Life Expectancy Drops Again

The CDC has released the latest data from the National Vital Statistics System. Life Expectancy for the U.S. population in 2021 was 76.4 years. This represents a decrease of 0.6 years from 2020.

Covid-19 remained in the top 3 leading causes of death. Covid-19 deaths were higher in 2021 than they were in 2020.

Life Expectancy 2021 United States

Pandemic leads to biggest drop in U.S. life expectancy since World War II …

The CDC data is in from 2020 and it shows that life expectancy continues to drop. We also know that 2021, which is not yet part of the tally, has been much worse with respect to mortality. It is anticipated we will see further drops to life expectancy. NPR story.

Updated U.S. Life Tables are here …

The latest U.S. life tables have arrived.  There were small gains for males and for females since the last major release at the end of last year (2016).  The life expectancy of a male at birth is now 76.5 (up 0.1) and for females it is now 81.3 (up 0.1).  It appears that the rate of gains made in the past few decades are now beginning to slow down.  We may be hitting a wall on gains to life expectancy. It is also possible that other factors are at play such as the emergence of new strains of resistant bacteria, increasing rates of diabetes and obesity, and little progress with cancer.  It will be interesting to see how the story unfolds over the next couple of decades.

Canadian – Life Expectancy

A life expectancy expert should note that the life expectancy of Canadian males is now listed in their report as 78.6. Females are listed as 83.1.

The latest expert data is now available from the
Statistics CanadacanadaThe data is part of an examination of Canada’s health indicators which are collected in conjunction with the Canadian Institute of Health Information. It measures Canada’s vital signs by looking at over 80 indicators, including health status and health system performance.

Note:  These numbers are slightly lower than the Human Mortality Database which has more recent data. The Human Mortality Database tends to publish at more regular intervals.

Lockerbie man – life expectancy

The Pan Am Flight 103 crash site was in Lockerbie, Scotland

The Libyan man convicted of the Lockerbie bombing was released in August 2009. The official justification for the early liberation was compassion, based on a prognosis of impending death – physicians were giving the man a life expectancy of 3 months. The fact that the man is still alive, now, and that he may still survive several years has shocked several, who now question the validity of the medical assessment that led to his liberation. Some commentators could see this as evidence that the true reasons behind the liberation were other than medical. There are, however, a number of alternate explanations.

First, and somewhat paradoxically, the assessment of 3 months may have been entirely accurate. A calculation of life expectancy is fundamentally, by definition, an average. It is an estimation of how the disease would progress (and life conclude) for a group of like patients, in the condition in which this particular patient is found. Among that group, not all would be expected to die at the same time. By prospectively estimating the many survival times of all patients, one can find an average. In some cases (e.g., a particular kind of cancer and a particular stage) there could be a skewed distribution of survival times, where 90% of patients survive for only one month, and 10% survive for 21 months. The life expectancy of this group would be 3 months, and our man could be in the fortunate 10%.

Second, it is quite possible that a standard scientific life expectancy calculation was not actually performed. Though incompetence may not be reassuring, it certainly should not be confused with politico-financial machinations. “The final assessment of prognosis was made by Dr. Andrew Fraser taking into account the deterioration in his clinical condition.” Upon reading this report it does not appear that a life expectancy calculation using the standard scientific method was actually performed (no articles are cited and no life table is provided). Quite possibly, this may have been the nonscientific ‘according to my wisdom and experience’ synthesis we often see erroneously applied.

Third, there is always the remote and unlikely chance that a significant and major medical advance may have occurred. A life expectancy calculation is a function of the current state of medical science. Rarely would radically transformative advances occur so swiftly as to dramatically alter such a short estimate, but it is technically possible that new modes of treatment have been discovered. Here, it appears unlikely, as there appears to have been no major recent advance curing metastatic prostate cancer.

We should therefore not conclude based solely on the fact that this man survived longer than his 3 month life expectancy that the release was in fact not granted for humanitarian reasons. There are plenty of alternate explanations for the disparity between the predicted and observed outcomes. That said, it is of course possible that politics were indeed involved. But that’s a topic beyond the realm of life expectancy analysis.

Fuzzy math: O’Reilly says higher Canadian life expectancy is “to be expected” because “we have 10 times as many people”

Oh, he didn’t really say this, did he?

A viewer asked: “Has anyone noticed that life expectancy in Canada under our health system is higher than the USA?”

Bill responded:  “Well, that’s to be expected Peter, because we have 10 times as many people as you do. That translates to 10 times as many accidents, crimes, down the line.”

This argument is nonsensical.

Life expectancy is the AVERAGE survival time across a large group of similar people (in this case Canadians or Americans).  It does not matter if the U.S. has 10 times as many people.  What matters is that you are calculating the arithmetic mean.

In fact, if you take what Mr. O’Reilly is saying as true – this would drop accidents and crimes out of the equation.  He is essentially saying the U.S. has 10 times as many people so we have 10 times the number of accidents and crimes.  In other words, he is saying they are similar.

To get to the truth of why Canadians have a longer life expectancy than Americans, you’d have to look to other variables.  One important one would be the level of obesity in the two countries.  America is much worse with respect to this particular disease.

Long-term survival after donating a kidney

kidney

Good news. A study by a group of researchers at John Hopkins School of Medicine indicates that people do not put their own health at risk by donating their kidney.

The study was conducted on 80,347 people who donated a kidney between April 1, 1994 and March 21, 2009.  Mortality rates were compared to a similar matched group from the third National Health and Nutrition Examination Survey (NHANES III).  This similar group did not donate a kidney.

“Regardless of what physiologic changes might occur in a healthy adult after kidney donation, our findings of similar  long-term survival between donors and healthy comparison patients suggest that these physiologic changes do not result in premature death.”

They feel that while further study is indicated to understand physiologic changes, their findings do not suggest that these changes result in premature death.  They also state that the current practice of live kidney donation should continue to be considered a reasonable and safe modality for addressing the profound shortage in deceased donor organs.

http://jama.ama-assn.org/cgi/content/short/303/10/959

Oldest person in US dies in NH at age 114

Mary Josephine Ray, the New Hampshire woman who was certified as the oldest person living in the United States, has died at age 114 years, 294 days.  Ray was born May 17, 1895, in Bloomfield, Prince Edward Island, Canada. She moved to the United States at age 3.

The oldest living American is now Neva Morris, of Ames, Iowa, at age 114 years, 216 days.

The oldest person in the world is Japan’s Kama Chinen at age 114 years, 301 days.

King Tut and Life Expectancy

King Tutankhamun, commonly known as King Tut, ruled ancient Egypt from 1333 to 1324 BC.  King Tutankhamun became Pharaoh in 1333 at the age of nine years old and ruled until he died at the age of 19. He is a well known pharaoh today because his tomb was discovered in the early 20th century. This newsworthy finding revealed to the world a rich and historical set of artifacts. In the Journal of the American Medical Association this week, we find out more about his possible cause of death.

“Over the years, many scholars have offered a wide variety of explanations for his early demise as well as the seemingly androgynous appearance of his face and gynecomastia portrayed in sculptures and other relics. These diagnoses have included Marfan syndrome, Wilson-Turner X-linked mental retardation syndrome, Fröhlich syndrome (adiposogenital dystrophy), Klinefelter syndrome, androgen insensitivity syndrome, aromatase excess syndrome in conjunction with sagittal craniosynostosis syndrome, and Antley-Bixler syndrome or one of its variants.”

“Although no evidence was found to confirm a diagnosis of either Marfan or Antley-Bixler syndromes, Tutankhamun did have juvenile aseptic bone necrosis of the left second and third metatarsals, which may be consistent with Köhler disease II or Freiberg-Köhler syndrome. Moreover, this orthopedic disease process appears to have been flourishing at the time of his death. Perhaps most interesting was the DNA evidence of Plasmodium falciparum in many of the royal mummies—including Tutankhamun’s. Indeed, this finding constitutes the oldest genetic proof of malaria in well-dated mummies. On the other hand, no evidence of bubonic plague, tuberculosis, leprosy, or leishmaniasis was found.”

So what is a Köhler disease? It is a rare bone disorder of the foot. It is often found in children below the age of 10.  It can cause pain and swelling in the foot and cause a limp.  It can usually be treated today, but in ancient times Mr. Tut likely suffered with the problem and may have used a cane as a result.

Mr. Tut’s autopsy appears to have revealed several inherited disorders that led to an inflammatory, immunosuppressive, and weakened condition.  With Malaria and a sudden fracture of his leg, this likely progressed to a life threatening condition.

Life Expectancy of an Egyptian at birth in that era: ~25
Survival Time of Mr. Tut:  19 years