US expectancy at 25 year low

 From a tweet by Eric Topol

Now at a 25 year low, life expectancy in the US continues to fall. Covid persists as the 3rd leading cause of death and increasing ~20% over 2020

And it's not just Covid.  Look at the surge in mortality from fentanyl.

From a reply by Elpenor Dignam

The third graphic is interesting.  I'm not sure how that squares with the USA spending a much larger percentage of GDP on health than other countries, with inferior outcomes.  Why it's interesting is that the rise in life expectancy in developed countries is so well correlated with the rise in health expenditure.

See my earlier piece Shit-Life Syndrome.

US life expectancy falls again

For the third year in succession, US life expectancy has fallen.

Source: The Economist
Does not include 2017 & 2018 data.

From Science Alert:

The US is the only wealthy country in the world where the life expectancy needle is moving the wrong way.

Between 1959 and 2014, the average length of time that Americans were expected to live was on the rise. Now, for the third year in a row, it's declining, according to a new study published in the Journal of the American Medical Association.

"Americans operate under a lot of misconceptions about how superior we are in many facets of our lives and this is not one of them," the study's lead author Steven Woolf told Business Insider. "We may think we have best medical care in world and highest life expectancy … but that's not the case."

This decline can't be linked to just one ethnicity, gender, or geographic area, either: It originates among an entire age group. People between the ages of 25 and 64 in the US are dying at higher rates, wracked by health problems like opioid addiction, obesity, alcoholic liver disease, and suicide.

Despite having the highest per capita health care spending in the world, Americans are "more likely to die before age 65 than people in other countries," Woolf added. "Their children, too, are less likely to live as long".

Woolf and his co-author Heidi Schoomaker's new study looked at more than 50 years' worth of data on US life expectancy from the US Mortality Database and the US Centres for Disease Control and Prevention's WONDER database.

Results showed that, in the 1970s, the country experienced a rapid and significant jump in life expectancy. But by the 1990s, that increase started to level off.  In 2011, US life expectancy plateaued, and three years later it started to drop.

"We've reached the point where we're going into a free fall," Woolf said.

Medical advances, particularly in the realms of cancer treatment and heart health, prompted an almost 10-year increase in the average American's lifespan. Between 1959 and 2013, life expectancy rose from 69.9 years to 78.9 years. Now, however, that average has dropped to 78.6 years.

The news isn't good if you compare it to other countries, either. In 1960, Americans had the highest life expectancy of any country in the world. But in the past couple of years, the US has plummeted to the bottom of the list of countries with a similar GDP and high average income, according to the Kaiser Family Foundation.

In fact, the US is currently ranked in the mid-40s globally in terms of life expectancy, squished between countries like Lebanon, Cuba, and Chile, which have GDPs that fall far short of our own.

This counterintuitive trend – of an affluent, first-world country that spends billions on privatised healthcare losing swaths of their middle-aged working class – could be traced back to one massive elephant in the room.

"It's a quandary of why this is happening when we spend so much on healthcare," Woolf said, adding: "But my betting money is on the economy."

Upticks in suicides, drug overdoses, and alcohol-related diseases "are all symptoms of people struggling in a poor economy who can't afford housing, find consistent jobs," and despair because of it, according to Woolf.

Drug overdose, alcohol abuse, and suicide – referred to by some as "deaths of despair" – appear to be the primary culprits [of the rising mortality rates].

This age group [25 -64] experienced a nearly four-fold increase in fatal drug overdoses between 1999 and 2017.

Suicide rates went up by nearly 40 percent for people between the ages of 25 and 64, and by 56 percent for people ages 55 to 64 during the same time frame. For Americans between the ages of 25 and 34, the rate of alcohol-related disease deaths spiked almost 160 percent, as well.

Obesity-related mortality rates among this age group also went up by 114 percent, and deaths linked to high blood increased by about 80 percent.

"Working-age Americans are more likely to die in the prime of their lives," Woolf said. Between 2010 and 2017, midlife US adults experienced a 6 percent total increase in mortality rate.

"We are seeing social determinants of health shaping well-being and outcomes," Howard Koh, a professor at the Harvard T.H. Chan School of public health who was not involved in the study, told Business Insider.

"Forces like income inequality and unstable employment cause psychological distress and drive conditions by which diseases and deaths occur," he added.

In countries around the world, research has shown that people with lower incomes die sooner than their wealthier counterparts.  A 2017 study linked low socioeconomic status to significant reductions in life expectancy.

But what makes the US unique, according to Woolf, is that "poor people in other countries live longer than poor people in our country".

[Read more here]


I talked about this before, in my piece Shit-Life Syndrome.  The standard American diet (SAD) is undoubtedly one factor in falling life expectancy, but that doesn't explain suicide, now at the highest rate since the Great Depression, nor rising deaths from alcoholism.  Rising inequality is killing people.  It's time for a change.

Shit-life syndrome

(Source)

In the anglosphere, where neo-liberalism has found its most enthusiastic acolytes, life expectancy is declining.  This is especially true of the US and the UK:

Britain and America are in the midst of a barely reported public health crisis. They are experiencing not merely a slowdown in [the rise in] life expectancy, which in many other rich countries is continuing to lengthen, but the start of an alarming increase in death rates across all our populations, men and women alike. We are needlessly allowing our people to die early.

In Britain, life expectancy, which increased steadily for a century, slowed dramatically between 2010 and 2016. The rate of increase dropped by 90% for women and 76% for men, to 82.8 years and 79.1 years respectively. Now, death rates among older people have so much increased over the last two years – with expectations that this will continue – that two major insurance companies, Aviva and Legal and General, are releasing hundreds of millions of pounds they had been holding as reserves to pay annuities to pay to shareholders instead. Society, once again, affecting the citadels of high finance.

Trends in the US are more serious and foretell what is likely to happen in Britain without an urgent change in course. Death rates of people in midlife (between 25 and 64) are increasing across the racial and ethnic divide. It has long been known that the mortality rates of midlife American black and Hispanic people have been worse than the non-Hispanic white population, but last week the British Medical Journal published an important study re-examining the trends for all racial groups between 1999 and 2016 .

The malaises that have plagued the black population are extending to the non-Hispanic, midlife white population. As the report states: “All cause mortality increased… among non-Hispanic whites.” Why? “Drug overdoses were the leading cause of increased mortality in midlife, but mortality also increased for alcohol-related conditions, suicides and organ diseases involving multiple body systems” (notably liver, heart diseases and cancers).

US doctors coined a phrase for this condition: “shit-life syndrome”. Poor working-age Americans of all races are locked in a cycle of poverty and neglect, amid wider affluence. They are ill educated and ill trained. The jobs available are drudge work paying the minimum wage, with minimal or no job security. They are trapped in poor neighbourhoods where the prospect of owning a home is a distant dream. There is little social housing, scant income support and contingent access to healthcare. Finding meaning in life is close to impossible; the struggle to survive commands all intellectual and emotional resources. Yet turn on the TV or visit a middle-class shopping mall and a very different and unattainable world presents itself. Knowing that you are valueless, you resort to drugs, antidepressants and booze. You eat junk food and watch your ill-treated body balloon. It is not just poverty, but growing relative poverty in an era of rising inequality, with all its psychological side-effects, that is the killer.

[Read more here]

Nearly all indicators of inequality show American income disparities have increased since the late 1970s. The magnitude of change in inequality is sensitive to the particular income measure we use, but essentially all measures imply that income gaps are bigger today than they were three decades ago.

Statisticians analyzing the most comprehensive income measures find that much of the jump in inequality was due to gains at the very top of the distribution. More than three-quarters of the relative income gains enjoyed by Americans in the top fifth of the income distribution were obtained by people in the top 1% of the distribution.

As many observers have noted, the United States has exceptionally wide inequality for a high-income country. It also has relatively low average life expectancy. Among 34 countries in the Organization of Economic Cooperation and Development (OECD), the U.S. ranks 27th in life expectancy at birth. If we limit our comparison to the 21 large OECD countries with high incomes, America ranks dead last. This lowly rank is especially surprising because average income in the U.S. is about 40% higher than it is on average in other OECD countries, and real health spending per person is about 150% higher than it is in the other countries. Of course, wide income disparities in the U.S. mean that low-income Americans have lower incomes than people in comparable positions in the income distributions of many other rich countries.

A recent study of American life expectancy uncovered trends that may be partly traceable to increased income inequality. S. Jay Olshansky and his colleagues found evidence that white men and women who lack high school diplomas have seen a noticeable drop in life expectancy over the past three decades. These groups have struggled as job prospects for less educated workers have dried up. Their declining economic position may be worsening their chances of living a long life.

An older study of changes in life expectancy used Social Security records to determine the relationship between workers’ position in the wage distribution and their mortality rates. Hilary Waldron, a Social Security Administration researcher, estimated mortality rates of white men born between 1912 and 1941 who had earnings between ages 45 and 55. She divided these men according to their average position in the earnings distribution when they were between 45 and 55, and she then determined the effects of their income position on their mortality rates between ages 60 and 89. Between ages 60 and 80 men with a worse earnings position had a higher mortality rate. More disturbingly, the mortality differential between low-earnings and high-earnings men increased substantially over time. The mortality rates of both low-earnings and high-earnings men improved during the period Waldron examined. However, improvements in life span overwhelmingly favored the men at the top of the earnings distribution. Men born in 1912 who had earnings in the top half of the wage distribution lived 1.2 years longer than men born in the same year who had earnings in the bottom half of the earnings distribution. For men born in 1941 the difference in life expectancy soared. Better paid men in the younger birth cohort can expect to live 5.8 years longer than men born in the same year who are in the bottom half of the wage distribution.

[Read more here]

Neo-liberalism has led to an extraordinary increase in inequality and a simultaneous decline in life expectancy.  Meanwhile, it appears that rising inequality reduces overall economic growth.  Why then do we still embrace it when it has clearly failed?  Why is it still the orthodoxy?