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December 21, 2017

US life expectancy just fell for the 2nd straight year. What's happening?

Daily Briefing

    U.S. life expectancy fell for the second year in a row in 2016, likely reflecting an apparent plateau in curbing heart disease mortality and an upswing in opioid-related deaths, according to a pair of CDC reports released Thursday.

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    Key findings on life expectancy

    One of the CDC reports relays final 2016 U.S. mortality data on deaths and death rates. The data came from data collected by the National Center for Health Statistics from death certifications from every state and Washington, D.C.

    CDC in the new report said U.S. life expectancy dropped from 78.7 years in 2015 to 78.6 years in 2016. The latest finding comes after CDC reported last year that life expectancy fell from 78.9 years in 2014. According to the Washington Post, the last time U.S. life expectancy dropped two years in a row was 1962 and 1963, when influenza led to a spike in deaths. A one-year drop in U.S. life expectancy was recorded in 1993 amid the height of the AIDS epidemic.

    However, while life expectancy declined, the overall death rate fell from 733.1 deaths per 100,000 individuals in 2015 to 728.8 deaths per 100,000 individuals in 2016.

    According to the researchers, age-adjusted death rates increased for some but not all racial and ethnic groups. Specifically, death rates increased for non-Hispanic black males and non-Hispanic white females, while age-adjusted death rates did not change significantly for non-Hispanic black females, non-Hispanic white males, Hispanic males, and Hispanic females, according to CDC. Broken down by race and ethnicity, the death rate per 100,000 in 2016 was:

    • 1,801.2 among non-Hispanic black males;
    • 734.1 among  non-Hispanic black females;
    • 879.5 among non-Hispanic white males;
    • 637.2 among non-Hispanic white females;
    • 631.8 among Hispanic males; and
    • 436.4 among Hispanic females.

    When CDC assessed the data by gender, it found a decline in life expectancy among U.S. males but not among females. According to the report, life expectancy for U.S. males dropped from 76.3 years in 2015 to 76.1 in 2016, while life expectancy for U.S. females held constant at 81.1 years for both years.

    CDC also found that age-specific deaths from 2015 to 2016 increased among younger age groups yet decreased among older age groups. The researchers recorded a significant increase in death rates for individuals in the 15-24, 25-34, 35-44, and 55-64 age groups. The researchers recorded significant decreases for the 65-74, 75-84, and 85 and older ages groups.

    Leading causes of death

    According to CDC, the list of the 10 leading causes of death in 2016 were the same as in 2015, together accounting for about three-fourths of all 2.7 million deaths in 2016. According to CDC, the leading causes of death, in order of prevalence, in 2016 were:

    • Heart disease;
    • Cancer;
    • Unintentional injuries;
    • Chronic lower respiratory diseases;
    • Stroke;
    • Alzheimer's disease;
    • Diabetes;
    • Influenza and pneumonia;
    • Kidney disease; and
    • Suicide.

    The researchers said age-adjusted death rates increased for seven of those causes and decreased for three: unintentional injuries (which includes drug overdoses), Alzheimer's, and suicide.

    Spotlight on the opioid misuse epidemic

    Robert Anderson, chief of CDC's division of mortality statistics, drew attention to the increase in drug overdose deaths, which CDC addressed in a separate report also released Thursday.

    In the second report, CDC found that the number of drug overdose deaths increased from about 52,000 in 2015 to 63,600 in 2016. According to CDC, about two-thirds of overdose deaths—or about 42,000—in 2016 involved opioids.

    According to the Post, fentanyl and other synthetic opioids—not including methadone—contributed to more deaths than any other legal or illegal drug, outpacing other opioids such as prescription pain pills and heroin for the first time.

    Overall, CDC found that West Virginia had the highest prevalence of age-adjusted drug overdose deaths, at 52 per 100,000, followed by Ohio, New Hampshire, Washington, D.C., and Pennsylvania. Drug overdose death rates were highest among individuals ages 25-34, 35-44, and 45-54, with rates of 34.6, 35, and 34.5 deaths per 100,000 population, respectively.

    CDC in that report stated, "Deaths from drug overdose are an increasing public health burden in the United States."


    Experts expressed concern about the life expectancy findings.

    Anderson said, "For any individual, that's not a whole lot," he said. "But when you're talking about it in terms of a population, you're talking about a significant number of potential lives that aren't being lived."

    He added, "If you look at the other developed countries in the world, they're not seeing this kind of thing. Life expectancy is going up." World Bank data show that the U.S. ranks behind dozens of high income counties on life expectancy. Japan has the world's highest life expectancy, at 84 years.

    "I'm not prone to dramatic statements," Anderson said. "But I think we should be really alarmed. The drug overdose problem is a public health problem and it needs to be addressed."

    Separately, Arun Hendi, a demographic and sociologist at the University of Southern California, added, "I was pretty shocked to see that our life expectancy has declined for the second year in a row," adding, "I think we should be very worried." He said the United States "urgently" needs to halt the supply of drugs, "particularly heroin and fentanyl" and boost access to substance use disorder treatment.

    Anne Case—a Princeton University economist who studies what she and Angus Deaton, her husband and fellow Princeton economist, have termed "deaths of despair"—said the opioid mortality trend is the tip of a broader problem. "It's also a crisis in which people are killing themselves in much larger numbers—whites especially," Case said. "Deaths from alcohol have been rising as well. So we think of it all being signs that something is really wrong and whatever is it is that's really wrong is happening nationwide" (Stein, "Shots," NPR," 12/21; AP/Los Angeles Times, 12/20; Bernstein/Ingraham, Washington Post, 12/21; Kochanek et al., "Mortality in the United States," December 2017; Hedegaard et al., "Drug Overdose Deaths in the United States, 1999-2016," December 2017). 

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