A study of life expectancy and mortality rates in the U.S. found it has risen since 1959, but the last three years have seen a decrease.
U.S. life expectancy dropped between 2014 and 2017 after losing pace with other wealthy countries in the 1980s, according to a study published in JAMA’s November 26, 2019, edition.
The study, which found an overall increase in life expectancy from 1959 (69.9 years) to 2016 (78.9 years), says the recent decrease is the culmination of increasing cause-specific mortality among adults between the ages of 25 and 64 beginning in the 1990s.
The study notes that, despite the “excessive spending” on healthcare, the U.S. has a long-standing health disadvantage relative to other high-income countries. It says that the increase in cause-specific deaths could be due to upticks in specific health issues. It cites an estimate that if the slow rate of increase in U.S. life expectancy continues, it could take more than 100 years to reach the average life expectancy that other high-income countries reached by 2016.
Fatal drug overdoses have had an influence on mid-life mortality since 1999. This increase primarily affects the white population and has come in three waves: the introduction of Oxycontin in 1996 and subsequent overuse of prescription opioids, increased heroin use by those addicted to prescription opioids, and the introduction of high-strength synthetic opioids such as fentanyl, according to the study.
Beside fatal drug overdoses, the study also identifies tabaco use, obesity, alcoholic liver disease, suicide, deficiencies in health care, psychological distress, and socioeconomic conditions as causes of the increase in mid-life mortality.
While the study says the U.S. has lower mortality rates from cancer and cerebrovascular disease than 16 other high-income countries, it cites The National Research Council’s examination of U.S. health disadvantages which identified nine domains which the country had poorer health outcomes than other high-income countries. These are:
· Drug-related deaths
· Adverse birth outcomes
· Injuries and homicides
· Adolescent pregnancy and sexually transmitted infections
· HIV and AIDS
· Obesity and diabetes
· Heart disease
· Chronic lung disease
This increase in cause-specific mortality led to an increase in all-cause mortality beginning in 2014 across all racial groups, according to the study.
The large increase in these mid-life mortality rates between 2010 and 2017 was associated with 33,307 excess U.S. deaths. The Ohio Valley was responsible for 32.8 percent of these deaths. The largest relative mid-life death increases occurred in New England and the Ohio Valley, with:
· New Hampshire: 23.3 percent
· West Virginia: 23 percent
· Ohio: 21.6 percent
· Maine: 20.7 percent
· Vermont: 19.9 percent
· Indiana: 14.8 percent
· Kentucky: 14.7 percent
The study says disparities between states could be due to different policy decisions on social determinants of health like education spending, minimum wage laws, and public health provisions.