Three essays on mortality and survivorship by causes of death in the U.S.
This dissertation comprises three papers that analyze various aspects of mortality in the United States. In the first paper we develop a new method for attributing changes in life expectancy to various causes of death. We used national level data on mortality for the U.S. between 1970 and 2000 to show that our method has a major difference with previous techniques in relation to diseases prominent at older ages such as cardiovascular disease. For applications where causes of death are the central focus, our technique appears to have a modest advantage because of its conceptual clarity and attractive byproducts in the form of cause-deleted life tables. The second paper documents trends in incidence of and survival with a first myocardial infarction (MI) since the mid-1950s. We estimate these trends using a longitudinal data that spans about 50 years, the Framingham Heart Study. Our results suggest that there has been a significant increase in incidence rates of first MI starting in late-1980s, relative to late-1950s. In addition, we found that there has been a significant decline in survivorship after a first MI event. The likelihood of death within 30-days after a first MI decline declined about 40% per decade in the period of study. In addition, relative to 1958–62, there has been a significant decline in the conditional hazard of death for those surviving one month, and one year after a heart attack starting in the mid-1970s. The last paper tests whether early childhood conditions, proxied by height and its components (sitting height and leg length), show an independent association with adult mortality net of other risk factors measured in adulthood. We use two U.S. nationally representative samples of people aged 30 or older, the National Health and Nutrition Examination Surveys (NHANES) I and II. We showed that sitting height is the only component of height that shows a significant association with the hazard of death, for all-causes and for causes other than cancer and cardiovascular disease, net of risk factors measured in adulthood.