An Alternative Mathematical Modeling Approach to Estimating a Reference Life Expectancy

Elizabeth R. Stevens, Qinlian Zhou, Glen B. Taksler, Kimberly A. Nucifora, Marc Gourevitch, R. Scott Braithwaite

Research output: Contribution to journalArticlepeer-review


Background. Reference life expectancies inform frequently used health metrics, which play an integral role in determining resource allocation and health policy decision making. Existing reference life expectancies are not able to account for variation in geographies, populations, and disease states. Using a computer simulation, we developed a reference life expectancy estimation that considers competing causes of mortality, and is tailored to population characteristics. Methods. We developed a Monte Carlo microsimulation model that explicitly represented the top causes of US mortality in 2014 and the risk factors associated with their onset. The microsimulation follows a birth cohort of hypothetical individuals resembling the population of the United States. To estimate a reference life expectancy, we compared current circumstances with an idealized scenario in which all modifiable risk factors were eliminated and adherence to evidence-based therapies was perfect. We compared estimations of years of potential years life lost with alternative approaches. Results. In the idealized scenario, we estimated that overall life expectancy in the United States would increase by 5.9 years to 84.7 years. Life expectancy for men would increase from 76.4 years to 82.5 years, and life expectancy for women would increase from 81.3 years to 86.8 years. Using age-75 truncation to estimate potential years life lost compared to using the idealized life expectancy underestimated potential health gains overall (38%), disproportionately underestimated potential health gains for women (by 70%) compared to men (by 40%), and disproportionately underestimated the importance of heart disease for white women and black men. Conclusion. Mathematical simulations can be used to estimate an idealized reference life expectancy among a population to better inform and assess progress toward targets to improve population health.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalMDM Policy and Practice
Issue number1
StatePublished - 2019


  • idealized scenario
  • mathematical simulation
  • maximum achievable life expectancy

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'An Alternative Mathematical Modeling Approach to Estimating a Reference Life Expectancy'. Together they form a unique fingerprint.

Cite this