Is life expectancy really falling for low SES groups? Lagged selection bias and artifactual trends in mortality.

Jennifer Beam Dowd, Amar Hamoudi

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Abstract

Recent public health studies made headlines,1–3 reporting that for some subpopulations in the USA, mortality rates have been higher and life expectancies lower for recent compared with earlier time periods.4–7 These patterns have been described in both popular and academic discourse as a ‘rise’ in mortality or a ‘decline’ in life expectancy. We suggest that it is long past time to admit an alternative—and arguably more plausible—interpretation of these patterns. The fact that a measure was computed at two different time points does not, by itself, make the difference between them a trend. Imagine if researchers measured the average temperature for the whole of the USA a decade ago, and then for only Alaska this year, and found the former number to be lower than the latter. Would it be appropriate to say that average temperatures had ‘declined’ over the decade? We argue that it would not, and that it is likewise not appropriate to be describing many of the observed differences in subgroup life expectancy or mortality as ‘trends’.
Original languageEnglish
Pages (from-to)983–988
JournalInternational Journal of Epidemiology
Volume43
Issue number4
Early online date31 Jul 2014
Publication statusPublished - Aug 2014

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