AgingPreventive Medicine


Life insurance companies, healthcare agencies like the CDC, economists, and the U.S. census bureau all have a keen interest in knowing how long people can be expected to live. These organizations use this information for numerous reasons, but knowing what factors affect the length of American’s lives has many implications.

Life expectancy is a term with which we’re all familiar. Though it’s not something we ever think much about, when we apply for life or disability insurance, it’s used to determine how much we will have to pay to be insured. Life expectancy is a measure of the health of the American populous. It is a number insurer, et al. use to compare your life situation to that of the general public. It takes into account lifestyle habits, race, socioeconomic status, and geographical location.

For decades the life expectancy of Americans was increasing. From 1959 to 2010, life expectancy increased from 68.9 to 78.9 years. This change was attributed to many things but major factors are:

Better Education

Smoking Cessation

Health Awareness and Preventive Medicine

Rising Living Standards

Improved Lifestyle

Access to Health Services

In the mid 1990s, however, the upward trend began to gradually slow. Then, after 2014 it began to decline. What happened in the1990’s to affect life expectancy? What caused the average life span of Americans to be shorter?

The answer lies in the opioid epidemic and drug use which has been an ever-increasing problem since the 90’s to where now it is a full-blown health crisis. Mental health issues, especially depression and suicide, have contributed to this decline as well. In past generations, life expectancy was affected by famine, wars, disease, and poor health habits.

But now, these societal aberrations have overcome the good accomplished by the factors listed above.

The shortening of life expectancy has been largely caused by those societal behaviors in the 25-64 year-old age group. This demographic has been affected by drug abuse and suicide to such an extent it has had a profound effect on overall life expectancy. Suddenly, because of fentanyl, OxyContin, heroin, alcohol abuse, and mental health issues in middle age groups, the average length of life has been reduced. If most people have been living into their 80’s and suddenly a large number of them are now dying in their 40’s or 50’s, the average lifetime will shorten. That’s a worrisome dilemma.

Studies have revealed that Asian Americans live the longest (87.1years) and African Americans the shortest (75.4 years). Latinos live 83.3, whites 78.9, and native Americans 76.9 years. An extensive study of this problem reported in JAMA found that residents of New England (New Hampshire, Maine, Vermont) and the Ohio Valley (West Virginia, Ohio, Indiana, Kentucky) had the largest increases in midlife mortality rates. It was folks of all racial groups in these areas who had the largest impact on shortening life expectancy numbers.

This study represented “a call to action.” But rather than confronting the opioid crisis head-on, they emphasized research into “how income inequality, unstable employment, divergent state policies, and other social dimensions affect the disease.” They emphasized how “social connection, spirituality, and community” themes influence life, and that a reversal of U.S. health disadvantage could “restore well-being opportunities for millions.” It is vital to understand the underlying cause of shortened life expectancy and to respond positively to that cause to interrupt this trend. I’m not sure how equalizing income, etc. affects that, but stemming the flow of illegal drugs into this country, and just like cigarette smoking, emphasizing to youth and adults from birth on, the incredible harm they can cause, is a good start.

References: Woolf SH, Schoomaker H. Life Expectancy and Mortality Rates in the United States, 1959-2017. JAMA 2019 Nov 26;322(20):1996-2013.

Koh HK, Parekh AK, Park JJ Confronting the Rise and Fall of US Life Expectancy. JAMA 2019 Nov 26;322(20):1963-1964.


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