Many Americans will not reach old age.

Many Americans will not reach old age.

America’s Struggle with Life Expectancy: A Closer Look at Wellness and Safety

Walking into the Rebound recovery centre on Hazard’s Main Street in Kentucky, one gets an instantly friendly welcome. However, the stories shared here paint a bleak picture. A whiteboard at the end of the room lists the names of former clients who have died of overdoses in the past few years. In a town with a population of just 5,000, there are at least 20 names. James Colwell, a former heroin addict turned recovery center worker, explains that although heroin addiction is less common now due to better treatment options, the rise of meth usage and the inclusion of the powerful opiate fentanyl in pills have taken a devastating toll on the community. He mentions a funeral he will be attending for a middle-aged former nurse who accidentally overdosed on fentanyl.

Hazard, named after Oliver Hazard Perry, a naval hero of the War of 1812, serves as an appallingly dangerous place to live. Even before the pandemic hit, the town and its surrounding Perry County ranked sixth-from-bottom out of America’s 3,142 counties in terms of age-standardized mortality. People in Hazard are far more likely to die at any age compared to the national average. Opiate addiction, which began spreading around 25 years ago when doctors prescribed them for chronic pain in former coal miners, contributes significantly to the alarming mortality rates. Heart attacks, traffic accidents, and even natural disasters further compound the issue. On average, people in Perry could expect to live only until age 69 in 2019, compared to the national average of 79.

In terms of economic measures, the United States has outperformed other wealthy countries over the past two decades. Median wages have grown more significantly than in Germany, and access to healthcare has improved. However, when it comes to the fundamental measure of wellness – life expectancy – the United States lags behind. In a study conducted by Jessica Ho of the University of Southern California, America ranked last among 18 high-income countries in terms of life expectancy in 2018. The situation has worsened in recent years, aggravated by the COVID-19 pandemic. Americans now expect to live six years less than people in other affluent nations, with the virus alone reducing life expectancy by over two and a half years.

Poor health is a substantial burden for Americans, significantly impacting life expectancy. While laws in the 20th century greatly improved public health, reducing smoking rates and air pollution and decreasing cholesterol levels, the rising obesity epidemic has reversed many of these gains. Obesity and diabetes rates in the United States are higher than in most other countries. Additionally, chronic diseases and premature deaths from drug overdoses, car crashes, and violence have all increased. Despite advancements in healthcare access, these factors contribute to the nation’s declining life expectancy.

While America’s poor health outcomes explain part of the life expectancy decline, they do not fully account for the country’s comparatively worse performance. Other countries have also observed rising obesity and diabetes rates, albeit at a lower scale. Moreover, the United States has made considerable strides in improving healthcare access and achieving high cancer survival rates. Therefore, the divergence can be attributed in part to the country’s escalating rates of violent deaths.

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William Farr, an early pioneer in medical statistics, famously stated, “Death is a fact. All else is inference.” This idea holds true when analyzing life expectancy estimates. Extrapolating probabilities from the total raw death rate at every age, deaths at younger ages have a more significant impact on life expectancy estimates. Disturbingly, the United States experiences a disproportionate number of premature deaths, particularly among young adults. In 2021, 38,307 Americans aged between 15 and 24 died, compared to just 2,185 in England and Wales. Americans are more likely to die at every age up to 85 compared to their counterparts in other wealthy nations.

The causes of these premature deaths are varied and alarming. Opioid-related fatalities, including those caused by heroin and fentanyl, are a significant contributor to the high mortality rates. Drug overdose deaths in the United States far exceed those in any other wealthy country. Car crashes, too, claim an alarming number of lives, with the U.S. having the highest fatality rate among developed nations. Homicide rates are another concerning factor, with the United States witnessing significantly more murders than countries like Italy. Workplace accidents, fires, and drownings also pose a higher risk to Americans compared to their international counterparts.

Geography plays a significant role in understanding America’s health disparities. Analysis conducted by Laura Dwyer-Lindgren of the University of Washington reveals stark regional variations in life expectancy. Counties like Hazard in eastern Kentucky have experienced a decline in life expectancy since 1980, while wealthier areas like Manhattan, New York, have seen substantial increases. County-level data highlights a band of high death rates spanning the southern and southeastern United States, while coastal regions and affluent mountain retreats like Colorado exhibit the lowest mortality rates.

Poverty alone does not entirely explain these variations. Hazard, for example, boasts upscale establishments alongside its struggling community. Moreover, death rates among average-income individuals in the southern United States surpass even those of the very poor in New York City. The issue lies not only in declining safety but also in the lack of progress compared to other countries. European nations have taken proactive measures to improve road safety, gun control, and drug abuse treatment, while the United States has been slow to adopt similar strategies.

The consequences of America’s high mortality rates are reflected in its political landscape. Former President Donald Trump capitalized on the resentment experienced by white working-class voters, who have seen the steepest increase in death rates. Their frustration and feelings of being left behind have influenced political outcomes. However, cultural factors also play a role. Americans value personal responsibility and often do not rely on the government to shield them from the consequences of poor choices.

To address these challenges, a shift in mindset is needed. Bombing Mexico or blaming external factors will not effectively reduce the death toll. Rather, a compassionate politics that acknowledges the frailties of human life and is willing to prioritize inconveniences for the sake of long-term safety is required. Positive changes are possible, as demonstrated by recent initiatives promoting safer infrastructure and modest gun-control measures. For the tens of thousands of Americans affected by these issues each year, swift action cannot come soon enough.

[Source: The Economist]