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The role of obesity in exceptionally slow US mortality improvement

Author

Listed:
  • Samuel H. Preston

    (Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA 19104)

  • Yana C. Vierboom

    (Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA 19104)

  • Andrew Stokes

    (Department of Global Health, Boston University School of Public Health, Boston, MA 02118)

Abstract

Recent studies have described a reduction in the rate of improvement in American mortality. The pace of improvement is also slow by international standards. This paper attempts to identify the extent to which rising body mass index (BMI) is responsible for reductions in the rate of mortality improvement in the United States. The data for this study were obtained from subsequent cohorts of the National Health and Nutrition Examination Survey (NHANES III, 1988–1994; NHANES continuous, 1999–2010) and from the NHANES linked mortality files, which include follow-up into death records through December 2011. The role of BMI was estimated using Cox models comparing mortality trends in the presence and absence of adjustment for maximum lifetime BMI (Max BMI). Introducing Max BMI into a Cox model controlling for age and sex raised the annual rate of mortality decline by 0.54% (95% confidence interval 0.45–0.64%). Results were robust to the inclusion of other variables in the model, to differences in how Max BMI was measured, and to how trends were evaluated. The effect of rising Max BMI is large relative to international mortality trends and to alternative mortality futures simulated by the Social Security Administration. The increase in Max BMI over the period 1988–2011 is estimated to have reduced life expectancy at age 40 by 0.9 years in 2011 (95% confidence interval 0.7–1.1 years) and accounted for 186,000 excess deaths that year. Rising levels of BMI have prevented the United States from enjoying the full benefits of factors working to improve mortality.

Suggested Citation

  • Samuel H. Preston & Yana C. Vierboom & Andrew Stokes, 2018. "The role of obesity in exceptionally slow US mortality improvement," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 115(5), pages 957-961, January.
    • Handle: RePEc:nas:journl:v:115:y:2018:p:957-961
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    Citations

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    Cited by:

    1. Michelle Frisco & Erin Baumgartner & Jennifer Van Hook, 2019. "The weight of school entry: Weight gain among Hispanic children of immigrants during the elementary school years," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 40(5), pages 95-120.
    2. David M. Cutler & Kaushik Ghosh & Kassandra Messer & Trivellore Raghunathan & Allison B. Rosen & Susan T. Stewart, 2020. "A Satellite Account for Health in the United States," NBER Working Papers 27848, National Bureau of Economic Research, Inc.
    3. Rodrigo R. Soares & Rudi Rocha & Michel Szklo, 2021. "American Delusion: Life Expectancy and Welfare in the US from an International Perspective," Working Papers 13, Instituto de Estudos para Políticas de Saúde.
    4. Christopher R Gustafson & Rachel Kent & Michael R Prate Jr, 2018. "Retail-based healthy food point-of-decision prompts (PDPs) increase healthy food choices in a rural, low-income, minority community," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-11, December.
    5. Samuel H. Preston & Yana C. Vierboom & Mikko Myrskylä, 2023. "Socio-behavioral factors contributing to recent mortality trends in the United States," MPIDR Working Papers WP-2023-019, Max Planck Institute for Demographic Research, Rostock, Germany.
    6. Andrew Fenelon & Michel Boudreaux, 2019. "Life and Death in the American City: Men’s Life Expectancy in 25 Major American Cities From 1990 to 2015," Demography, Springer;Population Association of America (PAA), vol. 56(6), pages 2349-2375, December.
    7. David McCarthy, 2021. "80 will be the new 70: Old‐age mortality postponement in the United States and its likely effect on the finances of the OASI program," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 88(2), pages 381-412, June.
    8. Lopez Barrera, Emiliano & Shively, Gerald, 2022. "Excess calorie availability and adult BMI: A cohort analysis of patterns and trends for 156 countries from 1890 to 2015," Food Policy, Elsevier, vol. 109(C).
    9. Vaughan, Adam S. & Schieb, Linda & Quick, Harrison & Kramer, Michael R. & Casper, Michele, 2018. "Before the here and now: What we can learn from variation in spatiotemporal patterns of changing heart disease mortality by age group, time period, and birth cohort," Social Science & Medicine, Elsevier, vol. 217(C), pages 97-105.
    10. Keegan, Conor & Brick, Aoife & Bergin, Adele & Wren, Maev-Ann & Whyte, Richard & Henry, Edward, 2020. "Projections of expenditure for public hospitals in Ireland, 2018–2035, based on the Hippocrates Model," Research Series, Economic and Social Research Institute (ESRI), number RS117, June.
    11. Nikoletta Vidra & Maarten J. Bijlsma & Fanny Janssen, 2018. "Impact of Different Estimation Methods on Obesity-Attributable Mortality Levels and Trends: The Case of The Netherlands," IJERPH, MDPI, vol. 15(10), pages 1-11, September.

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