“Altared,” Frarytd

 January 30, 2020; New York Times and Wall Street Journal

“Life expectancy is the most basic measure of the health of a society, and declines in developed countries are extremely unusual,” note Sabrina Tavernise and Abby Goodnough in the New York Times. So, it shouldn’t be news that US life expectancy climbed from 78.6 years to 78.7 years in 2018. However, 2018 marks the end of three consecutive years of declining life expectancy in this country. And US life expectancy in 2018 remains below its 2014 peak of 78.9 years.

This decline has been driven by what have come to be called “deaths of despair”—drug overdoses, alcohol-related deaths, and suicides. A single year’s increase does not necessarily mean that the US is now back on a sustained upward trajectory. But public health efforts by nonprofits and public agencies seem to be having an impact. A federal report released yesterday confirmed the first decline in drug deaths since the opioid epidemic began. In 2018, there were 67,367 drug overdose deaths in the US, a 4.1 percent decline from 2017 (70,237 deaths).

Tavernise and Goodnough caution, “The increase in life expectancy…was small—just over a month.” It is still too early to tell if the reduction in opioid overdoses will be sustained.

“It’s good news, but we don’t know yet if it’s the beginning of a new trend,” notes Elizabeth Arias, a demographer at the National Center for Health Statistics, an agency housed within the federal Centers for Disease Control and Prevention (CDC), which released the report. The two biggest drivers of this year’s life expectancy increase were a decline in cancer mortality rates and the decline of so-called “unintentional deaths” (mostly drug overdose-related).

Cancer deaths, notes Rebecca Siegel, the scientific director of surveillance research at the American Cancer Society in Atlanta, have been declining rapidly. In 2017, the overall cancer mortality rate drop was the largest since record-keeping began around 1930. Gains have been especially rapid with lung cancers, due both to declining tobacco use and treatment advances.

The good news is also tempered by the fact that, as Tavernise and Goodnough point out, “the United States lags far behind most European countries in life expectancy.” According to John Haaga, who served as director of the Division of Behavioral and Social Research at the National Institute on Aging before retiring last month, back in 2004, when he started working at the agency, life expectancy in the US was about equal to that of Portugal. But since then, the Portuguese have gained four years in their life expectancy, while Americans have gained only one. A similar trend can be seen with other countries—such as Costa Rica, Cuba, and Slovenia—all of which now have life expectancy levels that are higher than in the United States.

In the Wall Street Journal, Janet Adamy interviews Dr. Georges C. Benjamin, who serves as the executive director of the American Public Health Association. Benjamin highlights the irony of the US dramatically outspending its peer nations on healthcare, even as Americans live less long: “The United States should not celebrate because we are spending twice as much money as the other developed nations and getting worse outcomes.”—Steve Dubb