R. WILMOTH,

Department of Demography, University of California, Berkeley

BARNEY COHEN, Study Director

ROBERT POOL, Consultant

JACQUELINE R. SOVDE, Program Associate

Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
×

COMMITTEE ON POPULATION

LINDA J. WAITE (Chair),

Department of Sociology, University of Chicago

CHRISTINE BACHRACH,

Social Science Research Institute, Duke University, and School of Behavioral and Social Sciences, University of Maryland

EILEEN M. CRIMMINS,

Davis School of Gerontology, University of Southern California

PETER J. DONALDSON,

Population Council, New York, New York

BARBARA ENTWISLE,

Department of Sociology, University of North Carolina, Chapel Hill

JOSHUA R. GOLDSTEIN,

Max Planck Institute for Demographic Research, Rostock, Germany

CHARLES HIRSCHMAN,

Department of Sociology, University of Washington

BARTHÉLÉMY KUATE-DEFO,

Department of Demography, University of Montreal

WOLFGANG LUTZ,

World Population Program, International Institute for Applied Systems Analysis, Laxenburg, Austria

DUNCAN THOMAS,

Economics Department, Duke Global Health Institute, Duke University

BARBARA B. TORREY,

Independent Consultant, Washington, DC

MAXINE WEINSTEIN,

Center for Population and Health, Georgetown University

BARNEY COHEN, Director

Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
×

Acknowledgments

In 2008, at the request of the National Institute on Aging, the Committee on Population of the National Research Council (NRC) established a Panel on Understanding Divergent Trends in Longevity in High-Income Countries to examine trends in life expectancy at older ages, to identify possible lessons about modifiable risk factors, and to discern implications for the future trajectory of mortality at advanced ages. This document represents the final report of the panel and is the collective product of all panel members and staff.

This report would not have been possible without the help of numerous people and organizations. We would especially like to thank the report’s sponsor, the National Institute on Aging, and in particular to acknowledge the contributions of Dr. Richard Suzman, director of the Division of Behavioral and Social Research and Dr. John Haaga, deputy director of the Division. The support, encouragement, and intellectual energy that they brought to the panel helped us produce a stronger report.

In addressing its charge, the panel was faced with a large and burgeoning theoretical and empirical literature with contributions from many different fields within the social and health sciences. Consequently, as a first step, the panel decided to commission a set of background papers, each one dealing with a topic relevant to the panel’s work. These papers have been published by the National Academies Press in a companion volume titled International Differences in Mortality at Older Ages: Dimensions and Sources. These papers served as a valuable resource for the report, and each one was reviewed and debated at length. Members of the panel were heavily involved in the preparation of these papers, and many others contributed

Page viii Cite
Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
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as well. The contributors included Dawn Alley, University of Maryland; Mauricio Avendano, Harvard University; Magali Barbieri, Institut National d’Études Démographiques; Carl Boe, University of California, Berkeley; Kaare Christensen, University of Southern Denmark; Michael Davidsen, University of Southern Denmark; Krista Garcia, University of Southern California; Joop Garssen, University of Groningen; Maria Glymour, Harvard University; Jessica Ho, University of Pennsylvania; Knud Juel, University of Copenhagen; Ichiro Kawachi, Harvard University; Jung Ki Kim, University of Southern California; Renske Kok, Erasmus Medical Center; Anton Kunst, University of Amsterdam; Jennifer Lloyd, University of Maryland; France Meslé, Institut National d’Études Démographiques; Laust Mortensen, University of Southern Denmark; Fred Pampel, University of Colorado, Boulder; Roland Rau, University of Rostock; Michelle Shardell, University of Maryland School of Medicine; Andrew Steptoe, University College London; and Anna Wilkman, University College London.

In addition, the panel drew on the expertise of several other experts. As part of this project, the panel organized two public meetings. In December 2008, the panel benefited greatly from the expertise and insights provided by Toni Antonucci, University of Michigan; Steve Blair, University of South Carolina; Virginia Chang, University of Pennsylvania; Jim Harter, The Gallup Organization; Frank Hu, Harvard University; Richard Saltman, Emory University; and Jonathon Skinner, Dartmouth College. In March 2009, the panel benefited from presentations and detailed discussion with Dawn Alley, University of Maryland; Kaare Christensen, University of Southern Denmark; Shiro Horiuchi, Hunter College; Knud Juel, University of Southern Denmark; and Andrew Steptoe, University College London.

Several members of the staff of the National Academies made significant contributions to the report. The panel was established under the auspices of the Committee on Population. Particular thanks are due to Barney Cohen, who was an exceptionally effective study director, as well as to Robert Pool for research and writing assistance, Benjamin Galick for excellent research assistance, Jacqui Sovde for logistical support, Kirsten Sampson Snyder for help guiding the report through review, Rona Briere for skillful editing, and Yvonne Wise for managing the production process.

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
×

We wish to thank the following individuals for their review of this report: Barbara A. Anderson, Ronald Freedman collegiate professor of sociology and population studies, University of Michigan; Mauricio Avendano, Harvard Center for Population and Development Studies, Harvard University; John Bongaarts, Policy Research Division, The Population Council; David Burns, School of Medicine, University of California, San Diego; John Cawley, Department of Policy Analysis and Management, College of Human Ecology, Cornell University; Kaare Christiansen, professor of epidemiology, College of Human Ecology, University of Southern Denmark, and senior research scientist, Sanford Institute of Public Policy, Duke University; James S. House, Angus Campbell distinguished university professor survey research, public policy, and sociology, Gerald R. Ford School of Public Policy, University of Michigan; Michael A. Stoto, professor of health systems administration and population health, Georgetown University School of Nursing and Health Studies; and Klaas R. Westerterp, professor of human energetics, Department of Human Biology, Maastricht University, The Netherlands.

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Jane Menken, University of Colorado, Boulder. Appointed by the NRC, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring panel and the institution.

Finally, we would like to express our great appreciation to our fellow panel members. This report results from the exceptional efforts of the members of the panel, all of whom had many other responsibilities but who nonetheless generously gave much of their time and their expertise to the project.

Eileen M. Crimmins and Samuel H. Preston, Cochairs

Panel on Understanding Divergent Trends in Longevity in High-Income Countries

Suggested Citation:"Front Matter." National Research Council. 2011. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press. doi: 10.17226/13089.
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During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes.

According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages -- cancer and cardiovascular disease -- available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable.

Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which -- unlike randomized controlled trials -- are subject to many biases.

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