Years of Potential Life Lost Before Ages 65 and 85 -- United States, 1989-1990

Years of potential life lost (YPLL) is a public health measure that reflects the impact of deaths occurring in years preceding a conventional cut-off year of age, usually 65 years. YPLL is calculated using final mortality data from CDC's National Center for Health Statistics (NCHS) (1) for the most recent year available and provisional mortality data (i.e., a 10% sample of deaths) (2) for the following year. This report summarizes final YPLL data for 1989 and provisional YPLL data for 1990.

In the United States during 1989, 12,339,045 years of potential life were lost before age 65 (YPLL-65) (Table 1), a total consistent with 1989 provisional data (12,370,499) (4). Provisional data for 1990 indicate that there were 12,083,228 YPLL-65, a 2.1% decline from 1989 (1,2; NCHS unpublished data, 1992).

As in the preceding 10 years, unintentional injuries were the leading cause of YPLL-65 in 1990, accounting for 17.8% of all YPLL-65, followed by malignant neoplasms (15.2%), intentional injuries (homicide and suicide) (12.6%), diseases of the heart (11.2%), congenital anomalies (5.3%), and human immunodeficiency virus (HIV) infection (5.3%). The remaining listed causes of death accounted for less than 15% of total YPLL-65.

From 1989 to 1990, YPLL-65 decreased for nine causes of death and increased for four (Table 1). The largest percentage increases in YPLL-65 were for HIV infection (9.9%) and intentional injuries (8.4%); the largest percentage decreases were for prematurity (14.8%), pneumonia and influenza (10.2%), chronic liver disease and cirrhosis (8.9%), and unintentional injuries (3.9%).

For 1990, the causes of death ranked differently when YPLL was calculated to age 85 years (YPLL-85). Neoplasms ranked highest (23.5% of all YPLL-85), followed by diseases of the heart (21.6%), unintentional injuries (10.6%), intentional injuries (7.5%), cerebrovascular diseases (3.7%), and HIV infection (3.6%). The remaining listed diseases combined contributed less than 14% of YPLL-85.

Reported by: Applications Br, Div of Surveillance and Epidemiology, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: Crude death rates (Table 1) weight all deaths equally (i.e., the rates provide an estimate of the proportion of a population that dies during a specific period). In comparison, YPLL emphasizes deaths at early ages in two ways: 1) by not including deaths occurring at ages beyond the cut-off, and 2) by giving greater computational weight to deaths among younger persons. YPLL is calculated by multiplying the number of deaths that have occurred in an age category by the difference between the cut-off age and the mid-year of the age category; the weighted products in each age category are then added. In 1989, deaths occurring among persons aged less than 65 years accounted for 28.5% of U.S. deaths; deaths occurring among persons aged less than 85 years accounted for 78.7% of U.S. deaths. Differences between the rankings of causes of death by YPLL-65 and YPLL-85 reflect relative differences in rates of death at different ages.

The concept of YPLL, first used by CDC in 1982, was employed to indicate premature mortality and preventability (5). YPLL-65 emphasizes causes of death among younger persons, some of which may be prevented by known interventions (e.g., smoking cessation, early prenatal care, responsible sexual behavior, and use of safety belts). Although the concept of YPLL has been instrumental in directing attention toward certain preventable conditions (e.g., unintentional injury), the precise nature of the relations among YPLL-65, premature mortality, and preventability has not been established.

References

1. NCHS. Advance report of final mortality statistics, 1989. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1992. (Monthly vital statistics report; vol 40, no. 8, suppl 2).

2. NCHS. Annual summary of births, marriages, divorces, and deaths: United States, 1990. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1991. (Monthly vital statistics report; vol 39, no. 13).

3. CDC. Premature mortality in the United States. MMWR 1986;35(no. 2S).

4. CDC. Update: years of potential life lost before age 65 -- United States, 1988 and 1989. MMWR 1991;40:60-2.

5. CDC. Introduction to Table V. Premature deaths, monthly mortality, and monthly physician contacts -- United States. MMWR 1982;31:109-10.

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