It’s been nearly three years since I published a blog on the life expectancy of Americans. An article in the November 2019 issue of JAMA presented the results of research done jointly by the CDC, life insurance companies, the U.S. census bureau, and healthcare economists that stated since 2014, the average life expectancy of Americans had declined. The study blamed the opioid crisis for shortening the lives of mainly the 25-64 year-old demographic. Drug abuse and mental health issues replaced war and infectious disease as the leading causes of death among young and middle-aged adults.
Unfortunately, since 2014 this trend has not been reversed because effective solutions for this problem were never implemented. The smuggling of opioids across the southern border is out of control, and legalization of marijuana nationwide is just around the corner. Increasing the availability of fentanyl, heroin, cocaine, et al. will only affect life expectancy negatively.
Now, another article in the Journal of the American Medical Association (JAMA) has even worse news.The article states that between 2019 and 2021, the life expectancy of U.S. men declined by 3 years, and U.S. women declined 2.3 years! Men live 73 years and women about 79 years, the lowest levels since 1996. Seventy-five percent of the decline was blamed on deaths from COVID-19. Most of the remaining 25% were due to “unintentional injuries,” half of which were from opioid overdoses. “A staggering 109,000 overdose deaths were recorded in the U.S. from March 2021 to March 2022.”
Between 2020 and 2021, the causes of lost life expectancy differed between men and women. While men died from suicide, chronic liver disease, or homicide, women died from heart disease, stroke, and chronic liver disease. Chronic liver disease results from hepatitis B or C acquired through IV drug use or sexual promiscuity.
From a racial or ethnic perspective, between 2020 and 2021, American Indian and Alaskan native individuals had the largest decline from age 67 to 65. Non-Hispanic Whites dropped from 77 to 76. Black individuals dropped 8 months to 70.5 years, Hispanics dropped 2.5 months to age 78, and Asians dropped 1 month to 83.5 years.
The gap between the life expectancies of men and women has increased, too. In 2010, the gap was 4.8 years, the lowest ever recorded. In 2021, the male-female gap had increased to 6 years. I suspect the reason is men are more prone to practicing risky sexual and drug-use behaviors.
Recently, a good friend and medical colleague presented me with another article that is good news for the people involved but does nothing to reassure the general population. The article from a healthcare accountability organization stated that “on average, doctors live longer than the general population.” Yes, that’s right! Despite the stresses of the COVID-19 pandemic and the general rigors of medical practice, the mean age at death for all physicians was 78.9 years. The highest life expectancy among physicians was for primary care doctors at 80.3 years, while the lowest was emergency medicine physicians at 71.3 years. That’s quite a difference.
When broken down by specialty, a separation becomes apparent with family physicians topping the list at 80.3 years. Pathologists, the doctors who run the lab and do autopsies, were second with a mean of 79.8. ER docs were at the bottom.
From information I received this week, I did my own analysis of local physician life expectancy. It’s a small sampling, but I know of seventeen physicians on the medical staff of my hospital who died of “natural causes” in recent years. I omitted two of them whose deaths involved motor vehicle accidents. Of the remaining 15, the oldest was 94. The youngest was 55. The average/mean age was 78.2, very close to the 78.9 for all specialties and 78.89 for the general population.
Mean and average numbers are basically determined the same way and are different in name only. Average is the sum of all ages sampled divided by the total number. Mean is similarly calculated. For example for the numbers 80, 75, 74, 55 the average is the total (284) divided by 4, or 71. The number 55 lowers the average significantly.
The reason “doctors live longer” is attributed to their having a greater awareness of healthy lifestyle habits and practicing them. They are more aware of what it takes to prevent disease, and possess a broad knowledge of the methods of screening for chronic disease. The study suggests that “socioeconomic factors [are] important, and doctors “tend to be better educated and wealthier….traits [that are] associated with longer life.”
Physicians experience significant job stress, and burnout is an ever-increasing concern. Residency training is intended to prepare physicians for that, but the state of reimbursement in today’s medical environment makes physicians feel unimportant and under-appreciated. Thus, “rate[s] of suicide are higher among medical professionals than in the general population.” And physicians are seeking career change more often than ever.
Dr. G’s Opinion: Someone, or some agency, probably the CDC, is alarmed about the decline in life expectancy, and they should be. They’re reporting it to increase public awareness and perhaps influence policies to do something about the root causes. Declining life expectancy and the reasons for it says a lot about the state of American society. There should be outrage about the illegal entry of opioids into the U.S. It is leading to poverty, homelessness, destruction of our cities, and ultimately to opioid-induced deaths. COVID-19 deaths, or at least the reporting of them, have quieted down recently, but opioid problems have not. If reporting on the shortening of life expectancy has any influence on the problem, so be it!
The purpose of the physician study escapes me. It does, however, succeed in making family doctors look hale and hardy. If the intent is to imply doctors are stronger, more resilient, and healthier, it is misdirected praise. Yes, many doctors practice good health habits and are healthier than the general public, but I think their longevity is largely the result of ambition, committment, and perseverance that keep them going when others might quit. Good genes help, too. The older I get, the more I see colleagues dying or getting a terrible disease. It’s a real awakening when you learn 17 have died in the last two years alone! I’m ready for it spiritually, but not emotionally. We don’t have control over when it’s our time, so we should make the most of the time we have.
Reference: https://www.healthgrades.com/pro/medical-specialties-ranked-by-life-expectancy.
News from the Centers for Disease Control and Prevention: “Lowest US Life Expectancy Since 1996 Linked to COVID-19.” JAMA 2022 October 11;328(14):1389.
