US life expectancy is falling – here’s why

For most of the past century, life expectancy almost everywhere across the developed world has been on the rise. But not in the United States.

In 2014, life-expectancy-at-birth forecasts for Americans started to go into reverse. They’d been static for three years by that point – but the issue has been around for decades.

According to the American Medical Association, life expectancy began to slow in the US during the 1980s. By 1998, it had fallen behind the average life expectancy among OECD nations. And by 2011, it had stopped increasing.

Rising drug deaths

The problem has been attributed to an increase in mortality among the young and middle-aged.

Between 1999 and 2017, deaths caused by drug overdoses rose by 386.5% (from 6.7 deaths/100,000 to 32.5 deaths/100,000). A significant proportion of those deaths have been blamed on the so-called opioid epidemic.

Last year saw the first drop in overdose deaths since 1990, according to The New York Times. But at more than 68,000, those drug-related fatalities still number more than the highest ever annual levels of US death from car crashes, AIDS or guns. The biggest spike in drug deaths during that period was among those aged between 55 and 64 years old; from 2.3 deaths per 100,000 to 23.5 deaths per 100,000 – an increase of more than 900%.

That same group was found to be more likely to succumb to chronic liver disease and cirrhosis. During the 1999-2017 period, there was a 40.6% increase in mortality rates from alcohol-caused liver disease among that age group. But the generation below them has been hit even harder, with a 157.6% increase in deaths from alcohol-related liver disease.

A transatlantic tragedy

Across the Atlantic, life expectancy rates in Scotland have been hit by a wave of drug-related deaths, echoing the experience in the US.

More than two-thirds of drug-related deaths in Scotland were among people aged between 35 and 54 last year. Long-term use of drugs such as heroin has caused many people to age prematurely, exposing them to respiratory illness, liver disease and other conditions that make them vulnerable in the event of an accidental overdose.

It’s a phenomenon that has made Scotland the worst affected country in Europe for drug-deaths. Overall, the UK is falling behind other European countries for life expectancy.

The impact of lifestyle

A rise in non-communicable diseases (NCD) – including cardiovascular diseases, like heart attacks and stroke, respiratory diseases such as asthma, and diabetes – has increased mortality rates among some population groups.

Cardiovascular diseases account for the highest number of NCD deaths, according to the World Health Organization – around 17.9 million people annually. In a 2018 report on global NCD rates, the WHO said: “Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from an NCD.”

The effects of many of these diseases, which were once regarded as a blight on the developed world, can now be seen in a number of emerging economies, too.

For example, in 1985, 16% of China’s children were so malnourished their growth had been stunted. As the country has modernized and urbanized, diets and eating habits have changed for millions of people. Growth problems relating to malnutrition had fallen to just 2% by 2014. But over that same period the number of overweight and obese people in China has increased from 1% of the population to 20%.