Tuesday, November 26, 2019

U.S. Life Expectancy Falls as Rates of Death From Drug Overdose, Suicide Rise

Life expectancy among people living in the United States has fallen in recent years, driven in part by an uptick in deaths among young and middle-aged adults from drug overdose, alcohol consumption, and suicide, according to a report published today in JAMA.

“The implications of increasing midlife mortality are broad, affecting working-age adults and thus employers, the economy, health care, and national security. The trends also affect children, whose parents are more likely to die in midlife and whose own health could be at risk when they reach that age, or sooner,” wrote Steven Woolf, M.D., M.P.H., and Heidi Schoomaker, M.A.Ed., of Virginia Commonwealth University.

Woolf and Schoomaker analyzed life expectancy data collected by the Centers for Disease Control and Prevention and cause-specific mortality rates listed in the U.S. Mortality Database from 1959 to 2017.

The analysis revealed that from 1959 to 2014, U.S. life expectancy increased from 69.9 years to 78.9 years. The rate of increase was greatest from 1969 to 1979, plateaued in 2011, and decreased after 2014, the authors noted. From 2010 to 2017, age-adjusted all-cause mortality rates increased by 6% in those aged 25 to 64 years (defined by authors as midlife adults). The authors noted several changes in rates of midlife mortality:

  • From 1999 to 2017, midlife mortality from drug overdoses increased by 386.5%.
  • During this same period, death rates from alcoholic liver disease increased by 40.6%.
  • Similarly, the suicide rate among individuals aged 25 to 64 years increased by 38.3%, and 55.9% among individuals aged 55 to 64 years. (Suicide rates also increased among those younger than 25 years.)
  • The midlife mortality rates for hypertensive diseases increased by 78.9% and 114.0% for obesity.

“Multidisciplinary approaches can address mortality linked to the disturbing triad of alcohol-related conditions, drug overdoses, and suicide, recently proposed as ‘deaths of despair,’” wrote Howard K. Koh, M.D., M.P.H., of the Harvard T.H. Chan School of Public Health in an accompanying editorial. “[P]olicies including the 2008 Mental Health Parity and Addiction Equity Act have elevated conditions affecting mental and emotional well-being, long overlooked, to a level equivalent to physical well-being. Stricter enforcement of the law, a major limitation to date, will be required to realize its vision.”

They concluded, “The study by Woolf and Schoomaker, detailing years of cumulative insults to the nation’s health, represents a call to action. Further research must explore how income inequality, unstable employment, divergent state policies, and other social dimensions affect disease.”

For related information, see the Psychiatric News article “Mental Health Parity May Hold Key to Solving Suicide and Opioid Crises.”

(Image: iStock/carterdayne)

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