US Life Expectancy Has Finally Stopped Declining

The first increase in life expectancy since 2014 is largely due to a 4% decline in drug overdose deaths — the first such drop in 28 years.

Life expectancy in the US increased by about a month to 78.7 years in 2018, federal health officials reported on Thursday. The increase reverses an alarming — and unprecedented — drop for the past three years in the vital measure of national health.

Around 2.8 million people died in the US in 2018. US life expectancy in that year was still below its 2014 peak of 78.9 years, according to the National Center for Health Statistics. Falling heart disease and cancer death rates, the two leading causes of death, as well as a 4% decrease in drug overdose deaths, the first such drop in 28 years, appear to have arrested the decline in life expectancy seen since 2014.

"This news is a real victory," HHS Secretary Alex Azar said in a statement. "The drop in overdose deaths shows that the President’s new level of focus on the opioid crisis, and the administration’s science- and community-based efforts to combat it, are beginning to make a significant difference."

Death rates increased in 2018 for only 2 of the 10 leading causes of death, suicide and influenza, the NCHS report noted, coming after a severe flu season that winter.

“We should be cautiously optimistic,” Regina LaBelle of the O'Neill Institute for National and Global Health Law Georgetown University Law Center told BuzzFeed News. “Optimistic because it appears that life expectancy didn't decrease again and overdose deaths are down slightly. But cautious because this is a one year snapshot of a moving picture.”

Both the decline in cancer death rates, linked to decreasing rates of smoking, and fewer overdoses, following a nationwide expansion in drug treatment, point to the importance of long-term prevention efforts, LaBelle noted.

But LaBelle and other experts also pointed to the unevenness of the gains: While drug overdoses dropped in 14 states and the District of Columbia, they continued to increase in California, Delaware, Missouri, New Jersey, and South Carolina.

In the big picture, US life expectancy has been stagnating since 2010 despite small fluctuations, sociologist Francesco Acciai of Arizona State University told BuzzFeed News. In the 2000s, in contrast, US life expectancy had steadily increased by 1.7 years. "Whether the small increase of 2018 will be the beginning of a new period of growth or another fluctuation of a decade-long flat trend, only time will tell," he said.

An accompanying NCHS report on drug overdose deaths noted that, even amid the decline in painkiller and heroin deaths from 2012 through 2018, the rate of fatal overdoses involving cocaine had more than tripled and methamphetamine death rates increased nearly fivefold. Overdose deaths still stand at a staggering 67,000 lives lost in 2018.

“While life expectancy has continued to improve in large highly educated urban hubs, life expectancy declines have been much more pronounced in former industrial cities, much of Appalachia, and in many small towns and cities across America’s heartland,” Syracuse University sociologist Shannon Monnat told BuzzFeed News.

In young adults and working-age people especially, death rates have worsened for multiple reasons — not just drug overdoses, Monnat noted, but also suicides, alcohol-related diseases, some heart diseases, and other serious health problems like diabetes and organ failures. “There is more than one underlying cause at play,” she said.

A number of experts have pointed to an increase in so-called deaths of despair over the last two decades — notably from suicide, overdoses, and alcohol-related diseases — seen in parts of the country with job losses, declining populations, and hollowed-out towns. Life expectancy increasing to reverse the trend is encouraging, but has to be weighed against those long-term trends, said LaBelle.

“Declaring victory could slow down any momentum we're making,” she said. “We're just at the beginning of a much longer term effort to change the way we treat addiction in this country.”

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