Report: Americans are dying young

Death rates from suicide, drug overdoses, liver disease and dozens of other causes have been rising over the past decade for young and middle-aged adults, driving down overall life expectancy in the United States for three consecutive years, according to a strikingly bleak study published Tuesday that looked at the past six decades of mortality data.

The report, published in the Journal of the American Medical Association, was immediately hailed by outside researchers for its comprehensive treatment of a still-enigmatic trend: the reversal of historical patterns in longevity. The United States, despite massive expenditures on health care, has seen increasing mortality and falling life expectancy for people ages 25 to 64, who should be in the prime of their lives, while other wealthy nations have generally experienced continued progress in extending longevity. Although earlier research emphasized rising mortality among non-Hispanic whites, the broad trend detailed in this study cuts across gender, racial and ethnic lines. By age group, the highest relative jump in death rates from 2010-17 — 29 percent — has been among people ages 25 to 34. The findings are sure to fuel political debate about causes and potential solutions, because the geography of rising death rates overlaps to a significant extent with states and regions that are hotly contested in the run-up to the 2020 presidential election. About a third of the estimated 33,000 “excess deaths” that the study says occurred since 2010 were in just four states: Ohio, Pennsylvania, Kentucky and Indiana — the first two of which are critical swing states in presidential elections. The state with the biggest percentage rise in death rates among working-age people in this decade — 23.3 percent — is New Hampshire, the first primary state. “It’s supposed to be going down, as it is in other countries,” said the lead author of the report, Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “The fact that that number is climbing, there’s something terribly wrong.” He said many factors are at play. The opioid epidemic is a major driver of the worrisome numbers, but far from the sole cause. The study found that improvements in life expectancy, largely because of lower rates of infant mortality, began to slowdown in the 1980s, long before the opioid epidemic became a national tragedy. The 33,000 excess deaths are an estimate based on the number of all-cause midlife deaths from 2010 to 2017 that would be expected if mortality was unchanged vs. the number of deaths actually recorded by medical examiners. “Some of it may be due to obesity, some of it may be due to drug addiction, some of it may be due to distracted driving from cellphones,” Woolf said. Given the breadth and pervasiveness of the trend, “it suggests that the cause has to be systemic, that there’s some root cause that’s causing adverse health across many different dimensions for working-age adults.” The all-cause death rate — meaning deaths per 100,000 people — rose 6 percent from 2010-17 among working-age people in the United States. Men, overall, have higher all-cause mortality than women, but the report pulls out some disturbing trends. Women are succumbing to diseases once far more common among men, even as men continue to die in greater absolute numbers. The risk of death from drug overdoses increased 486 percent for midlife women between 1999 and 2017; the risk increased 351 percent for men in that same period. Women also experienced a bigger relative increase in risk of suicide and alcohol-related liver disease.