Journal of Business & Economic Policy

Modifiable Behavioral Risk Factors and the Value of Lifetime Earnings Lost among US Citizens From 2000-2016
GJ Putzer, MD, PhD; J Jaramillo, PhD

Abstract
There has been a steady, long-term decline in mortality rates in the US. Yet, modifiable behavioral risk factors still appear responsible for approximately one million yearly premature deaths or 40% of the annual total mortalities in the United States. This study evaluated seven modifiable behavioral risk factors (tobacco smoking, misuse of alcohol, poor diet and physical inactivity, motor vehicle crashes, suicide, illicit use of drugs, and risky sexual behaviors) with respect to using the value of lifetime earnings lost (VLTEL) attributable to premature deaths. In this study, we estimated US annual deaths caused by modifiable behavioral risk factors for the period of years inclusive of 2000-2016 and it was stratified by age groups. Annual deaths per modifiable risk factor and age group were used to estimate trends on mortality. Potential economic cost of these deaths was calculated using mortality cost and expected death distribution. Finally, expected life tables were obtained using yearly mortality. We assessed the overall trends of the seven modifiable risk factors over the last 16 years in the US and found putatively more than 1 million premature mortalities. This study also showed VLTEL associated with premature mortalities to be almost $400 billion on an annual basis. Smoking and obesity were the two most common risk factors. Illicit drug use and misuse of alcohol have been increasing quite rapidly over the last decade. There are several noteworthy trends in the data. Smoking is one modifiable risk factor that has been decreasing among US citizens. In contrast, several other risk factors, such as illicit use of drugs, have been increasing in both incidence and monetary costs. The premature deaths examined in this study are important from a public health and health management perspective because they represent potentially preventable loss of life.

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