The "double jeopardy" of midlife and old age mortality trends in the United States

Proc Natl Acad Sci U S A. 2023 Oct 17;120(42):e2308360120. doi: 10.1073/pnas.2308360120. Epub 2023 Oct 9.


Since 2010, US life expectancy growth has stagnated. Much research on US mortality has focused on working-age adults given adverse trends in drug overdose deaths, other external causes of death, and cardiometabolic deaths in midlife. We show that the adverse mortality trend at retirement ages (65+ y) has in fact been more consequential to the US life expectancy stagnation since 2010, as well as excess deaths and years of life lost in 2019, than adverse mortality trends at working ages. These results reveal that the United States is experiencing a "double jeopardy" that is driven by both mid-life and older-age mortality trends, but more so by older-age mortality. Understanding and addressing the causes behind the worsening mortality trend in older ages will be essential to returning to the pace of life expectancy improvements that the United States had experienced for decades.

Keywords: aging population; life expectancy; mortality trends.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cause of Death
  • Drug Overdose*
  • Ethical Theory
  • Humans
  • Life Expectancy*
  • Mortality
  • Retirement
  • United States / epidemiology