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‘An emergent crisis’: U.S. life expectancy falls for third year in a row

Since the 1980s, U.S. life expectancy has been losing pace with other developed countries, and is now decreasing — even though U.S. spending on health care “vastly” exceeds that of other wealthy nations, the study points out.

Since the 1980s, life expectancy in United States has been losing pace with other developed countries, and is now decreasing — even though U.S. spending on health care “vastly” exceeds that of other wealthy nations, the new study points out.
Photo by Aaron Burden on Unsplash

The life expectancy of Americans has fallen for the third year in a row, and the decrease is being driven by the growing numbers of deaths of working-age people — those between the ages of 25 and 64, according to a deeply troubling study published recently in the Journal of the American Medical Association (JAMA).

From 1959 through 2016, life expectancy in the United States climbed by almost 10 years, from 69.9 years in 1959 to 78.9 years in 2014, the study reports. Most of that increase occurred, however, during one decade: 1969 to 1979.

After 1980, U.S. life expectancy rose more slowly, eventually plateauing after 2010 and then falling for three straight years, starting in 2015.

The life expectancy of babies born in the U.S. in 2017 was 78.6 years.

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“This is an emergent crisis,” said Dr. Steven Woolf, the study’s lead author and director emeritus of the Center on Society and Health at Virginia Commonwealth University, in an interview with Reuters reporter Linda Carroll. “And it is a uniquely American problem since it is not seen in other countries. Something about life in America is responsible.”

Since the 1980s, life expectancy in United States has been losing pace with other developed countries, and is now decreasing — even though U.S. spending on health care “vastly” exceeds that of other wealthy nations, the new study points out.

“According to one estimate, if the slow rate of increase in US life expectancy persists, it will take the United States more than a century to reach the average life expectancy that other high-income countries had achieved by 2016,” Woolf and his co-authors write.

As Woolf explained in his Reuters interview, those other high-income countries are not experiencing higher death rates among their working-aged adults. That’s likely because “in other countries there are more support systems for people who fall on hard times,” he said. “In America, families are left to their own devices to try to get by.”

Estimated Excess Deaths From Increasing Midlife Mortality, United States, 2010-2017
Estimated Excess Deaths From Increasing Midlife Mortality, United States, 2010-2017

A variety of causes

Like other recent research has noted, this new study found that a greater proportion of Americans, particularly those at midlife, are dying from “deaths of despair” — drug-overdoses, suicides and alcoholism-related diseases — than in the past. But the current study also reports that Americans are dying at earlier ages from a variety of other causes, including heart disease, stroke, diabetes, pregnancy, certain cancers, infectious diseases and Alzheimer’s disease.

As an editorial that accompanies the study points out, obesity, which now affects almost 40 percent of American adults, is a factor in many of these early deaths, particularly ones caused by heart disease, stroke, diabetes and cancer.

“The negative effects of obesity on life expectancy were first predicted nearly 15 years ago,” the editorial notes.

But poverty, income inequality and other economic stressors are also factors. The study found that the highest increases in mortality rates are in the industrial Midwest (particularly Ohio, Pennsylvania, Kentucky and Indiana) and other regions of the country that have been hard-hit since the 1980s by the loss of manufacturing jobs and other negative changes in the economy.

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That pattern can also be observed within states. For example, in Minnesota and four other states (California, Kansas, Missouri and Virginia), increases in deaths among working-aged adults from “stress-related” conditions (drug overdoses, suicide, alcohol poisoning and alcohol-related liver disease) were highest in counties with a long history of high levels of poverty, unemployment and stagnant household income, the study reports.

“You have people and communities that have gone through a long period of economic stress,” Woolf told HealthDay reporter Dennis Thompson. “If you’re a family that’s been struggling for many years with these kind of stresses, that might lead to a set of consequences that could affect your health in multiple ways.”

But that stress doesn’t only lead people to turn to drugs, alcohol or suicide, he added. Americans who are struggling economically tend to live in conditions — known as “social determinants of health” — that can undermine their health. They may have limited access to healthful foods or may live in unsafe neighborhoods, for example. They may also not have enough money to afford health care or medications to treat chronic diseases, such as heart disease and type 2 diabetes.

“It might turn out that investment in the middle class, and helping to bring jobs and economic development to those communities, might do more to save lives than adding another wing onto the hospital,” Woolf said.

FMI: You’ll find the study on JAMA’s website. The data used in the study comes from the Centers for Disease Control and Prevention’s WONDER database and the U.S. Mortality Database. Life expectancy data for 2018 is not yet available, but should be sometime early next year.