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Friday, August 24, 2018

Deaths of Despair

 A study looked at trends across 18 high-income countries and found that most countries experienced declines in life expectancy in 2015. This is the first time in recent decades that so many high-income countries simultaneously experienced declines in life expectancy for both men and women. 
Out of 18 countries in the study, 12 experienced life expectancy declines among men and 11 experienced life expectancy declines among women. Most of these countries reversed their life expectancy decline in the 2015-2016 period, but in the US and the UK, the declines continued, the authors note.
"This hasn't occurred in decades, and the size of these most recent declines were larger than prior declines," said study co-author Jessica Ho of the University of Southern California in Los Angeles.
In the US, the source of reduced life expectancy was concentrated at younger ages, particularly deaths among those in their 20s and 30s, and largely driven by increases in drug overdose deaths related to the nation's ongoing opioid epidemic.
A second study in the BMJ suggests, however, that the problems driving life expectancy declines in the US are broader than just the opioid crisis and may extend to a wide range of causes unrelated to drug use or substance abuse.
"A leading cause is fatal drug overdoses—fueled by the opioid epidemic—but we make a mistake if we focus only on the drug problem, which is just the tip of the iceberg," said lead study author Dr. Steven H. Woolf of Virginia Commonwealth University in Richmond. "Deaths from alcoholism and suicides have also increased, what some call deaths of despair," Woolf said.
"Although a part of this health disadvantage of lower socioeconomic classes is explained by 'traditional' risk factors, such as poor diet, alcohol, and smoking, the question remains why these people have a higher risk of choosing such health-damaging behaviors," Jasilionis, author of an editorial accompanying the studies, said. "There is strong evidence that psychological factors, often having social origins including social exclusion, poor prospects for social mobility, and high income inequality are the main contributors to these 'bad choices,' especially in the lowest socioeconomic groups." 
The study also found rising midlife death rates from dozens of diseases of the heart, lungs, digestive systems, and other organs. It even found rising death rates during pregnancy and early childhood, Woolf said. "Something far-reaching is affecting the health of Americans in the prime of their lives," Woolf said.

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