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The Declining Life Expectancy in the US: Understanding the Factors

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In recent years, life expectancy in the US has seen a troubling decline. In fact, the country has experienced the longest sustained decrease in life expectancy since the First World War. Although the US is one of the wealthiest and most developed countries in the world, it lags behind in terms of the average lifespan of its people. This issue is a complex one, and a range of factors contribute to the declining life expectancy in the country.

The importance of this issue cannot be overstated. Life expectancy is a key measure of a population's health, and a decline in this metric implies a systemic failure in healthcare and other structural areas. Furthermore, a decline in life expectancy incurs significant economic and social costs, ever-increasing healthcare bills, and reduced productivity. We need to evaluate the factors that have been driving this trend to understand what needs to be corrected to prevent a further decline in life expectancy.

Factors Contributing to Falling Life Expectancy

Opioid Epidemic

The opioid epidemic has had a significant impact on the overall life expectancy of individuals in the US. The misuse and overuse of opioids have led to an alarming increase in the number of opioid-related deaths. In 2019 alone, there were an estimated 50,000 such deaths in the US. Additionally, the opioid epidemic has caused a sharp rise in the number of drug overdoses, leading to more ER visits and hospital admissions.

Increase in Opioid-related Deaths

Opioid-related deaths have been on a steady increase since the early 2000s. In fact, from 2013 to 2018, there was a sharp rise in opioid-related deaths in the US, with over 130 deaths per day. This increase in deaths can be attributed to many factors, including over-prescription of opioids, lack of regulation of opioid prescriptions, and the increase in illicit opioid use.

Impact on Overall Life Expectancy

The opioid epidemic has had a significant impact on the overall life expectancy of individuals in the US. In 2016, for example, there was a decrease in overall life expectancy due to opioid overdoses. The epidemic has also contributed to a decrease in the quality of life and an increase in health problems.

Obesity and Poor Diet

Obesity and poor diet have also played a significant role in the declining life expectancy in the US, particularly among younger adults and children.

Current Rates of Obesity in the US

The current rates of obesity in the US are staggering, with more than one-third of adults and about 17% of children and adolescents in the country being obese. Obesity rates have remained high for decades, and the issue is becoming more prevalent among the population.

Health Consequences of Obesity

Obesity has been associated with various health problems, including diabetes, heart disease, and stroke. Additionally, the increase in obesity rates has led to an increased demand for healthcare services, further straining the healthcare system and causing more problems for individuals.

Lack of Access to Healthcare

The lack of access to adequate healthcare is another significant factor contributing to the falling life expectancy in the US. Many people in the country are uninsured or underinsured, which limits their access to quality healthcare services.

Number of Uninsured Individuals

The number of uninsured individuals in the US remains high, despite efforts to provide access to healthcare. In 2019, there were approximately 28 million uninsured individuals in the country. This lack of insurance coverage contributes to delays in receiving care and preventive services.

Consequences of Lack of Healthcare

The lack of access to healthcare can have severe consequences, leading to a decrease in overall health outcomes and life expectancy. For example, individuals with limited access to healthcare services may not receive timely screening for diseases or may not be able to afford necessary medications or treatments.

Mental Health Issues

Finally, an increase in rates of depression and anxiety has also contributed to the declining life expectancy in the US.

Increase in Rates of Depression and Anxiety

There has been a sharp rise in the number of individuals diagnosed with depression and anxiety in recent years. Over 19 million people in the US experience depression each year, with anxiety disorders being the most common mental health disorder in the country.

Impact on Overall Life Expectancy

The impact of depression and anxiety on life expectancy is significant, with individuals with these conditions being at a higher risk of other health problems, such as heart disease and diabetes. Additionally, mental health problems can lead to unhealthy coping mechanisms, such as drug or alcohol abuse, which further exacerbates the problem.

Effects of Falling Life Expectancy

The declining life expectancy in the US has not only impacted individuals' health but has also led to several social, emotional, and economic consequences.

Economic Consequences

The declining life expectancy has resulted in several economic consequences. Two main economic implications are decrease in productivity and increased healthcare costs.

Decrease in Productivity

The loss of life due to the factors contributing to decreased life expectancy has led to the loss of human capital. The loss of workers with valuable knowledge and experience leads to a decrease in productivity. This can result in lasting economic impacts, particularly in small businesses and rural communities.

Increased Healthcare Costs

The declining life expectancy has led to an increase in healthcare costs. As healthcare services are in increasing demand, the cost of providing those services also increases. Additionally, individuals with poor health and chronic conditions require more healthcare than those who are healthy. The resulting increase in healthcare costs further exacerbates the economic consequences of the declining life expectancy.

Social and Emotional Consequences

The declining life expectancy in the US has led to several social and emotional consequences. Two significant consequences include increased stress and anxiety and the loss of loved ones at younger ages.

Increased Stress and Anxiety

The decline in life expectancy has led to increased stress and anxiety in the general population. Fear of premature death and concern about the future has impacted the emotional and mental health of individuals. This anxiety may further lead to unhealthy behaviors, such as substance abuse and overeating, which can result in poor health outcomes.

Loss of Loved Ones at Younger Ages

The decline in life expectancy has led to the loss of loved ones at younger ages. This can have a significant impact on individuals' social and emotional well-being. Losing someone close to them unexpectedly can lead to grief and depression, which can also impact their physical health.

Steps to Improve Life Expectancy

Improving life expectancy in the US requires a multifaceted approach. Addressing the root causes of the decline in life expectancy is crucial. Here are some strategies to improve life expectancy in the US:

Addressing the Opioid Epidemic

The opioid epidemic has been one of the leading causes of declining life expectancy in the US. Here are two ways to tackle it:

  • Treatment Options: Access to medication-assisted treatment (MAT) can be expanded. MATs are an effective way to treat opioid addiction and help individuals overcome their addiction. MATs use medications such as buprenorphine to reduce opioid withdrawal symptoms and block the effects of opioids.
  • Prevention Efforts: Implementing prevention programs and policies such as prescription drug monitoring programs and limiting the number of opioids prescribed can curb opioid abuse and prevent overdose deaths.

Promoting Healthy Lifestyles

Poor diets and sedentary lifestyles contribute to several chronic conditions like obesity, heart diseases, and diabetes. Educating individuals on healthy eating habits, exercise routines, and providing access to healthy food options can help improve health outcomes. Here are two ways to achieve a healthy lifestyle:

  • Education on Nutrition and Exercise: Providing public education on healthy eating and exercise can help individuals make healthier life choices and impact their health positively.
  • Access to Healthy Food Options: Increasing access to healthy food options in communities, especially those with few resources and limited access to healthy foods, will be helpful.

Expanding Access to Healthcare

Limited access to healthcare is one challenge people face in the US. Here are two ways to achieve universal healthcare:

  • Universal Healthcare: A system where every resident of the US would get the treatment they need irrespective of their financial abilities. This would help reduce healthcare disparities and ensure everyone gets the care they need.
  • Programs to Address Healthcare Disparities: Public health programs that promote preventive medicine and target communities and populations where inequalities exist can help reduce healthcare disparities. Such programs can provide essential medical services such as screening, cancer prevention, and management of chronic diseases like diabetes.

Addressing Mental Health Issues

Poor mental health can adversely impact the overall well-being of an individual. Addressing mental health issues is essential to improve life expectancy. Here are two measures that need to be implemented:

  • Improving Access to Mental Healthcare: Community mental health centers and increased access to psychologists, psychiatrists, and therapists can help ensure individuals receive proper care for mental health conditions.
  • Reducing Stigma: Reducing the stigma associated with mental health issues can help individuals open up about their struggles and seek the help they need. Education on the impact of mental health issues on overall health and well-being can be helpful in reducing stigma.

Often, successful interventions come from combining different approaches rather than a single approach. Implementing these approaches can significantly contribute to improving life expectancy in the US.


Falling life expectancy is a concerning trend in the US that needs urgent attention. The factors outlined in this article, such as the opioid epidemic, unhealthy lifestyle practices, limited access to healthcare, and untreated mental health conditions, have all contributed to this decline.

It is time to take action to improve life expectancy in the US. Implementing policies that address the root causes of declining life expectancy is an essential step to take. We need to promote healthy living, expand access to healthcare, and address the stigma surrounding mental health.

Of these strategies, promoting healthy lifestyles is particularly crucial. Encouraging healthy eating habits and regular exercise can significantly lower rates of obesity and chronic diseases. Providing access to healthy food options and educating individuals on the impact of healthy living is essential.

Expanding access to healthcare is another vital strategy to promote healthy living and improve life expectancy. Cost should not be a barrier to receiving essential healthcare services. Universal healthcare and targeted intervention programs can help bridge the gap in healthcare disparities in the US.

Finally, there is hope for a healthier future. With the right policies and interventions, we can reverse the current downward trend in life expectancy and create a healthier future for all. It is essential to take action now to improve the health and well-being of individuals across the US.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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