Reports on HIV/AIDS: 1990

JANUARY 19,1990, MMWR, Vol. 39, No. 2, pp. 20-22
Years of Potential Life Lost
Before Ages 65 and 85 - United States, 1987 and 1988
Based on final mortality data from CDC's National Center for Health Statistics,
there were 12,074,193 years of potential life lost (YPLL) before age 65 in the United
States in 1987 (Table 1)-approximately the same as that previously reported on the
basis of provisional data (12,045,778 YPLL before age 65) (1). YPLL before age 65 is
a measure of mortality that reflects only deaths occurring before age 65 (2).
Provisional mortality data for 1988 show 12,281,741 YPLL before age 65-an increase
of 1.7% over final data for 1987. As in previous MMWR reports, YPLL before age 65
for 1987 and 1988 are calculated for the 15 leading causes of death (3) and certain
additional conditions of infancy.
In 1988, unintentional injuries remained the leading cause of YPLL before age 65
(18.9%), followed by cancers at all sites (14.7%), diseases of the heart (11.9%), suicide
and homicide (11.1%), and congenital anomalies (5.5%). From 1987 to 1988, YPLL
before age 65 caused by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) increased by 30% to become the sixth leading cause of
YPLL before age 65 (Table 1). YPLL before age 65 attributable to diabetes and to
homicide increased by 6% each, while YPLL before age 65 attributable to sudden
infant death syndrome (SIDS) decreased by 12%.
YPLL before age 85 reflect deaths occurring before age 85. In 1988, of the
23,398,098 YPLL before age 85, diseases of the heart were the leading cause (22.9%),
followed by cancers (20.1%), unintentional injuries (16.7%), suicide and homicide
(6.2%), and cerebrovascular diseases (3.9%). From 1987 to 1988, YPLL before age 85
associated with HIV/AIDS increased 30% to become the ninth leading cause of YPLL
before age 85. Suicide and pneumonia/influenza increased by 6%, diabetes by 5%,
and congenital anomalies by 4%; YPLL before age 85 associated with SIDS declined
by 12%.
Reported by: Div of Surveillance and Epidemiologic Studies, Epidemiology Program Office,
CDC.
Editorial Note: Crude mortality rates weight all deaths equally; in comparison, YPLL
before age 65 and YPLL before age 85 emphasize deaths among younger persons.
Measures of YPLL emphasize deaths among younger persons in two ways: 1) deaths
occurring beyond a specific cutoff age are not counted, and 2) deaths occurring at
younger ages are weighted more heavily. YPLL before age 85 emphasize deaths
among younger persons less than does YPLL before age 65. In 1988, 28.6% of deaths
occurred before age 65 and an additional 50.3% occurred before age 85.
Based on both crude mortality and YPLL measures, the largest change from 1987
to 1988 was the increase in HIV/AIDS-associated mortality. Although HIV/AIDS deaths
accounted for only 3.8% of YPLL before age 65, they accounted for more than one half
the 1.7% increase in YPLL before age 65 from 1987 to 1988.
References
1. CDC. Years of potential life lost before age 65-United States. MMWR 1987;38:27-9.
2. CDC. Premature mortality in the United States. MMWR 1986;35(no. 2S).
3. NCHS. Annual summary of births, marriages, divorces, and deaths: United States, 1988.
Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service,
CDC, 1989. (Monthly vital statistics report; vol 37, no. 13).