UW School of Medicine and Public Health: UW-Madison research paper named best of 2018

Contact: Andrew Hellpap

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ahellpap@uwhealth.org

MADISON, Wis. – Work published by three University of Wisconsin-Madison researchers, on decreasing the gap in life expectancy of the United States population compared to European peers, earned top honors from the American Public Health Association.

The winning paper, “Meeting the Institute of Medicine’s 2030 US Life Expectancy Target,” was a collaboration between David Kindig, emeritus professor, population health sciences; Jenna Nobles, professor of sociology; and Moheb Zidan, PhD candidate in economics, UW-Madison.

The research concluded it will be challenging for the United States to achieve recommended growth in life expectancy over the next 15 years, compared to peer countries.

“Many may be surprised, as I was, to learn how recently we departed from our European peers in life expectancy trends,” Kindig said.

In 1960, U.S. life expectancy grew at a similar rate to that of Japan, Sweden and France, at .26 percent per year, until the mid-1980s when it began to slow. From 1985 to 2010, the rate slowed to .2 percent per year and again from 2012 to 2013 to .06 percent per year. Subsequent growth has been negative.

The causes of the slowing in growth rate are numerous, including birth complications, accidents, addiction, injuries, homicide, HIV/AIDS, heart disease, diabetes and health factors related to obesity, according to the paper. These factors can be attributed to societal circumstances including food-consumption patterns, gun violence, unprotected sexual intercourse, environments that hinder physical activity, barriers to health care access, child poverty and high income inequality.

The National Academy of Medicine and the Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine established a per-year growth improvement target of .3 percent. This means that the average peer-nation life expectancy for women at age 50 would require life expectancy increases of 1.5 years, and .8 years for men, according to the study. Overall U.S. life expectancy would need to grow by .32 percent a year between 2016 and 2030.

“Closing the current gap will be difficult without sustained political will,” Kindig said. “Failure to do so is costing us significant, unnecessary loss of life.”

Achieving the necessary growth rate has some precedent, according to Kindig and Nobles’ research.

More than 204 five-year periods in countries around the world they examined showed that almost 50 percent of the nations showed growth at or above .32 percent, and 8.2 percent of U.S. states demonstrated growth in life expectancy at a rate faster than .32 percent.

“Using annual benchmarks – like the needed 0.3 percent growth in life expectancy each year – allows progress and accountability to be monitored,” Kindig said.

But, according to the research, for the U.S. to meet this aim, it will take a strong commitment to equity improvement among the entire U.S. population, particularly given the unprecedented fall in life expectancy since the study was conducted.

“A national strategy, like that proposed in recently introduced legislation by Rep. Wasserman-Schultz (HR7035), is an important step forward,” Nobles said.

Funding for the multi-institutional research paper was provided in part by a grant from the Robert Wood Johnson Foundation Health and Society Scholars program, and from the Center for Demography and Ecology at the UW-Madison.

“It is a clear example of how different disciplines have to work together to tackle broad policy issues,” Kindig said.