Causes of death contributing to changes in life expectancy in New York City between 1983 and 1992

Recent changes in life expectancy among race and sex groups in New York City were evaluated by analyzing the relative effects of different causes of death in 1983 and 1992, a period in which life expectancy at birth declined by 1.1 years among white males, remained unchanged among black males, and increased 1.2 years among white and black females. Heart disease was found to be the leading cause of death making positive contributions to changes in life expectancy regardless of race or sex, and HIV/AIDS was the leading negative contributor. Overall, deaths from infectious diseases and external causes are becoming more important compared to degenerative conditions in explaining trends in life expectancy in New York City. Past improvements in survival due to reductions in infant deaths are being reversed due to an increase in deaths from preventable causes such as violence and AIDS. Future gains in longevity may require a greater emphasis on policies and programs emphasizing conflict resolution and HIV prevention.