US Life Expectancy Drops, Mortality Rises Among Younger Adults

US life expectancy rates are dropping, while trends show a surge in young adult and midlife mortality, according to 2 linked studies published in The BMJ.

Increases in mortality tend to be attributed to severe epidemics and typically affect older individuals. However, the new findings indicate more troubling trends that affect younger populations and span across multiple racial and ethnic groups.

In the first study, led by researchers from the University of Southern California and Princeton University, decreasing life expectancy was observed across 18 high-income countries, most occurring simultaneously in 2015. While many of the countries rebounded in 2016, the United States and United Kingdom continued to see declines for 2 consecutive years.

With the lowest life expectancy among high-income countries, the United States fares poorly across a wide range of ages, health conditions, and causes of death compared with their counterparts. Although most countries saw a decline concentrated in individuals older than 65 years, the US expectancy decline primarily affected young adults, according to the researchers.

Causes of death in non-US countries included influenza and pneumonia, respiratory disease, cardiovascular disease, and Alzheimer disease, as well as other mental and nervous system disorders. In the United States, drug overdose deaths drove the decline, pointing to the ongoing opioid epidemic as a key contributor.

In the second study, researchers used national data to compare midlife death patterns from 1999 to 2016. According to their findings, drug overdoses, suicides, and alcoholism were the main causes of excess deaths, but mortality rates also increased substantially for organ diseases involving the heart, lung, and other body systems.

Overall death rates were higher among men than women, and the relative increases in fatal drug overdoses and suicides were greater in women as well, the researchers noted.

Although the report indicates that opioids may have played an important role, the researchers caution that no single factor can explain the trend. However, the researchers noted that the study “signals a systemic cause and warrants prompt action by policy makers to tackle the factors responsible for declining health in the US.”

The researchers also called for more reliable data to improve monitoring of trends in life expectancy and population health, concluding that “in the interest of timely identification of shared threats to life expectancy and population health more broadly, countries should make the release of accurate vital statistics data a priority.”

References

Ho J, Hendi AS. Recent trends in life expectancy across high income countries: retrospective observational study. BMJ. 2018. Doi: https://doi.org/10.1136/bmj.k2562

Jasilionis D. Reversals in life expectancy in high income countries? BMJ. 2018. Doi: https://www.bmj.com/content/362/bmj.k3399