September 11, 2024 | News | SPOTLIGHT

Less smoking and better education: Improving U.S. Mortality Trends

Study highlights role of social and behavioral factors

[SPOTLIGHT]

A recent study found that behavioral changes, such as a decline in smoking, and social progress, including an expansion of education, have contributed to recent improvements in U.S. mortality. Together, these two factors accounted for 65% of the improvements in mortality. The researchers also identified an increase in psychological distress as a contributing factor to the slowing of mortality improvement in the U.S. during the study period, but most of the slowing remains unexplained.

One of the socio-behavioral factors leading to improved mortality in the USA is a decline in smoking. © iStockphoto.com / Suriyawut Suriya

A study published in early August by the Max Planck Institute for Demographic Research and the University of Pennsylvania identifies the main factors that contributed to changes in adult mortality in the United States in the two decades before the COVID-19 pandemic. To do this, the researchers developed and applied a new method to identify the role of many socio-behavioral factors in recent changes in U.S. mortality. The results highlight the role of behavioral changes (decline in smoking) and general social progress (expansion of education). Both factors have contributed most to recent improvements in mortality.

The authors of the study are Samuel Preston (University of Pennsylvania), Yana Vierboom (MPIDR) and Mikko Myrskylä (MPIDR). Their analysis is based on data from the National Health Interview Surveys (NHIS) from 1997 to 2018 and considers factors such as alcohol consumption, cigarette smoking, health insurance, education level, mental health problems, obesity and ethnicity. “The NHIS is an ideal survey because it includes a long range of years—all linked to death records— allowing for a comprehensive view of mortality trends,” explains Yana Vierboom.

The decline in smoking and the increase in educational attainment together accounted for 65 percent of the improvements in mortality. "In a secondary analysis, we compared two subperiods to see if these variables could account for the overall observed slowdown in U.S. mortality improvement during the study period. The increase in psychological distress, combined with the very high risks associated with this distress, contributed substantially to the slowdown. However, most of the slowdown remains unexplained," says Samuel Preston.

"Our study shows that behavioral changes and social progress are crucial factors in improving mortality in the US," says Mikko Myrskylä, Director of the MPIDR. "The results of our study can help make better mortality predictions and develop strategies to improve the health and well-being of the population."

Original Publication

Samuel Preston, Yana Vierboom, Mikko Myrskylä: Socio-behavioral factors contributing to recent mortality trends in the United States in Demographic Research (2024); DOI 10.4054/DemRes.2024.51.7