Decomposition of disparities in life expectancy with applications to administrative health claims and registry data.
Decomposition methods
Disparities
Life expectancy at 65
Medicare
Time trends
Journal
Theoretical population biology
ISSN: 1096-0325
Titre abrégé: Theor Popul Biol
Pays: United States
ID NLM: 0256422
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
31
07
2022
revised:
11
05
2023
accepted:
31
05
2023
pmc-release:
01
10
2024
medline:
23
8
2023
pubmed:
10
6
2023
entrez:
9
6
2023
Statut:
ppublish
Résumé
Research shows that geographic disparities in life expectancy between leading and lagging states are increasing over time while racial disparities between Black and White Americans have been going down. In the 65+ age strata morbidity is the most common cause of death, making differences in morbidity and associated adverse health-related outcomes between advantaged and disadvantaged groups an important aspect of disparities in life expectancy at age 65 (LE65). In this study, we used Pollard's decomposition to evaluate the disease-related contributions to disparities in LE65 for two types of data with distinctly differing structures: population/registry and administrative claims. To do so, we analyzed Pollard's integral, which is exact by construction, and developed exact analytic solutions for both types of data without the need for numerical integration. The solutions are broadly applicable and easily implemented. Applying these solutions, we found that the largest relative contributions to geographic disparities in LE65 were chronic lower respiratory diseases, circulatory diseases, and lung cancer; and, to racial disparities: arterial hypertension, diabetes mellitus, and cerebrovascular diseases. Overall, the increase in LE65 observed over 1998-2005 and 2010-2017 was primarily due to a reduction in the contributions of acute and chronic ischemic diseases; this was partially offset by increased contributions of diseases of the nervous system including dementia and Alzheimer's disease.
Identifiants
pubmed: 37295513
pii: S0040-5809(23)00034-5
doi: 10.1016/j.tpb.2023.05.001
pmc: PMC10526891
mid: NIHMS1906939
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
50-68Subventions
Organisme : NIA NIH HHS
ID : R01 AG063971
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG066133
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG046860
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG057801
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG046860
Pays : United States
Informations de copyright
Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.
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