Life expectancy trends downward for three years in a row. A recent reversal in upward longevity trends is being driven by young and middle-aged adults, according to new research published in the Journal of the American Medical Association (JAMA). The findings fall in line with other recent research on U.S. longevity and public health, placing the bulk of the blame for younger deaths on suicide, drug overdoses, and alcohol abuse, along with “a diverse list of organ system diseases.”
Researchers Steven H. Woolf and Heidi Schoomaker looked at U.S. mortality data published from January 1990 through August 2019. They find that U.S. life expectancy peaked in 2014, at 78.9 years old, and has been declining since.
For 2017, life expectancy was down to 78.6 years.
“The recent decrease in U.S. life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010,” they write in the JAMA paper. “During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases.”
These trends were strongest in New England (up 23.3 percent in New Hampshire, 20 percent in Maine, and 19.9 percent in Vermont) and what they term the Ohio Valley (up 23 percent in West Virginia, 21.6 percent in Ohio, 14.8 percent in Indiana, and 14.7 percent in Kentucky). “The increase in midlife mortality during 2010-2017 was associated with an estimated 33,307 excess U.S. deaths, 32.8% of which occurred in four Ohio Valley states,” the authors write.
Between 1959 and 2016, U.S. life expectancy rose from 69.9 years to 78.9 years, increasing the fastest between 1969 and 1979. Then:
Life expectancy began to advance more slowly in the 1980s and plateaued in 2011 […] The National Center for Health Statistics reported that US life expectancy peaked (78.9 years) in 2014 and subsequently decreased significantly for 3 consecutive years, reaching 78.6 years in 2017. The decrease was greater among men (0.4 years) than women (0.2 years) and occurred across racial-ethnic groups; between 2014 and 2016, life expectancy decreased among non-Hispanic white populations (from 78.8 to 78.5 years), non-Hispanic black populations (from 75.3 years to 74.8 years), and Hispanic populations (82.1 to 81.8 years).
In addition to drugs and alcohol, other lifestyle factors can be blamed for the rise in younger deaths:
Between 1999 and 2017, age-adjusted midlife mortality rates for hypertensive diseases increased by 78.9% (from 6.1 deaths/100 000 to 11.0 deaths/100 000) and for obesity increased by 114.0% (from 1.3 deaths/100 000 to 2.7 deaths/100 000).
Early studies reported increasing midlife mortality from heart disease and lung (notably chronic pulmonary) disease, hypertension, stroke, diabetes, and Alzheimer disease, but the trend appears to be even broader.
As Ron Bailey pointed out yesterday, however, the JAMA study isn’t all bad news:
Some good news is that mortality rates continued to fall at the tail ends of the age distribution. Between 1999 and 2017, the infant mortality rate dropped from 736 to 567 per 100,000 births while mortality among children ages 1 through 14 declined from 22.9 to 16.5 deaths per 100,000. Older Americans are living longer too: The mortality rate among adults between the ages of 65 and 84 fell from 3,774.6 to 2,875.4 deaths per 100,000.
Considering the bulk of the decline in longevity comes from “adults with less education and in rural areas or other settings with evidence of economic distress or diminished social capital,” the authors of the study suggest things like prescription opioids are to blame. But as Bailey writes:
They fail to note the unintended consequences of the federal government mandate for an abuse-deterrent reformulation of prescription opioids that resulted in the massive rise in overdose deaths as users switched to street heroin and fentanyl.
What to do? A good start would be to end the drug war and adopt policies that enable folks to get out of the local poverty traps in which they are stuck.
FREE MINDS
Due process shouldn’t conflict with #MeToo goals. David Harsanyi calls foul on the idea that due process somehow stands in opposition to holding people accountable for sexual harassment and assault. From a Monday article (not an opinion piece!) in The Washington Post:
While the #MeToo movement brought increased public scrutiny to harassment and assault, the Trump administration’s proposal pushes the pendulum in the reverse direction by strengthening due process protections for those accused of offenses.
Writes Harsanyi:
If on the one side of the pendulum is increased scrutiny over sexual assault, then the “reverse” can’t be the right to due process. The two, in fact, aren’t even on the same pendulum. Due process concerns itself with procedure, not substance. It allows “emotionally charged conflicts,” as the Post helpfully puts it, to be adjudicated in an impartial manner. The opposite of increased public scrutiny to harassment and assault is less scrutiny, not fewer rights for the accused. It’s alarming that this even has to be debated.
More here.
FREE MARKETS
The abject stupidity of the war on vaping. I’m in Spectator USA this week on the ways in which anti-vaping advocates are emulating crusaders against “Big Tobacco,” but without actually protecting anyone’s health. New York and California are both suing JUUL, for instance. A lot of politicians are keen on banning flavored vaping products (for the children, obviously), something leaders in New York City and Massachusetts voted for just last week. Meanwhile:
The American Medical Association (AMA) is now recommending a “total ban on all e-cigarette and vaping products” that aren’t classified by the U.S. food and Drug Administration as “smoking cessation” aids.
Interestingly, President Donald Trump has emerged as a rare realist when it comes to vaping. He told reporters last Friday that if the U.S. banned flavored nicotine vaping products, they were just “going to come here illegally.” Trump continued:
That’s the one problem I can’t seem to forget. You just have to look at the history of it. Now, instead of having a flavor that’s at least safe, they’re going to be having a flavor that’s poison.
It’s been black-market THC vapes causing illnesses and deaths, with most cases linked to products that used synthetic vitamin E as a filler.
To respond to that set of facts by banning flavored nicotine vaping products is like the government responding to counterfeit multivitamins killing people by banning all supplements except Riboflavin. It makes no sense.
More on the madness here.
ELECTION 2020
New Quinnipiac national Dem WH poll
Biden 24%
Buttigieg 16%
Warren 14%
Sanders 13%
Bloomberg 3%
Harris 3%
Bennet 2%
Booker 2%
Castro 2%
Yang 2%https://t.co/zGDNDEVb1b— Steve Kornacki (@SteveKornacki) November 26, 2019
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QUICK HITS
- A federal judge just blocked (for now) the Trump administration’s attempt to require proof of health insurance before receiving a visa.
- More evidence that it’s vitamin E acetate—not nicotine, and not vaping generally—that is causing illnesses and deaths.
- The Supreme Court will hear a Louisiana abortion case in 2020.
- A California county’s ban on marijuana delivery now has the state attorney general’s office joining in—against the county. The state has been fighting against locales setting their own marijuana regulations and rules.
- Vice is freaking out because “some nootropics contain a substance not approved by the FDA.”
- Are you ready for police robopups?
- Next week is Reason‘s annual webathon, where we ask you to support our journalism! We’ll be taking your questions on a special Reason Roundtable podcast on December 3. Please submit your questions for Katherine Mangu-Ward, Nick Gillespie, Matt Welch, and Peter Suderman to [email protected].
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