{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:46:13Z","timestamp":1791726373111,"version":"4.3.4"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":54,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG075208"],"award-info":[{"award-number":["R01AG075208"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG074019"],"award-info":[{"award-number":["R01AG074019"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG024832"],"award-info":[{"award-number":["P30AG024832"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stagnating cardiovascular disease mortality and rising drug- and suicide-related deaths are key drivers of stalled US mortality improvements. However, prior research has largely overlooked disease histories preceding death, despite increasing multimorbidity. We examined changes in disease-history profiles in the US population and assessed how shifts in profile composition and within-profile mortality shaped mortality trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed adults aged \u226530\u2009years (N\u2009=\u2009510\u2009372) from the IPUMS-NHIS (National Health Interview Survey) 1997\u20132018 linked mortality files (follow-up through 2019). Latent class analysis on the pooled sample across all ages and years identified disease-history profiles based on self-reported cancer, diabetes, cardiovascular disease, mental health, internal diseases, obesity, and physical limitations. Logistic regression was used to estimate profile-specific 5-year mortality over time, and counterfactual decomposition was used to quantify the contributions of compositional change and within-profile mortality improvement to overall mortality trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five disease-history profiles were identified. Prevalence and 5-year death probability ranged from disease-free (62.4%; men 3.7% [95% confidence interval (CI) 3.5\u20133.8], women 2.4% [95% CI 2.3\u20132.5]) to high-burden multimorbidity (5.9%; men 17.8% [95% CI 16.8\u201318.8], women 12.6% [95% CI 11.9\u201313.3]), with substantial gradients across intermediate profiles. Profile composition varied substantially by gender, education, and race\/ethnicity. The disease-free population declined by nearly 1% annually, replaced primarily by cardiometabolic and high-burden multimorbidity profiles. Most profiles experienced stagnating or increasing mortality after the mid-2000s. The decomposition shows that within-profile mortality improvement was the dominant driver of declining mortality; compositional shifts, mostly driven by the declining disease-free share, partially offset these gains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Stagnating US mortality reflects both the growing prevalence of high-morbidity profiles and worsening or stagnating survival within them, highlighting the limited reach of prevention and disease-management efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ije\/dyag217","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:53:40Z","timestamp":1789041220000},"source":"Crossref","is-referenced-by-count":0,"title":["Sicker at all ages? Two decades of changing disease histories and mortality in the United States"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6531-8525","authenticated-orcid":false,"given":"Marcus","family":"Ebeling","sequence":"first","affiliation":[{"name":"Max Planck Institute for Demographic Research , Rostock,","place":["Germany"]},{"name":"Institute of Environmental Medicine, Karolinska Institute , Stockholm,","place":["Sweden"]},{"name":"Max Planck \u2013 University of Helsinki Center for Social Inequalities in Population Health , Rostock,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6671-8435","authenticated-orcid":false,"given":"Neil K","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Texas Medical Branch , Galveston (TX),","place":["United 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