Increase in US Midlife Mortality Points to Deeper Issues

Growth in midlife mortality includes conditions such as heart disease, liver cancer, pulmonary disease, obesity, and neurologic disorders.

“Life expectancy in the United States has been decreasing since 2014.”

It’s a bleak statement, but a study of changes in midlife death rates in the US has the data to back it up. Investigators analyzed data about deaths among people ages 25 to 64 from 1999 to 2016 and found that midlife mortality rates from various causes have risen across racial-ethnic groups in the US.

Drug overdoses were a leading cause, but deaths due to alcohol-related disorders and suicides were important contributors as well, according to lead author Steven H Woolf, MD, MPH, director emeritus, Center on Society and Health, Virginia Commonwealth University, and professor, Department of Family Medicine and Population Health, Virginia Commonwealth University.

“It’s not supposed to be this way,” said Woolf in an interview with MD Magazine®. “In other industrialized countries, mortality rates are decreasing and life expectancy is increasing. But in the US, people are facing a growing risk of dying before age 65, despite being a country that spends more on health care than any other.”

Across the 20 broad categories of causes of deaths, the study reported that mortality rates increased in 13 categories during the study period. Among these, the largest proportional increases were in deaths due to external causes, such as drug overdoses and suicides. While the so-called “deaths of despair” have received much attention, the rise in midlife mortality extends beyond these, says Woolf, and includes heart disease, liver cancer, pulmonary disease, obesity, neurologic disorders, and more.

“The larger takeaway from our study is that the diverse impact on mortality—cutting across multiple body systems—suggests a systemic cause,” emphasized Woolf. “Something about modern American life may be responsible for this trend, but this is unlikely to be something the health care system or individual clinicians can address at the bedside. Society, policymakers, and voters have greater control over these factors.”

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