
U.S. Life Expectancy Falls Further - Thorondor
https://www.wsj.com/articles/u-s-life-expectancy-falls-further-1543467660
======
rolal
If you can't read the original article:
[https://outline.com/nzuAst](https://outline.com/nzuAst)

~~~
exprA
You can also prefix any WSJ links (among others) with “facebook.com/l.php?u=”
to receive content reserved for users arriving from Facebook; that is, if you
don't mind Facebook tracking.

------
jillesvangurp
I can think of a few other causes like sickness being a potentially
bankrupting event so people don't go to a doctor when they should or too late.

This apparently is a risk, even if you have insurance because you are at the
mercy of insurers not tossing you out over such whimsical reasons as pre-
existing conditions or other bureaucratic tricks they use to kill their
customers rather than getting them cured.

There are also these mafia extortion schemes that are completely legal where
you have to pay through your nose for insurance in exchange for the privilege
of not being charged tens of thousands of dollars for completely routine stuff
like broken bones or other things that can and will go wrong for most people
at some point. This is not a thing in most modern countries other than the US.
Even many third world countries tend to get organized on this front to the
best of their abilities.

Then there is the widespread obesity because of corn syrup being a heavily
subsidized food ingredient (got to help those poor republican voting farmers).
Also it seems there is a whole legislative game around shameless advertising
on products where products that contain obscene amounts of corn syrup are
advertised as "fat free" instead of "don eat this you stupid fat F __* ".

The reason for the drug overdoses is decades of shameless attempts by big
pharma to coerce the US government on not cracking down on their quite
successful attempts at selling heroine disguised as pain medication roughly at
the same time when the war on drugs was a big thing. This too is much less of
a thing outside of the US where pain medication tends to be very strictly
regulated and not advertised every 10 minutes on TV.

In short, the above is the result of decades of misguided policies, failures
to regulate, and greedy companies getting away with stuff they shouldn't get
away with and lobbying successfully to get away with ever more.

~~~
cpursley
> Then there is the widespread obesity because of corn syrup being a heavily
> subsidized food ingredient

You forgot to mention that the US Gov't also subsides the other side via food
stamps, which poor folks use to purchase corn syrup and cheap grain foods,
further exasperating the obesity epidemic. It's true insanity.

~~~
rsync
"... which poor folks use to purchase corn syrup and cheap grain foods ..."

This is true. It is truly insane that public food benefits can be used to buy
soft drinks, sugar cereals and candy:

"Soft drinks, candy, cookies, snack crackers, and ice cream are food items and
are therefore eligible items"[1]

[1] [https://www.fns.usda.gov/snap/eligible-food-
items](https://www.fns.usda.gov/snap/eligible-food-items)

~~~
jogjayr
It doesn't seem insane to me, just a reflection of the reality that people
sometimes buy unhealthy foods - for both legit and frivolous reasons.

Sometimes your kid will only eat sugary cereals for breakfast, because
children can be fussy eaters. Or maybe you want to kick back with a can of
Coke after a hard day at work (or need the caffeine to wake up for work in the
morning, and coffee is too expensive). Or you want some Snickers bars to take
on the train or bus to snack on. Policing what kind of food people spend their
food stamps on seems like a pointless waste of time and government resources
to me.

~~~
ACow_Adonis
Let me guess...American? Because coming from outside, the way you pile sugar
into everything (including breakfast) is just insane and aa little stomach
churning.

Obviously it's a bit nurture on both our parts, but sugar for breakfast is
crazy, as is being taught that things like soda or snickers should ever be
eaten except for in exceptional/celebratory circumstances.

One needs to be taught that those food stuffs are acceptable and gain a
palette for them, because foreigners find your food sickly sweet. Clearly this
is a policy/cultural thing...

~~~
jogjayr
Guessed wrong! I do live in the US at present, however.

> Obviously it's a bit nurture on both our parts, but sugar for breakfast is
> crazy, as is being taught that things like soda or snickers should ever be
> eaten except for in exceptional/celebratory circumstances.

There's always a gap between how things should be done and how they are
actually done. I personally don't eat sugary cereals, or drink soda. I like
sweets and candy and I'll admit it's a struggle to control sometimes,
especially when I'm stressed out. I won't judge someone in far worse
circumstances than I for indulging in sugar - it might be the only good thing
in their life. And I don't approve of government resources being spent on
checking what kind of food people eat - you can get far more bang for your
buck elsewhere.

------
dmschulman
The decline is mostly the product of an increase in drug overdose deaths and
suicides (likely also related to drug abuse[1]). Cancer mortality is
continuing to decline which is nice to hear:

"Earlier this century, the steady and robust decline in heart-disease deaths
more than offset the rising number from drugs and suicide, Dr. Anderson said.
Now, “those declines aren’t there anymore,” he said, and the drug and suicide
deaths account for many years of life lost because they occur mostly in young
to middle-aged adults.

While progress against deaths from heart disease has stalled, cancer
deaths—the nation’s No. 2 killer—are continuing a steady decline that began in
the 1990s, Dr. Anderson said. “That’s kind of our saving grace,” he said.
“Without those declines, we’d see a much bigger drop in life expectancy.”

Drug-overdose deaths skyrocketed between 2015 and 2017, particularly for
adults between ages 25 and 54. The main culprit was fentanyl and other
synthetic opioids that became pervasive in illicit drug supplies in the U.S.
around that time.

Deaths from synthetic opioids rose 45% in 2017, while the death rate from
heroin, which had risen sharply after 2010, was flat."

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499285/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499285/)

~~~
mrweasel
> The decline is mostly the product of an increase in drug overdose and
> suicides

The US is pretty much also the only country where suicides are increasing.

~~~
adventured
Suicide rates in several other developed nations are either higher or compable
to the US. Things must be really, really bad in Belgium, Finland and Iceland
eh (you know, just three of the nicest countries on Earth). How could Sweden,
France and Australia be anywhere near the US rate?

Suicide rates in order per 100k: South Korea 20.2, Belgium 15.7, Japan 14.3,
Finland 13.8, US 13.3, Iceland 13.3, France 12.1, Sweden 11.7, Australia 11.7,
New Zealand 11.6, Switzerland 11.3, Ireland 10.9, Canada 10.4, Norway 10.1

Others in Europe: Russia 26, Lithuania 25.7, Belarus 21.4, Ukraine 18.5,
Latvia 17.2, Estonia 14.4, Hungary 13.6, Moldova 13.4, Poland 13.4, Slovenia
13.3, Austria 11.4

Why are Europeans killing themselves at such high rates?

~~~
scottlocklin
I think it is rate of change which has people concerned. The rate of suicide
in the US is up 25% in the last 15 years.

~~~
ArchTypical
> The US is pretty much also the only country where suicides are increasing

So the initial assertion was not compelling.

> it is rate of change which has people concerned.

Do you have any source about people being concerned (what people?) for the new
goalpost?

------
beginningguava
The opioid epidemic is an amazing example of human psychology and the power of
a visual. More people die from it every year than Vietnam, yet there's been no
large public outcry to resolve the situation because it isn't right in your
face like a 9/11 or pearl harbor. Even ignoring the human impact and just
going to economics, those lost lives will cost the US billions in lost
productivity over time, yet nobody really cares.

Honestly, somebody should make a Kony2012 style video about it. It was a sham
but I can still remember how viral that thing went, because it hit all the
buttons of human psychology.

~~~
yesenadam
_More people die from it every year than Vietnam_

[Kind of off-topic] I'm guessing you mean by 'than Vietnam', 'than Americans
died in the Vietnam war"? (Well I think so. Apologies if not.) That's a pretty
macabre unit. Can you imagine how a Vietnamese person would feel reading that?
Maybe in Vietnam they say 'More people die from [something] every year than
America' \- meaning what they call the American War[0]. Wouldn't that sound
super-weird. That's something like how what you said sounds to me. Only for
them it would mean 1-3 million.

[0] or the Resistance War Against America.

edit: Downvoter, care to explain how I can improve my comment? Thanks.

~~~
brotoss
You're being pedantic for the sake of outrage.

~~~
BeetleB
>You're being pedantic for the sake of outrage.

Eh no.

Imagine you're sitting in Canada and say "The opiod epidemic kills more people
annually than WW II", and then when confronted, you say "Of _course_ I mean
Canadian lives in WW II!"

Americans may only see 55000 deaths in Vietnam. The rest of the world (and HN
is international in audience) sees a lot more.

------
peteradio
Drug overdose and abuse seem to me to be a symptom of something way more
troubling. I can't help but feel like there is a sense of uselessness felt by
and toward a large population in the US and rather than lift them up we are
letting them be snuffed out.

~~~
all2
> Drug overdose and abuse seem to me to be a symptom of something way more
> troubling.

A general feeling of disconnectedness? Perhaps some existential dread in
there. The United States (by and large) used to be lashed to religious
moorings, which provided some sense of purpose and moral grounding, as well as
fending off pesky questions like "what happens to me when I die?"

The statistics that claim the US is still largely religious are hallow. People
wear labels of their religion as a means to exclude or silently signal
'better-than-you', when the purpose and message of those religions has nothing
to do with that.

I don't mean to say lack of religion is the primary cause of our opioid
epidemic, rather a significant contributing factor.

I would venture a guess that things like easy access and over-prescription
also play a role.

~~~
akuji1993
I'm honestly shocked how American doctors seem to give out opioid
prescriptions for any illness or pain. I've not once heard from somebody here
(Germany) that was prescribed opioids by their dentist after a surgery. They
usually tell you to take some tylenol and rest at home, I've never heard of
somebody getting opioid for that. But I've heard it mentioned multiple times
regarding american dentists.

There surely are more examples where the docs seem to be a lot less careful
about giving out these drugs. Also I think, and that's not only regarding the
US, but all of the world, people should be getting way more education about
what these drugs are, what they cause, how they should be taken and how you
should stop taking them / what risks it bears if you don't.

~~~
maccard
> People should be getting way more education about what these drugs are, what
> they cause, how they should be taken and how you should stop taking them /
> what risks it bears if you don't.

My experience is that it's too complicated for people. My parents can just
about understand don't take more than 8 paracetamol/tylenol per day, or don't
take advil if you've got high blood pressure, but any more complex than that
and they just can't really understand it.

They can't (or don't want to) understand that certain antibiotics mix poorly
with alcohol (Don't drink on antibioitics) or that some painkillers are _not_
suitable for hangovers (headache == tylenol). They don't understand how
statistics of side effects work (10% of people have one or more of the
following side effects means "It won't happen to me"), or that some
supplements can interfere with medication (warfarin and St Johns wort), and
that this is bad, even though they're not medicines.

------
jartelt
Note that if you are in the demographic of well educated and high income
Americans, your life expectancy is still quite high and you should assume you
will live to your 90s when planning for retirement!

The decrease in life expectancy observed is being largely driven by people on
the middle to lower portion of the income spectrum. It's very unfortunate that
it is happening and so many people are struggling. Hopefully our country can
come up with solutions to help out people who are struggling with addiction
and poor health.

But, it's important to remember that if you are not in that demographic, you
are still likely to live a very long life and need to plan for that.

~~~
sorokod
The article is about the trend - not the absolute numbers

------
taway314
A lot of premature deaths are not just a direct result of suicide or drug
abuse, but a deeper result of despair and isolation. Improved healthcare would
help, but I feel like it's a cultural issue as well.

My grandfather died in his early 70's a few years ago. By any other measure,
he should have lived well into his 80's. He had a comfortable middle-class
life and was quite healthy when he was younger. But he spent the last decades
of his life in rural Maryland with very little social contact. My family
rarely visited him. For reasons I'm still unsure, my dad didn't talk to him
for almost 2 decades. His physical and mental health really disintegrated.

My wife is from India, and I'm convinced that this sort of thing is more rare
there. There is a strong, almost sacred connection between family members. If
your parent is sick or unwell, you bring them into your house and take care of
them. No questions asked. For the most part, the culture in (white, middle-
class) America looks at things very differently, and I'm not really sure what
the solution could be.

------
protomyth
And subtract 5.5 for Native Americans
[https://www.ihs.gov/newsroom/factsheets/disparities/](https://www.ihs.gov/newsroom/factsheets/disparities/)

Native Americans on reservations have free health care from IHS
[https://www.ihs.gov/](https://www.ihs.gov/)
[https://www.ihs.gov/forpatients/faq/](https://www.ihs.gov/forpatients/faq/)

------
vivekd
This seems like a case of temporary circumstances and statistical creating a
doomsday picture. The temporary circumstances seem to be the suicide rate
brought on by the still recovering economy and glib life prospects. Partly
related to this is a new deadly drug that is gaining popularity.

Add to this the statistical factors like the anti smoking and healthy living
campaigns hitting their peak effect a few decades after improvents in modern
science hit their peak effectiveness.

To me, it seems like life exectancy will improve again as the economy improves
and governments find ways to fight fentynal.

Improving life expectancy maked great advancements in healthcare and sanitaion
and lifestyle in the past. As these improvements seem to have peaked I dont
know that life expectany is still a good indicator of progress in rich nations

~~~
hn_throwaway_99
> To me, it seems like life exectancy will improve again as the economy
> improves and governments find ways to fight fentynal.

I find this exceedingly difficult to believe in the rural areas of the US. The
current expansion is almost the longest on record, going on since 2009. The
structural forces that have hollowed out the economies of rural areas
(widening inequality, e-commerce, globalization, etc.) are only increasing,
not decreasing. The drug overdoses may be caused by powerful opiates like
fentanyl, but the drug _use_ is mainly a symptom, not cause, of despair.

------
mbroncano
It’s remarkable how much of the article narrates a tale of opioids and
suicide, whereas the obvious elephant in the room seems the be the poor, or
lack thereof of a public health care system.

~~~
vivekd
I dont disagree that public healthcare would improve life expectancy but it
wouldn't cause a decrease in life expectancy as healthcare is not any less
accessible today than in the past

~~~
mbroncano
Citation needed, if only because of the increased expense.

Also, public heath care plays a massive role in opioids treatment and suicide
prevention, at least in developed countries.

What seems to be clear is, unless the issue if acknowledged, the US will
continue to slide literally to developing countries life expectancy levels.

~~~
JoeAltmaier
I wonder if I should be concerned. If I simply avoid opioids and suicide, I'm
safe?

~~~
mbroncano
It depends. Do you attend a high school in America?

~~~
jeffreyrogers
Is this a reference to shooting deaths? If so, you should be aware that there
are ~100 mass shooting deaths a year despite the sensational coverage they get
in the media. America does have many more gun deaths than other countries, but
the majority of those deaths are suicides and a majority of the homicides are
in high crime areas. This is a problem that we can address, but mass
shootings, though tragic and terrifying, are not a large public health issue.

~~~
mbroncano
The intentional murder rate in the US is around an order of magnitude bigger
than in most countries in Western Europe, Australia or Canada. If you think
that’s not an issue, I guess I must disagree.

~~~
jeffreyrogers
I do think that's an issue, and I said it's one we can address. It's separate
from the issue of mass shootings in schools, which is what I was commenting
about.

------
budu3
Can someone explain the link of the lowered life expectancy to flu and
pneumonia? I thought that these were deceases that were only fatal for people
with compromised immunity.

~~~
JoeAltmaier
Wow, maybe (not being sarcastic) eating a monocultured food diet and living as
sedate humans in sterile environments has a bigger effect on our immune
systems than we'd like. This must have been measured? Compare immunity in
farmers vs office workers or some such?

~~~
consp
I think you underestimate the amount of bad health environments there are in
cities (anecdotal evidence only). I would not call most cities or working
environments anywhere close to sterile.

~~~
tamcap
To be honest, nobody is talking about very deadly exposure to pesticides in
farmers populations. There actually have been papers published on that. While
living outside a big city might be on average better for you, being a farmer
is probably not.

~~~
JoeAltmaier
Right; nobody was talking about that.

------
femiagbabiaka
I’ve been re-reading the foundation series by Asimov lately. Without spoiling
the plot, one common theme in the book is the decline of empire. It’s
uncomforably germane.

------
nonbel
I would like to see this correlated to access to "health care", which need not
necessarily translate to improved health.

From personal experience, I have a strong suspicion that much of this "care"
is actually harming people. In particular I am concerned about over-
prescription of anti-pain/anxiety/depressant medications and incorrect dietary
modifications (eg, to eat a low-fat/salt/cholesterol diet).

EDIT:

Very roughly, there is a link to "obamacare". From TFA:

> _" The U.S. has lost three-tenths of a year in life expectancy since 2014, a
> stunning reversal for a developed nation, and lags far behind other wealthy
> nations."_

> _" The ACA's major provisions came into force in 2014. By 2016, the
> uninsured share of the population had roughly halved, with estimates ranging
> from 20 to 24 million additional people covered during 2016."_
> [https://en.wikipedia.org/wiki/Patient_Protection_and_Afforda...](https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act)

~~~
rjkennedy98
The psychiatrist David Healy wrote an awesome, but poorly titled book called
Pharmageddon just on this point. By some estimates up to 500K people a year
are killed due to bad interaction with the medical system. Per a Johns Hopkins
report they estimate around 180K. Its worth noting this is not just medical
errors which are incredibly frequent, but much of it is due to side effects of
correctly prescribed drugs.

~~~
nonbel
Thanks, not sure if I would read an entire book on it though. What source of
data does he use?

------
kauffj
(On edit: below comment is retracted. At least for 2015 to 2016, the decline
is not attributable to Simpson's paradox. See Table 4 in the CDC report linked
below.)

This is either incompetence or maliciousness on behalf of the CDC, WSJ, or
both. Life expectancy in the US is falling, but it's only falling due to
Simpson's Paradox [1].

The CDC's own data [2] shows life expectancy increasing for all genders and
races except black men, which decreased marginally over the last few years.

The primary reason life expectancy is falling is due to changes in the racial
composition of the population, not because of opioids or suicide.

[1]:
[https://en.wikipedia.org/wiki/Simpson%27s_paradox](https://en.wikipedia.org/wiki/Simpson%27s_paradox)

[2]:
[https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_05.pdf](https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_05.pdf)
(see Figure 5)

~~~
vasilipupkin
From the document you posted:

since 1990. • In 2016 compared with 2015, life expectancy decreased for non-
Hispanic white males (0.2 year), non-Hispanic black males (0.4), non-Hispanic
black females (0.2), Hispanic males (0.2), and Hispanic females (0.1). Life
expectancy for non-Hispanic white females remained unchanged

So, no, it's not just Simpson's paradox.

~~~
kauffj
You're correct. I edited the parent.

------
elocinstr8t
"Life expectancy for Americans fell again last year, despite growing
recognition of the problems driving the decline and federal and local funds
invested in stemming them."

If lack of awareness isn't the problem, then what is? What drives people to
end their lives? Is it the way we live our lives? The people around us and our
inner demons telling us it's the only way to stop the pain? And would projects
involving life extension work and make them not go through their plan of
taking their own lives?

------
lurquer
Measuring life expectancy from birth is more a measure of infant mortality.

The data on life expectancy from 5 years old is remarkably consistent... mid
to upper 70's.

It's even more consistent when one looks at life expectancy from 21 years.

I do not have links to the charts showing this. But, last time I checked, I
was quite surprised at how a sensational story about life-expectancy from
birth loses much of its significance when one disregards the deaths that occur
in the first 5 years of life.

------
DigiMortality
My little brother killed himself last month.

My cousin OD'ed on heroin in 2016. My old classmate, 2 weeks after him - same
church for the funeral.

One of my best friends killed himself in 2015.

~~~
rabboRubble
I am so very sorry for your losses.

------
nyghtly
As with many problems in the U.S., income and wealth inequality are largely to
blame: [https://www.vox.com/science-and-
health/2018/1/9/16860994/lif...](https://www.vox.com/science-and-
health/2018/1/9/16860994/life-expectancy-us-income-inequality)

------
ryanmercer
Stress, cancer, inactivity, obesity, diabetes, prescription and street drug
abuse... doesn't surprise me unfortunately :(

~~~
inscionent
Nicotine, Valium, Vicodin, Marijuana, Ecstasy, and Alcohol ....C-c-c-cocaine

[https://www.youtube.com/watch?v=bAXPUN2z2CE](https://www.youtube.com/watch?v=bAXPUN2z2CE)

------
sunshinelackof
Visit the rural parts of the US and you'll see that see-destructive behaviors
are way too common. There's no hope right now for half the country. Whatever
wealth they had has been mined out.

------
narrator
I think we've reached the point of diminishing marginal returns to health care
spending. That means when we spend more money on healthcare as a percent of
GDP, life expectancy starts to fall. We are already at 16% of GDP spent on
healthcare. That's double the amount that any other country spends on
healthcare. We also have worse life expectancy vs. countries that spend much
less as a percent of GDP than we do.

One of the most disturbing trends in American healthcare, IMHO, is that the
suicide rate has been steadily rising since 2000. It's now back to where it
was in the 1980s before SSRIs.

~~~
rsynnott
US healthcare outcomes in most areas aren't actually particularly good, though
(iirc, it does reasonably well on cancer, but is under par on most other
stuff). The US healthcare system is expensive because it's inefficient.

~~~
avgDev
I would argue that it's expensive because it is private and unregulated.

The amount of anger the healthcare system can cause in the US is unbelievable.
Example, I had a surgery that was pre-approved. Then, I received a bill for
$20k. I called the insurance and they said the company wanted to charge them
to much and they could not come to an agreement, therefore, they are not
paying. So, I call the surgery place and told them there is no way I am paying
that bill.

I kept getting bills for 4-5 years, till they settled with insurance company
and send me a bill for $500. At that point, I decided just not to pay it,
because it angered me so much.

Doctors are under pressure now too. There is pressure to see many patients in
a day. Push drugs, vaccinations and so on. It is terrible for everyone
involved except companies who benefit financially from it.

~~~
rsynnott
> I would argue that it's expensive because it is private and unregulated.

Oh, sure, that's likely what makes it inefficient.

~~~
the_why_of_y
Empirically, the US health care market is both the most privatized and the
most inefficient.

[http://voices.washingtonpost.com/ezra-
klein/2010/01/america_...](http://voices.washingtonpost.com/ezra-
klein/2010/01/america_spends_way_way_way_mor.html)

[https://www.eurekalert.org/pub_releases/2011-08/cu-
ups080211...](https://www.eurekalert.org/pub_releases/2011-08/cu-
ups080211.php)

------
pasbesoin
You want a clear sign that the U.S. is failing? Here's one.

It's the short, statistical version of a thousand thousand tragic individual
tales.

------
alecco
How is the obesity epidemic not affecting deaths?

I remember clearly nurses saying hospitals are full of elderly and obese
people.

------
pseudolus
Is there any indication as to whether life expectancy has fallen for all
income groups? Are there any income related discrepancies?

~~~
Leary
Rich people's life expectancy is increasing just fine, it's the poorer people
that are having trouble.

Source: [https://jamanetwork.com/journals/jama/article-
abstract/25135...](https://jamanetwork.com/journals/jama/article-
abstract/2513561?utm_campaign=articlePDF%26utm_medium%3darticlePDFlink%26utm_source%3darticlePDF%26utm_content%3djama.2018.2521)

------
myroon5
Article:

Life expectancy for Americans fell again last year, despite growing
recognition of the problems driving the decline and federal and local funds
invested in stemming them.

Data the Centers for Disease Control and Prevention released on Thursday show
life expectancy fell by one-tenth of a year, to 78.6 years, pushed down by the
sharpest annual increase in suicides in nearly a decade and a continued rise
in deaths from powerful opioid drugs like fentanyl. Influenza, pneumonia and
diabetes also factored into last year’s increase.

Economists and public-health experts consider life expectancy to be an
important measure of a nation’s prosperity. The 2017 data paint a dark picture
of health and well-being in the U.S., reflecting the effects of addiction and
despair, particularly among young and middle-aged adults, as well as diseases
plaguing an aging population and people with lower access to health care.

“The continuation of this trend is a warning for all of us that our country
has not found a way of addressing the profound needs of the people who are
dying,” said Eric Caine, professor of psychiatry and director of the Injury
Control Research Center for Suicide Prevention at the University of Rochester
Medical Center. “While the economy may be recovering at the macro level, it’s
very uncertain whether it’s affecting the lives of these people.”

The U.S. has lost three-tenths of a year in life expectancy since 2014, a
stunning reversal for a developed nation, and lags far behind other wealthy
nations.

Life expectancy is 84.1 years in Japan and 83.7 years in Switzerland, first
and second in the most-recent ranking by the Organization for Economic
Cooperation and Development. The U.S. ranks 29th.

“It’s significant,” Bob Anderson, chief of the mortality-statistics branch of
the CDC’s National Center for Health Statistics, said in an interview. “It
doesn’t seem like a lot, but in terms of human cost you’ve got a lot of life
that’s not being lived.”

White men and women fared the worst, along with black men, all of whom
experienced increases in death rates. Death rates rose in particular for
adults ages 25 to 44, and suicide rates are highest among people in the
nation’s most rural areas. On the other hand, deaths declined for black and
Hispanic women, and remained the same for Hispanic men.

“These sobering statistics are a wakeup call that we are losing too many
Americans, too early and too often, to conditions that are preventable,” said
CDC Director Robert Redfield.

As drug and suicide mortality has risen, deaths from heart disease, the
nation’s leading killer, went down only slightly, failing to offset the
increases in mortality from other causes and prolonging another worrisome
trend. A decadeslong decline in deaths from heart disease—brought about by
antismoking and other public-health campaigns, along with medications to
control blood pressure and cholesterol—has stalled in recent years, with
heart-disease deaths even increasing slightly in 2015.

Earlier this century, the steady and robust decline in heart-disease deaths
more than offset the rising number from drugs and suicide, Dr. Anderson said.
Now, “those declines aren’t there anymore,” he said, and the drug and suicide
deaths account for many years of life lost because they occur mostly in young
to middle-aged adults.

While progress against deaths from heart disease has stalled, cancer
deaths—the nation’s No. 2 killer—are continuing a steady decline that began in
the 1990s, Dr. Anderson said. “That’s kind of our saving grace,” he said.
“Without those declines, we’d see a much bigger drop in life expectancy.”

Drug-overdose deaths skyrocketed between 2015 and 2017, particularly for
adults between ages 25 and 54. The main culprit was fentanyl and other
synthetic opioids that became pervasive in illicit drug supplies in the U.S.
around that time.

Deaths from synthetic opioids rose 45% in 2017, while the death rate from
heroin, which had risen sharply after 2010, was flat.

Methamphetamine and cocaine use is on the rise in the U.S., but deaths from
those drugs weren’t broken out from the total. Those statistics will be
released in mid-December, in a separate report, said Holly Hedegaard, a
medical epidemiologist at the CDC and lead author of the reports released
Thursday on drug overdoses and suicide.

There is some hope the decline in life expectancy won’t be prolonged. The rise
in drug-overdose deaths was slower in 2017 than the previous year. Total
overdose deaths for the preceding 12 months dropped slightly between late last
year and April, though they remain high.

“We may have reached a peak in regards to the drug-overdose epidemic,” Dr.
Anderson said. “I’m hopeful, given what we’ve seen in recent months.“ But, he
cautioned, “This might just be a lull.”

More federal and local resources have been devoted to the opioid crisis.
States began accessing nearly $1 billion in federal grants in 2017 to combat
the opioid crisis. In addition, opioid prescriptions are monitored more
tightly, and medication to reverse opioid overdoses has become more available,
among other factors possibly behind the tentative improvement.

Suicides rose 3.7% in 2017, accelerating an increase in rates since 1999, the
CDC said. The gap in deaths by suicide widened starkly between cities and the
most rural areas between 1999 and 2017, the data show. The rate is now far
higher in rural areas. “There’s a much wider spread,” Dr. Hedegaard said.

“This is extremely discouraging,” Christine Moutier, chief medical officer of
the American Foundation for Suicide Prevention, said of the suicide-rate
increase. Studies show that traumas such as economic difficulties or natural
disasters, along with access to lethal means including guns and opioid drugs,
and lack of access to care can affect suicide rates, she said. More accurate
recording of deaths may also have added to the numbers, she said.

Scientific understanding of suicide and its risk factors is improving, Dr.
Moutier said, and new prevention programs are being implemented. But their
effects have yet to be felt, because they haven’t been scaled up yet, she
said.

“The science is growing tremendously,” she said. “We now have answers about
how to prevent suicide.”

------
GuyPostington
USA #1! You can't kill yourself as good as we can!

------
nonbel
What do they mean by overdose?

The WSJ did not seem to properly cite its sources here, but I am guessing it
is this:

>"Drug overdose deaths are identified using underlying cause-of-death codes
from the Tenth Revision of ICD (ICD–10): X40–X44 (unintentional), X60–X64
(suicide), X85 (homicide), and Y10–Y14 (undetermined)."
[https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-
data.htm#no...](https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-
data.htm#notes)

    
    
      Accidental poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics
      Accidental poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics
      Accidental poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified  
      Accidental poisoning by and exposure to other drugs acting on the autonomic nervous system
      Accidental poisoning by and exposure to other and unspecified drugs, medicaments and biological substances 

[http://apps.who.int/classifications/apps/icd/icd10online2004...](http://apps.who.int/classifications/apps/icd/icd10online2004/fr-
icd.htm?gx40.htm+)

    
    
      Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics 
      Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified 
      Intentional self-poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified 
      Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system 
      Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substances 

[http://apps.who.int/classifications/apps/icd/icd10online2003...](http://apps.who.int/classifications/apps/icd/icd10online2003/fr-
icd.htm?gx60.htm+)

    
    
      Assault by drugs, medicaments and biological substances 

[http://apps.who.int/classifications/apps/icd/icd10online2005...](http://apps.who.int/classifications/apps/icd/icd10online2005/fr-
icd.htm?gx85.htm+)

    
    
      Poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics, undetermined intent 
      Poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics, undetermined intent 
      Poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified, undetermined intent 
      Poisoning by and exposure to other drugs acting on the autonomic nervous system, undetermined intent 
      Poisoning by and exposure to other and unspecified drugs, medicaments and biological substances, undetermined intent 

[http://apps.who.int/classifications/apps/icd/icd10online2004...](http://apps.who.int/classifications/apps/icd/icd10online2004/fr-
icd.htm?gy10.htm+)

Overdosing on opiods is only one part of this category. Basically if you take
too little/much of a medication (eg, blood pressure medication) you would be
counted here. So I wonder if this increase is not just reflecting a general
increase in taking medications.

------
harperlee
The world definitevely needs to move past GDP as key metric to evaluate
success of a nation.

~~~
cwperkins
What does this contribute exactly to conversation about this topic? Most
people when evaluating success of a country take into account a slurry of
values such as GDP, Life Expectancy, GDP Per Capita (more important than GDP
IMO), Unemployment, Fertility, Education, Income Inequality. Take a look at
the OECD data sheet for the United States: [https://data.oecd.org/united-
states.htm](https://data.oecd.org/united-states.htm).

Comments like this just scream America hating and serve to inflame, they don't
contribute to a substantive conversation.

~~~
harperlee
It is not America hating, as this is not just an issue for US. Sorry if it
sounded that way.

You are right in that there are more indicators already defined, but you don’t
see presidents boasting these figures - and even press and newspapers focus
way more on economy and GDP. It’s simply more important in most heads, in my
opinion, and this whould change (again my opinion!)

