Cause-of-death mortality burdens incorporating lifespan inequality contributions for the United States
Description
Do file and dataset for dominance analysis on US cause-deleted age-at-death distributions. Abstract: Comparisons of cause-of-death mortality burdens ignore contributions to lifespan inequality or assess them separately from life expectancy impacts. We compare cause-of-death mortality burdens that take account of contributions to both life expectancy and lifespan inequality. Using 2021 U.S. National Center for Health Statistics mortality data stratified by sex and race/ethnic group, we distinguish eight causes of death (deaths of despair, homicides, accidents, CVD, cancer, COVID-19, infectious diseases, and respiratory diseases), construct a cause-deleted life table for each and use it to simulate an age-at-death distribution if that cause were eliminated. We rank these distributions and the respective causes using (higher-order) stochastic dominance analysis founded on value judgments concerning the distribution of lifespan. If longer and more equal lifespans are considered better, then we find that among non-Hispanic (NH) Whites, deaths of despair impose a larger mortality burden than those generated by homicides, COVID-19 (males), cancers (males), infectious diseases and respiratory diseases. If concern about lifespan inequality is stronger around younger ages at death, then the mortality burden of deaths of despair is even larger than that of CVD for NH White males. For NH Black males, the mortality burden of homicides is larger than that of respiratory diseases if there is concern about lifespan inequality and it is larger than the burdens of COVID-19 and cancers if there is greater concern about inequality between younger ages of death. These and other results can inform inequality-sensitive decision-makers looking to prioritize interventions that target causes of death that contribute most to the mortality burden through both reduced life expectancy and increased lifespan dispersion.