BACKGROUND: Years of potential life lost (YPLL) indirectly measures the burden of disease in a population and heavily puts weight on deaths in the young. This measure is often used with or as a component of other life expectancy and mortality metrics such as years lived with disability (YDLs) and disability-adjusted life years (DALYs). This combination provides a broader picture of mortality and morbidity in a population. There are a number of accepted methods to calculate YPLL depending on the research question and population of interest.
METHODS: America’s Health Rankings has calculated YPLL rates for all 50 states and the nation for the past 26 years using 75 years as the reference age. While these data provide a consistent benchmark for states to track progress, they do not account for different age structures between states and changing age distributions within states over time. An adjusted estimate of years of life lost was calculated by multiplying the YPLL in each age group by the weight of that age group in the state compared with the nation. Summing the years of potential life lost over all age groups within a state gives the YPLL. For this presentation, we calculated the YPLL using the 2006 non-standard population; we chose this as the midpoint between the years of interest, 1999 to 2013.
RESULTS: Overall, the adjusted YPLL declined from 7,089 to 6,571 years per 100,000 population from 1999 to 2013. However, the rate has been relatively stagnant from 2010 to 2013 and has increased in certain states. Many Southern states—South Carolina, Louisiana, Mississippi, Kentucky, and Tennessee—remained well above the national average from 1999 to 2013. Georgia, Minnesota, New Hampshire, New Mexico, North Carolina, and Washington are the only states with a decrease in YPLL over the past two years.
CONCLUSIONS: Our results show that premature mortality tends to be similar between neighboring states or within specific regions of the United States. We did not conduct significance testing and thus cannot point out statistically significant trends, but the stagnation in YPLL in the nation and in the majority of states suggests a lack of improvement in infant mortality rates, which has accounted for most of the decline in YPLL over the last two decades. Rising drug death rates, suicide rates, and diabetes prevalence could be slowing our nation’s progress in the YPLL measure.