Between 1959 and 2014, the United States experienced an unprecedented increase in life expectancy, rising from 69.9 years to 78.9 years. However, after 2014, life expectancy began declining. The US experienced three years in a row of declining life expectancy, the first such prolonged decline since 1915 to 1918, when Americans experienced both World War I and a flu pandemic. The United States is now the only developed country in the world whose average life expectancy stopped increasing after 2010, ranking 35th globally. The average American can expect to live 3.5 years less than the average Canadian.
A comprehensive report in JAMA identified the causes of this decline, focusing on midlife adults ages 25 to 64. Since 1999, drug overdose deaths in midlife increased almost 400%, while deaths from alcoholic liver disease and suicide increased by about 40% each. Mortality rates from illnesses related to high blood pressure increased by nearly 80%, while those from obesity-related illness rose 114%. Meanwhile, deaths due to heart disease, cancer, HIV, and motor vehicle injuries have decreased substantially.
Disparities Across Demographics
Men have lower life expectancy than women overall, though overdose deaths among women increased 1.4 times higher than among men. Deaths related to alcoholic liver disease were 3.4 times higher among women than men. Death rates of non-Hispanic black individuals in midlife have remained substantially higher compared with non-Hispanic white people over the past decades, with a relative increase of over 170% in fatal drug overdoses between 2010 and 2017.
Where people live significantly impacts life expectancy, with a seven-year difference between the highest and lowest life expectancy states. States hit hardest by the opioid overdose epidemic have seen decreases in life expectancy, particularly those in New England and the Ohio Valley. Between 2010 and 2017, over 33,000 excess deaths occurred, with about a third occurring in just four Ohio River Valley states: West Virginia, Ohio, Indiana, and Kentucky.
Potential Solutions
The nation must address stigma around addiction, increase treatment resources, guarantee access to inexpensive medicines for chronic conditions, recognize mental illness as a chronic disease with appropriate behavioral health services, and address social determinants of health to resume progress in extending people’s lives. A positive note: a 2018 report showed life expectancy increased by 0.1 years.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.health.harvard.edu/blog/whats-in-a-number-looking-at-life-expectancy-in-the-us-2020020718871