Public Health - Santé Publique

New data released by the Centers for Disease Control and Prevention (CDC) this month showed that Americans’ life expectancy fell from 2014 to 2015, from 78.9 years to 78.8 years. Though this may sound like a trivial change, declines in life expectancy are rare in the developed world outside of periods of war or national crisis. For the United States, last year’s was the first such decline since the height of the AIDS epidemic.

 

Much of the attention given to this phenomenon has understandably focused on rising rates of drug overdoses, particularly opioids. The opioid epidemic led to more than 33,000 deaths last year alone and has devastated families and communities in every corner of the country. Sadly, suicide and alcohol-related deaths also have become more common in recent years—part of a rise in what Princeton economist Anne Case has called “deaths by despair.”

 

However, drugs, alcohol, and suicide do not, on their own, explain our declining life expectancy. As the new CDC data show, these factors accounted for only about 30 percent of the overall rise in mortality from 2014 to 2015.1 Death rates also rose for eight of the top 10 causes of death—including heart disease, America’s number-one killer. “Deaths by despair” simply aren’t enough to tell the whole story.

 

This observation holds true when looking at mortality trends for the working-age white population, where the epidemic of overdoses and suicide has largely been concentrated. For this group, after decades of steady decline, all-cause mortality rates essentially flatlined after 1999 (Exhibit 1). (Mortality continued to fall for black Americans and Hispanics.) If whites’ mortality had continued to improve at its previous rate, about 100,000 deaths would have been avoided in 2015 alone.

 

Further Reading:

• “The Awful U.S. Life Expectancy Despite Awesome Dollars Spent on Healthcare!”; http://sco.lt/4ut8JF
• “Disparity in Life Spans of Rich vs Poor More Than Doubled Since 70s”; http://sco.lt/5KxYq9
• “Innovative Cancer Medicines Have Led to Increased Survival Rates & Higher Life Expectancy” says PhRMA; http://sco.lt/4n1y5Z

Via Pharma Guy

The US stands out as an outlier: the US spends far more on health than any other country, yet the life expectancy of the American population is not longer but actually shorter than in other countries that spend far less.

If we look at the time trend for each country we first notice that all countries have followed an upward trajectory – the population lives increasingly longer as health expenditure increased. But again the US stands out as the the country is following a much flatter trajectory; gains in life expectancy from additional health spending in the U.S. were much smaller than in the other high-income countries, particularly since the mid-1980s.

This development led to a large inequality between the US and other rich countries: In the US health spending per capita is often more than three-times higher than in other rich countries, yet the populations of countries with much lower health spending than the US enjoy considerably longer lives. In the most extreme case we see that Americans spend 5-times more than Chileans, but the population of Chile actually lives longer than Americans. The table at the end of this post shows the latest data for all countries so that you can study the data directly.

Via Pharma Guy