The evolving geography of US mortality. A state-level analysis of converging/diverging trends in the length of life

International audienceThe paper focuses on inter-state differences in longevity in the United States from 1959 to 2016, using data from the United States Mortality DataBase and the NCHS to better understand the historical context of recent increase in geographic inequalities. After describing trends in survival across states and changes in the magnitude of the gap between the two extremes of the distribution in terms of life expectancy at birth, the study focuses on the results of a cluster analysis in which states are grouped according to both their level of life expectancy at birth and their year-to-year changes in life expectancy over two consecutive time periods (1959-1984 and 1984-2016). Inter-cluster variations in mortality patterns are examined and differences in life expectancy at birth between each cluster and the US as a whole are decomposed by age groups and by causes of death

Drug and pregnancy related deaths: Levels, trends, and geographic differentials during the recent drug epidemics

The drug and opioid epidemics in the US are affecting pregnant women. Few, if any studies have systematically examined the relationship between maternal mortality and substance use in the US. We aim to look at multiple causes of death involving both a maternal mortality cause and drug use (both prescription and illegal), considering maternal age, variation by state, and change over time. Employing death certificates from the Center for Disease Control and Prevention between 1979 and 2016, we will map where these deaths are occurring, at what rate, and how this has changed over time. The continued burden of maternal mortality in the US and the increasing (mis-)use of drugs among women of reproductive age warrant a better understanding of the relationship between pregnancy-related and drug-related deaths in the US. Understanding this relationship will unify policy, pregnancy care, and substance abuse treatment to reduce deaths from pregnancy and drug use

The evolving geography of US mortality. A state-level analysis of converging/diverging trends in the length of life

International audienceThe paper focuses on inter-state differences in longevity in the United States from 1959 to 2016, using data from the United States Mortality DataBase and the NCHS to better understand the historical context of recent increase in geographic inequalities. After describing trends in survival across states and changes in the magnitude of the gap between the two extremes of the distribution in terms of life expectancy at birth, the study focuses on the results of a cluster analysis in which states are grouped according to both their level of life expectancy at birth and their year-to-year changes in life expectancy over two consecutive time periods (1959-1984 and 1984-2016). Inter-cluster variations in mortality patterns are examined and differences in life expectancy at birth between each cluster and the US as a whole are decomposed by age groups and by causes of death

Jointly Estimating Subnational Mortality for Multiple Populations

Understanding patterns in mortality across subpopulations is essential for local health policy decision making. One of the key challenges of subnational mortality rate estimation is the presence of small populations and zero or near zero death counts. When studying differences between subpopulations, this challenge is compounded as the small populations are further divided along socioeconomic or demographic lines. In this paper, we build on principal component-based Bayesian hierarchical approaches for subnational mortality rate estimation to model correlations across subpopulations. The principal components identify structural differences between subpopulations, and coefficient and error models track the correlations between subpopulations over time. We illustrate the use of the model in a simulation study as well as on county-level sex-specific US mortality data. We find that results from the model are reasonable and that it successfully extracts meaningful patterns in US sex-specific mortality. Additionally, we show that ancillary correlation parameters are a useful tool for studying the convergence and divergence of mortality patterns over time

Jointly estimating subnational mortality for multiple populations

Background: Understanding patterns in mortality across subpopulations is essential for local health policy decision-making. One of the key challenges of subnational mortality rate estimation is the presence of small populations and zero or near zero death counts. When studying differences between subpopulations, this challenge is compounded as the small populations are further divided along socioeconomic or demographic lines. Objective: We aim to develop a model to estimate subnational age-specific mortality rates that accounts for the dependencies in mortality experiences across subpopulations. Methods: We develop a Bayesian hierarchical principal components-based model that shows correlations across subpopulations. Results: We test this approach in a simulation study and also use the model to estimate age- and sex-specific mortality rates for counties in the United States. The model performs well in validation exercises and the US estimates suggest substantial variation in mortality trends over time across geographic lines. Contribution: Our proposed model jointly estimates age-specific mortality rates for multiple subpopulations at the subnational level. By sharing information across subpopulations, our model improves on previous approaches that treat subpopulations as independent. Additionally, we demonstrate that ancillary correlation parameters are a useful tool for studying the convergence and divergence of mortality patterns over time

MAXIMA: An Experiment to Measure Temperature Anisotropy in the Cosmic Microwave Background

We describe the MAXIMA experiment, a balloon-borne measurement designed to map temperature anisotropy in the Cosmic Microwave Background (CMB) from l=80 to l=800. The experiment consists of a 1.3 m diameter off-axis Gregorian telescope and a receiver with a 16 element array of bolometers cooled to 100 mK. The frequency bands are centered at 150, 240, and 410 GHz. The 10′ FWHM beam sizes are well matched to the scale of acoustic peaks expected in the angular power spectrum of the CMB. The first flight of the experiment in its full configuration was launched in August 1998. A 122 deg2 map of the sky was made near the Draco constellation during the 7 hour flight in a region of extremely low galactic dust contamination. This map covers 0.3% of the sky and has 3200 independent beamsize pixels. We describe the MAXIMA instrument and its performance during the recent flight