Wednesday, December 14, 2016

“Despair Deaths”

Americans are dying at a faster rate, and they’re dying younger. A pair of new studies suggest Americans are sicker than people in other rich countries, and in some states, progress on stemming the tide of basic diseases like diabetes has stalled or even reversed. The studies suggest so-called “despair deaths”—alcoholism, drugs, and suicide—are a big part of the problem, but so is obesity, poverty, and social isolation. One research paper published suggested that Americans would live nearly four years longer if the U.S. had a safety net as generous as those of European countries.

American life expectancy fell by one-tenth of a year since 2014, from 78.9 to 78.8, according to a report released last week by the National Center for Health Statistics. As The Washington Post reported, the last time the life expectancy went down instead of up was in 1993, during the throes of the AIDS epidemic. Meanwhile, the number of years people are expected to live at 65 remained unchanged, suggesting people are falling ill and dying young. The overall death rate rose by 1.2 percent in 2015, the first time since 1999. The death rates went up for white men and women and for black men.

Heart disease and cancer were the most common causes, accounting for nearly half of all deaths. Still, cancer deaths are declining, while deaths from all other causes, including heart and lung diseases, strokes, Alzheimer's, diabetes, and suicides have risen. Deaths from unintentional injuries, including drug overdoses, are also up.

Much of the increase in mortality can be explained by obesity. In 2015, weight problems accounted for more than 10 percent of all American deaths, according to Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, but just 7 percent in the U.K. and 3 percent in Japan.

However, poverty and its associated struggles, such as depression, stress, and poor nutrition, are also clearly playing a role.

“We might be seeing the drag that decades of stagnant wages, growing inequality, and the associated behavioral (e.g. smoking, diet, activity) and psychosocial (e.g. chronic stress, depression) factors have on eventual mortality,” said Michael Kramer, a professor of epidemiology at Emory University, via e-mail. Americans are hit harder than other rich countries are by these forces, he posits, both because of our skimpy preventive health care and because “the U.S. has higher income inequality and less comprehensive social safety net, so the ill-effects of poverty may take an undo toll.” 

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