US Life Expectancy Decreasing After Decades of Increasing

Life expectancy in the United States between 1959 to 2016 increased from 69.9 years to 78.9 years, but based on data from a recent JAMA study, rates are in decline.

Steven H Woolf, MD, MPH, and Heidi Schoomaker, MAEd, both from the Center on Society and Health, at Virginia Commonwealth University School of Medicine in Richmond, VA, explained in the study that after nearly 60 years, expectancy rates began to slow down and showed a decline in 2014.

“A major contributor has been an increase in mortality from specific causes (eg, drug overdoses, suicides, organ system diseases) among young and middle-aged adults of all racial groups,” explained Dr Woolf and Ms Schoomaker.

According to the results, there are several disparities in mortality rates across varying races and geographic locations. For example, “the [data that shows] White populations first experienced a larger increase in overdose deaths than nonwhite populations may reflect their greater access to health care (and thus prescription drugs),” stated the researchers.

They went on to explain that similarly, “[the fact that] non-Hispanic black and Hispanic populations experienced the largest relative increases in fentanyl deaths after 2011 may explain the retrogression in overdose deaths observed in these groups.”

When examining disparities across geographic locations, the researchers from Virginia Commonwealth University School of Medicine found that midlife mortality was higher in rural areas when compared to metropolitan counties. However, these “Geographic disparities in mortality were associated with demographic characteristics and with community contextual factors independent of individual and household characteristics.”

“The National Research Council examined the US health disadvantage in detail and identified 9 domains in which the United States had poorer health outcomes than other high-income countries.” These included:

• drug-related deaths;
• adverse birth outcomes;
• injuries and homicides;
• adolescent pregnancy;
• sexually transmitted infections (HIV and AIDS);
• obesity and diabetes;
• heart disease;
• chronic lung disease; and
• disability.

When comparing average mortality rates to 16 other high-income countries, the US had lower mortality rates in cancer and cerebrovascular diseases but higher mortality rates for several other major causes of death like circulatory disorders, external causes, and infectious diseases.

Researchers note that if trends continue this way, the US will need more than 100 years to regain the average life span that was expected in 2016.

The researchers concluded that the implications of the results of their research are substantial for public health and economy, and emphasized the importance of learning about the underlying causes.

—Edan Stanley

Reference:
Woolf SH, Schoomaker H. Life Expectancy and Mortality Rates in the United States, 1959-2017. JAMA. 2019;322(20):1996-2016. doi:10.1001/jama.2019.16932