Vierboom, Yana
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Publication Recent Changes in US Mortality: Continued Deterioration Relative to Peers(2017-09-18) Vierboom, Yana; Preston, SamuelSeveral 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.Publication The Contribution of Differences in Adiposity to Educational Disparities in Mortality in the United States(2017-06-05) Vierboom, YanaBackground: There are large differences in life expectancy by educational attainment in the United States. Previous research has found obesity’s contribution to these differences to be small. Those findings may be sensitive to how obesity is estimated. Methods: This analysis uses discrete time logistic regressions with data from the National Health and Nutrition Examination Survey (NHANES), pooled from 1988-1994 and 1999-2010, to estimate the contribution of differences in adiposity, or body fat, to educational differences in mortality. I show that results depend upon the measure of adiposity used: body mass index (BMI) at survey or lifetime maximum BMI. Results: High school graduates had higher BMIs at time of survey than college graduates (28.6 vs 27.3, respectively), as well as higher maximum BMIs (30.8 vs 29.1, respectively. Lifetime maximum BMI performed better than BMI at survey time in predicting mortality using criteria for model selection. Differences in maximum BMI were associated with 9.2% of educational mortality differences, compared to 2.2% for BMI at survey. Among non-smokers, 15.8% of the differential was associated with differences in maximum BMI. Contribution: Adiposity is an overlooked contributor to educational differences in mortality. Previous findings that obesity does not contribute to educational disparities were based on BMI at survey, which is less informative than maximum BMI. The contribution of adiposity to educational mortality differences will likely grow as smoking prevalence declines. Health surveys should collect information on weight history.