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The opioid epidemic is partly responsible for a startling decline in US life expectancy
OPIOID BLUES

US life expectancy is dropping for the first time since the AIDS epidemic

By Zoë Schlanger

A new US government report (pdf) shows a decline in life expectancy in the country for a second year in a row, influenced significantly by a surge in deaths caused by the nation’s worsening opioid epidemic. The 2016 average life expectancy fell from 78.7 in 2015 to 78.6 in 2016, following a decline from 78.9 in 2014.

A year of decline is one thing; two years in a row is a concerning trend, according to Robert Anderson, chief of the mortality statistics branch at the US National Center for Health Statistics, who spoke to NPR.

While older Americans are living longer, younger people are dying at a higher rate. Between 2015 and 2016, death rates dropped 0.5% for 65-74 year-olds, 2.3% for 74-85 year-olds, and 2.1% for people over 85, according to a the US Centers for Disease Control. Death rates went up 7.8% for 15–24 year-olds, 20.5% for 25-34 year-olds, and 6.7% for 35-44 year-olds.

A portion of this can be attributed to the sharp uptick in opioid deaths. In 2015, 33,000 died from opioid overdoses. In 2016, that number rose to 42,200 (pdf), almost double the number who died from all other drugs combined. Those increases have primarily been seen in the 15–44 age ranges. Some states have been hit worse than others; in Ohio, morgues are running out of space, and West Virginia spent $1 million last fiscal year transporting corpses.

“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. We need to get a handle on it.”

How does a life expectancy of 78.6 years stack up globally? Japan’s average life expectancy, among the highest in the world, was 84.06 years in 2016, up 0.26 year from 2015. Canada enjoyed a life expectancy of 82.2 years in 2015, while the UK’s was 81.1 years (79.2 years for UK men, and 82.9 years for UK women, compared to 76.1 for US men and 81.1 for US women).

Even Costa Rica, a country with far lower per capita income, and which spends far less on healthcare, significantly outperforms the US on life expectancy. Research has suggested this could be partly due to the US’s socioeconomic inequality gap, which is much larger than Costa Rica’s. The poorest Costa Ricans are living longer than the poorest Americans, which researchers linked to worse access to health care and higher rates of dying from chronic diseases among impoverished Americans versus impoverished Costa Ricans.

Chile, Guam, Cuba, Czech Republic, and Lebanon are among other countries that beat out the US for average life expectancy as of 2015, the most recent year for which the World Bank has data for those countries.

Life expectancy “gives you sort of an overall sense of what’s going on,” Anderson told NPR, and when the figure declines, it’s a clear signal of nation with a problem. The last time US life expectancy last fell two years in a row was in 1962 and 1963, as the generation who came of age in World War II began to die of heart disease and cigarette-related cancers, according to Princeton University economist Angus Deaton, who spoke to Buzzfeed.

Even a single-year drop is a big deal. The last time US life expectancy dropped for even one year was in 1993, and that was largely due to the AIDS epidemic.

Large numbers of Americans have died from opioid overdoses in the last few years, and the numbers are rising. At this point, there are nearly 100 opioid-related deaths in the US each day, and the epidemic “appears to be accelerating,” Anderson told NPR.

But opioids aren’t the only reason life expectancy is dropping; suicides are up too. “It’s also a crisis in which people are killing themselves in much larger numbers—whites especially,” Princeton economist Anne Case told NPR. “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.” The erosion of the American social safety net, and widening class inequality, may be behind the rising rates of what Case calls “deaths of despair.”

“They have a much more fragile existence than they would have had a generation ago,” she told NPR. “It may be the deaths from drugs, from suicide, from alcohol are related to the fact that people don’t have the stability and a hope for the future that they might have had in the past.”