Drugs, alcohol and suicides contributing to alarming drop in US life expectancy

February 07, 2018

Drugs, alcohol and suicides are contributing to an alarming drop in US life expectancy, particularly among middle-aged white Americans and those living in rural communities, warn experts in The BMJ today.

Steven Woolf at Virginia Commonwealth University and Laudan Aron at the Urban Institute in Washington DC, argue that the ideal of the "American Dream" is increasingly out of reach as social mobility declines, and fewer children face a better future than their parents.

US life expectancy has decreased for the second year in a row, they explain. This is alarming because life expectancy has increased for much of the past century in advanced countries, including the US.

In 1960, for example, Americans had the highest life expectancy - 2.4 years longer than the average for countries in the Organization for Economic Cooperation and Development (OECD). But the US started losing ground in the 1980s, when life expectancy fell below the OECD average in 1998, plateaued in 2012, and is now 1.5 years shorter than the OECD average.

A 2013 report found that Americans have poorer health in many areas, including birth outcomes, injuries, homicides, adolescent pregnancy, HIV/AIDS, obesity, diabetes, and heart disease.

Americans also engage more in unhealthy behaviors (such as high calorie intake, drug abuse, and firearm ownership), live in cities designed for cars rather than pedestrians or cyclists, have weaker social welfare supports, and lack universal health insurance.

The report also found high US death rates from drugs. Between 2000 and 2014, the rate of fatal drug overdoses increased by 137%, a crisis fueled by the growing use of highly addictive opioid drugs. And in 2015 alone, more than 64,000 Americans died from drug overdoses, devastating families and the social fabric of communities.

US death rates from alcohol abuse and suicides have also been increasing, say the authors. Between 1999 and 2014, the suicide rate increased by 24%, disproportionately impacting white Americans aged 25-59 years, those with limited education, and women. The sharpest increases are occurring in rural counties, often with longstanding social and economic challenges.

Why white Americans are dying at higher rates from drugs, alcohol, and suicides is unclear, complex, and not explained by opioids alone, say the authors. Possibilities include the collapse of industries and the local economies they supported, the erosion of social cohesion and greater social isolation, economic hardship, and distress over losing the stability their parents once enjoyed.

The US is rich but this wealth is not inclusive, they write. Its social compact is weaker than in other countries - those in need have less access to social services, health care, or the prevention and treatment of mental illness and addiction.

In theory, policymakers would be keen to correct these conditions by promoting education, supporting struggling families and communities, and strengthening health care systems. Instead, the authors say, recent legislation and regulations may even prolong or intensify the economic burden on the middle class and weaken access to health care and safety net programs, they warn.

"The consequences of these choices are dire: not only more deaths and illness, but also escalating health care costs, a sicker workforce, and a less competitive economy. Future generations may pay the greatest price," they conclude.


Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.