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Study: Life expectancy declines in US

By BELINDA ROBINSON in New York | CHINA DAILY | Updated: 2019-12-05 10:32

The life expectancy of US citizens has declined for three years in a row due to a host of problems, including drug overdoses, suicides, alcohol-related illnesses and obesity, a medical study has found.

The study published in November in the Journal of the American Medical Association, or JAMA, looked at data from 1959 to 2017 and found that life expectancy had declined from 78.9 years in 2014 to 78.6 in 2017.

Deaths increased most in the Ohio Valley, which includes the states of Ohio, West Virginia, Indiana and Kentucky, followed by northern New England, which includes the states of Maine, New Hampshire and Vermont.

The age groups most affected were adults aged 25 to 64, whose mortality rates jumped by 6 percent.

Howard Koh, professor of public health leadership at Harvard University, said: "A whole constellation of conditions... impacts life expectancy. It is not just medical conditions, but also the social drivers that appear to be at play, like income inequality and mental distress."

The figures mark a change in trends in the past half-century, because life expectancy in the United States had increased by almost 10 years from 69.9 in 1959 to 78.9 in 2016.

Despite the US being one of the wealthiest countries in the world and a healthcare system that spends more per capita than most countries do, the number of years that a US citizen can expect to live began slowing in the 1980s and reversed beginning in 2014.

The decrease in mortality rates was greater among men (0.4 years) than women (0.2 years). All racial groups were affected, including the non-Hispanic white population, the non-Hispanic black population and the Hispanic population.

Several factors are to blame for the decline in the mortality rates. Among people in mid-life, fatal drug overdoses increased 386.5 percent between 1999 and 2017. That could be due, in part, to the opioid epidemic in the US, which started in the 1990s when pharmaceutical companies assured the medical community the certain drugs were strong nonaddictive painkillers, but many people nonetheless became addicted.

Suicide rates in the US also soared by 38.3 percent for people aged 25 to 64 and by 55.9 percent among those aged 55 to 64, the study showed.

Another leading cause of death among US residents is alcoholism, or alcohol-related illnesses, such as alcoholic liver disease, the study found. Among those aged between 25 and 34, the rate of alcohol-related disease deaths increased by 157 percent from 1999 to 2017.

George Koob, director of the National Institute on Alcohol Abuse and Alcoholism, estimates that 6 percent of the US population, or 14 million people, have an alcohol-use disorder, and 2 million have an opioid-use disorder.

Koob said: "The three things we've identified about why (alcohol has an impact on life expectancy rates) are liver disease, which has been increasing; overdoses, as alcohol contributes to that and causes overdoses unto itself, because people can actually die from drinking too much.

"When you combine alcohol with any sedative hypnotic, anything, like an antihistamine and certainly an opioid, which is a central nervous system depressant... alcohol can facilitate overdoses when combined with other sedative drugs," he said.

The study also flagged obesity as a key driver of falling life expectancy because people who are obese have a higher risk of heart disease, cancer, diabetes and other life-threatening illnesses.

Obesity rates among those in mid-life shot up 114 percent between 1999 and 2017. Deaths due to high blood pressure, increased by 78.9 percent. And deaths linked to alcohol-related problems, like chronic liver disease and cirrhosis, increased 40.6 percent.

June Stevens, PhD, Distinguished Professor of Nutrition and Epidemiology at the University of North Carolina at Chapel Hill told China Daily: "About 40 percent of American adults are obese, so I would call our obesity problem as a society very bad to tragic…Obesity impacts life expectancy through its effects on metabolism and the weight load that has to carried by the skeleton.  Many of the metabolic effects work through a key hormone, insulin, and result in increased risk of the organ diseases cited as increasing death in the JAMA paper.

Stevens said that research from her group has shown that only 18 percent of American Adults have optimum metabolic health, which means that 82 percent have at least one of their metabolic health markers out of range.

"The weight load effects of obesity can result in falls and in problems with the hips and knees," Stevens said.  "These health problems can be related to death, and they most assuredly influence quality of life."

She adds that in America, obesity impacts Hispanics and Blacks more than Caucasians.  But she says that there is a glimmer of hope, as there is a slew of public health efforts underway to tackle obesity in children and adults.

Koob adds that Americans need to remember that alcohol is a drug, despite being a "social lubricant." After seeing four scientist friends die from alcoholism, he warns "alcohol spares nobody."

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