Preston, Samuel

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Now showing 1 - 10 of 20
  • Publication
    Low Life Expectancy in the United States: Is the Health Care System at Fault?
    (2010-01-01) Preston, Samuel HY; Ho, Jessica Y
    Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.
  • Publication
    Estimating Smoking-attributable Mortality in the United States
    (2011-02-25) Fenelon, Andrew; Preston, Samuel H.
    Tobacco is the largest single cause of premature death in the developed world. Two methods of estimating the number of deaths attributable to smoking use mortality from lung cancer as an indicator of the damage from smoking. We reestimate the coefficients of one of these, the Preston/Glei/Wilmoth model, using recent data from U.S. states. We calculate smoking attributable fractions for the 50 states and the U.S. as a whole in 2000 and 2004. We estimate that 21% of adult deaths among men and 17% among women were attributable to smoking in 2004. Across states, attributable fractions range from 11% to 30% among men and from 7% to 23% among women. Smoking related mortality also explains as much as 60% of the mortality disadvantage of Southern states. At the national level, our estimates are in close agreement with those of the Centers for Disease Control (CDC) and Preston/Glei/Wilmoth, particularly for men. But we find greater variability by state than does CDC. We suggest that our coefficients are suitable for calculating smoking-attributable mortality in contexts with relatively mature cigarette smoking epidemics.
  • Publication
    Sex Mortality Differentials in the United States: The Role of Cohort Smoking Patterns
    (2005-02-01) Preston, Samuel; Wang, Haidong
    This paper demonstrates that, over the period 1948-2003, sex differentials in mortality in the age range 50-54 to 85+ widened and then narrowed on a cohort rather than on a period basis. The cohort with the maximum excess of male mortality was born shortly after the turn of the century. Three independent sources suggest that the turnaround in sex mortality differentials is consistent with sex differences in cigarette smoking by cohort. An age/period/cohort model reveals a highly significant effect of smoking histories on men’s and women’s mortality. This model suggests that improvements in mortality at older ages are likely to accelerate in the future.
  • Publication
    1994-95 Advisory Council on Social Security Technical Panel on Assumptions and Methods Final Report
    (1996) Young, Howard; Allen, Barry; Crimmins, Eileen; Cutler, David; Holmer, Martin; Manunovich, Diane; Myers, Robert; Preston, Samuel H.; Steuerle, Eugene; Sze, Michael; Utgoff, Kathleen; Wiltse, Larry; Wolfe, Barbara
    The Panel's major conclusions are: The "intermediate" projection of the Trustees Report for the Old-Age. Survivors. and Disability Insurance (OASDI) program provide a reasonable evaluation of the financial status. Although the Panel suggests that modifications be considered in various specific assumptions, the overall effect of those suggestions would not significantly change the financial status evaluation. There should be evolutionary implementation of procedures to indicate more adequately the uncertainties involved in the projections. Even though such uncertainties are unavoidable, stochastic analysis should be used to examine more explicitly the probabilities of alternative projections. It is emphasized that there should be an extended period during which the new procedures would supplement, rather than replace, the current methods of considering high-cost and low-cost projections and individual assumption sensitivity analysis. Evaluation of the long-range financial status should put less emphasis on the "75-year actuarial balance" and the "test of long-range close actuarial balance." Prior to enactment of legislation reforming the program, primary emphasis should be on the projected date the Trust Fund Ratio would fall below 100 percent; when definitive legislative revisions are adopted, subsequent long-range evaluation should compare up-dated projections with the intended results of the legislation. There should be a substantial expansion of SSA's resources and its interaction with experts in related areas: increased recognition should be given to the interrelationships between OASDI and many public and private programs as well as other aspects of the economy. Social Security Administration (SSA) staff does high quality work, but is relatively small and works with inadequate resources. In addition to internal expansion, there should be greater use of outside consultants and contractual research; periodic comprehensive review by technical panels should be supplemented by ongoing arrangements for advice on specific matters.
  • Publication
    The US Health Care System and Lagging Life Expectancy: A Case Study
    (2009-03-25) Preston, Samuel; Ho, Jessica Y.
    Life expectancy in the United States fares poorly in international comparisons. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral factors. This paper compares mortality trends from prostate cancer in the United States to those in other developed countries. Prostate cancer is chosen because it can be detected at an early stage, because effective treatments are available, and because it is less heavily influenced by behavioral factors than most other chronic diseases. We find that, after the introduction of the PSA screening test for prostate cancer, mortality from the disease declined significantly faster in the United States than in the set of comparison countries. Trends in incidence and survival rates support the interpretation that the US health care system has worked very effectively to reduce mortality from this important disease. A brief consideration of breast cancer suggests that similar processes may have been at work among women.
  • Publication
    Using Successive Censuses to Reconstruct the African-American Population, 1930-1990
    (1996-12-01) Preston, Samuel H.; Elo, Irma T.; Gale, Lynn
    The Census Bureau's program to estimate the completeness of decennial census counts for age, sex, and race groups relies principally upon what it terms "demographic analysis." The essence of this approach is to introduce extraneous information on the number of births, deaths, and migrations, derived from non-census sources, to estimate the true size of each birth cohort at the time of a census (Robinson et al., 1993; Himes and Clogg, 1992). Comparison of this alternative estimate to the census count provides an estimate of the degree of under - or over-enumeration in the census, often termed the census undercount. Acceptance of the estimated undercount implies that the census itself is irrelevant to estimating the true size of the population; whatever deficiencies it contained would be accurately and completely revealed by comparison to the estimate based on demographic analysis.
  • Publication
    Are Educational Differentials in Mortality Increasing in the United States?
    (1994-08-01) Preston, Samuel H.; Elo, Irma T.
    Because of the value that individuals place on health and longevity, levels of mortality are among the most central indicators of social and economic well-being. Analysts are concerned not only with the average level of mortality but also with its distribution among social groups, which is a fundamental indicator of social inequality. The principal dimension on which these assessments are now made in the United States is educational attainment. The decisive shift from occupational groups, the classic dimension used by the Registrar-General of England and Wales, to educational groups as the basis for assessment occurred with the publication of Kitagawa and Hauser's (1973) major study of American mortality differentials in 1960. Educational attainment has two main advantages relative to occupation and income, the other common indicators of social stratification. It is available for people who are not in the labor force; and its value is less influenced by health problems that develop in adulthood. Since health problems can lead to both high mortality and low income, comparisons of death rates of different income groups, for example, are biased by their mutual dependence on a third variable, the extent of ill health. For these reasons, educational attainment has become the principal social variable used in epidemiology as well as in demography (Liberatos et al. 1988).
  • Publication
    A New Method for Attributing Changes in Life Expectancy to Various Causes of Death, with Application to the United States
    (2007-04-05) Beltrán-Sánchez, Hiram; Preston, Samuel
    This article focuses on decomposition of changes in life expectancy by cause of death. We propose an alternative to Arriaga's (1984) method for performing such decompositions. We apply our method to changes in life expectancy in the United States between 1970 and 2000 and compare results to those produced using Arriaga's formulation. The major difference between the approaches pertains 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.
  • Publication
    Effects of Age Misreporting on Mortality Estimates at Older Ages
    (1997-09-01) Preston, Samuel H.; Elo, Irma T.; Stewart, Quincy
    This study examines how age misreporting typically affects estimates of mortality at older ages. We investigate the effects of three patterns of age misreporting & age overstatement, age understatement, and symmetric age misreporting & on mortality estimates at ages 40 and above. We consider five methods to estimate mortality: conventional estimates derived from vital statistics and censuses; longitudinal studies where age is identified at baseline; variable-r procedures based on age distributions of the population; variable-r procedures based on age distributions of deaths; and extinct generation methods. For each of the age misreporting patterns and each of the methods of mortality estimation, we find that age misstatement biases mortality estimates downwards at the oldest ages.
  • Publication
    Recent Changes in US Mortality: Continued Deterioration Relative to Peers
    (2017-09-18) Vierboom, Yana; Preston, Samuel
    Several recent studies have documented a slowdown in rates of improvement in mortality in the United States (Case and Deaton 2017; Crimmins et al. 2011; Institute of Medicine and National Research Council 2013; Kochanek et al. 2016; Squires and Blumenthal 2016). Middle-aged white women have actually experienced rising mortality over much of the past several decades (Astone et al. 2015; Case and Deaton 2015; Kochanek 2016). The relatively slow declines in US mortality occur against a background in which US mortality was already high by standards of other OECD countries (Crimmins et al. 2011; Institute of Medicine and National Research Council 2013; Ho 2013; Ho and Preston 2010; Palloni and Yonker 2016). In this paper, we describe recent patterns of change in US adult death rates by age in comparison to those of other OECD countries. This age-pattern of change has received relatively little attention in previous accounts.