Guns, Germs, and Drugs Are Largely Responsible for the Decline in U.S. Life Expectancy

“So why did U.S. life expectancy trends slow and then peak in 2014? And what, if anything, can policy makers and politicians realistically do to make increasing it a priority? As noted above, the big recent dip largely resulted from the COVID-19 pandemic. A 2023 Scientific Reports article “estimated that US life expectancy at birth dropped by 3.08 years due to the million COVID-19 deaths” between February 2020 and May 2022. But let’s set aside that steep post-2020 downtick in life expectancy resulting from nearly 1.2 million Americans dying of COVID-19 infections.

A 2020 study in Health Affairs chiefly attributed the 3.3-year increase in U.S. life expectancy between 1990 and 2015 to public health, better pharmaceuticals, and improvements in medical care. By public health, the authors meant such things as campaigns to reduce smoking, increase cancer screenings and seat belt usage, improve auto and traffic safety, and increase awareness of the danger of stomach sleep for infants. With respect to pharmaceuticals, they cited the significant reduction in cardiovascular diseases that resulted from the introduction of effective drugs to lower cholesterol and blood pressure.

So a big part of what propelled increases in U.S. life expectancy is the fact that the percentage of Americans who smoke has fallen from 43 percent in the 1970s to 16 percent now. Smoking is associated with higher risks of cardiovascular diseases and cancers, rates of which have been dropping for decades. In addition, the rising percentage of Americans who are college graduates correlated with increasing life expectancy.

However, since the 2004 peak, countervailing increases in the death rates from drug overdoses, firearms, traffic accidents, and diseases associated with obesity contributed to the flattening of U.S. life expectancy trends.

A 2021 comprehensive analysis of the recent stagnation and decline in U.S. life expectancy in the Annual Review of Public Health (ARPH) largely concurs, finding that “the proximate causes of the decline are increases in opioid overdose deaths, suicide, homicide, and Alzheimer’s disease.” Interestingly, the U.S. trend in Alzheimer’s disease prevalence has been downward since 2011. In addition, the ARPH review noted that “a slowdown in the long-term decline in mortality from cardiovascular diseases has also prevented life expectancy from improving further.” So enabling and persuading more properly diagnosed Americans to take blood pressure and cholesterol-lowering medications would likely boost overall life expectancy.”

https://reason.com/2024/01/08/guns-germs-and-drugs-are-largely-responsible-for-the-decline-in-u-s-life-expectancy/