The Ultimate Health Outcome, Mortality, Is Rising in America

How long can people living in the U.S. expect to live? 78.6 years of age, if you were born in 2017.

That’s a decline of 0.1 year from 2016.

This decline especially impacted baby boys: their life expectancy fell to 76.1 years, while baby girls’ life expectancy stayed even at 81.1 years.

That’s the latest data on Mortality in the United States, 2017, soberly brought to you by the Centers for Disease Control and Prevention, part of the U.S. Department of Health and Human Services.

Underneath these stark numbers are the specific causes of death: in 2017, more Americans died due to unintentional injuries, lower respiratory diseases, stroke, Alzheimer Disease, diabetes, influenza and pneumonia, and suicide, increasing in prevalence among the top ten causes of death in the U.S. On the upside, deaths fell due to cancer, and rates for heart and kidney disease stayed relatively even.

There are three underlying stats that are particularly concerning in this report:

1. The rates of death for younger ages significantly grew between 2016 and 2017 in the age cohorts 25-34 and 35-44.

2. For infant deaths, unintentional injuries significantly rose over the year. There was also a marked increase in maternal complications.

3. Drug overdoses were the cause of over 70,000 U.S. deaths — related to the growing use of synthetic opioids.

That’s due to the fact that the age-adjusted rate of drug overdose deaths with synthetic opioids (not methadone) increased by 45% between 2016 and 2017. This is shown in the third graphic, the line chart showing the hockey-stick growth of synthetic opioids since 2013.

While there is obvious and important attention being paid to drug overdoses and the opioid crisis, and suicides among younger people, Americans should be mindful too of lack of significant progress dealing with mortality due to respiratory disease, stroke, Alzheimer’s, and the flu, along with infant deaths due to maternal complications and unintentional injuries.

Health Populi’s Hot Points: It’s a stark, sad reality that Americans are losing years of life that could be conserved. The nation spends more resources on healthcare than any country on Planet Earth, and the ultimate ROI should be life-years, and quality of those life-years.

If you look at the map, you’re seeing states by the rate of drug overdoses in 2017. The higher-than-national-average rates are in dark blue. This is not to say there aren’t deaths due to overdose in the green-hued states. But this is one lens on one’s ZIP code being a risk factor for health, and in this case, death from overdosing.

This challenge is but one of many that are, partly, addressable by getting real about social determinants. For these deaths of despair, job security and unemployment, social connections and loneliness, access to healthcare services (THINK: mental health, anxiety, depression, pain), and education are all pathways to socioeconomic status and social security (meant in the phrase as written, not as the U.S. Federal program of “Social Security”).

Three years ago here on Health Populi, I wrote about the deaths of despair, a phrase coined by Angus Deaton and Ann Case of Princeton. Then, I said,

“The authors note that the increase in midlife mortality is only partly understood. Increased availability of opioid prescription drugs, chronic pain (for which opioids are often prescribed), and the economic crisis which began in 2008 may all have contributed to an increase in overdoses, suicide, and increased liver disease associated with alcohol abuse.”

Three years later, there’s little national/Federal progress on resourcing the social determinants and personal/household economies that could help turnaround this public health challenge. (Most Americans didn’t feel a short-term sustained benefit from the recent tax reform legislation). While Congress and the President do chat about the opioid crisis, look for more action from the private sector and State Governors than Congress in 2019.

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