Catching up with stagnation: cause-specific dynamics of change in life expectancy at age 65 in the United States, Canada and Latin America, 2000-2019.

Background and objectives: Recent focus on United States longevity stagnation at higher ages has focused on comparisons with other high-income countries, with less attention paid to its performance relative to peer nations in the Americas. This study examines changes in life expectancy at age 65 (LE65) in the United States, Canada, and seven Latin American countries-Argentina, Brazil, Chile, Costa Rica, Colombia, Mexico, and Peru-between 2000 and 2019, disaggregated by sex and cause of death.

Research design and methods: This observational study used United Nations World Population Prospects life tables and World Health Organization death causes data, applying decomposition methods to assess the contribution of death causes to changes in LE65.

Results: United States, Canada, and Costa Rica experienced substantial increases in LE65 during 2000-2010 in both sexes, with gains ranging from 1.3 to 2 years. These gains were primarily driven by reductions in cardiovascular disease (CVD) mortality, which contributed between 1 and 1.3 years to LE65 growth, widening the gap with some Latin American countries. From 2010-2019, the contribution of CVD to LE65 more than halved (and the relative contribution of CVD to gains in LE65 diminished in the United States, Canada and Mexico), and total gains in LE65 stagnated between 0.5 and 1 years. Females presented a higher relative contribution of CVD to changes in LE65 than males.

Discussion and implications: Thestagnation in LE65 observed across the Americas during 2010-2019 highlights the need for developing national, sex-specific strategies to reduce cardiovascular mortality across countries in the region.