How US life expectancy fell off a cliff
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
Two decades ago, people in the US enjoyed reasonably long lives, comparable to most peer countries. An American girl born in 1990 could expect to live almost 79 years if mortality rates remained as they were then, giving her the best part of a year longer than her contemporaries born in England and Wales, Germany and Denmark.
While the picture was slightly less rosy for her brother, he would live to 72 on average, roughly neck-and-neck with the same cohort in western Europe. In the two decades since then, something — or some things, to be more precise — have gone very wrong.
As recently as 10 years ago, you might have struggled to pick the US out of the pack on a chart of life expectancy, but today that task could scarcely be easier. If we put aside the grim mortality shock of the past two years for a moment, the pattern is stark: a flock of developed countries streaks up and to the right, and then one solitary line slows, falters, and begins falling back to earth.
A yawning gulf has since opened up. On the eve of the pandemic, the average US baby boy was expected to live almost four years fewer than the average child born in similarly wealthy countries. Even its crisis-racked cousin across the Atlantic puts it to shame. The life expectancy at birth for a male child born in the US in 2019 was 76.1 years, the same as a boy born in England in 2001.
Dig beneath the surface, and the driving factors are clear. By stripping out deaths from specific causes in all countries, I have created a series of counterfactuals for how life expectancy would have evolved, both in the US and elsewhere, if certain factors were absent.
Some influence the level — if we equalise rates of obesity in all countries, the US deficit by 2019 shrinks from 3.6 years to 2.2 — but the shape remains unchanged, with male life expectancy still arcing downwards. There is only one factor on which the blame can be pinned for the recent reversal: deaths from drug overdoses.
By my calculations, the opioid epidemic has thus far wiped off the best part of a year from US male life expectancy at birth, and the vertiginous climb in new drug-related deaths during the pandemic will only have accelerated this trend.
There are several other areas that, if addressed, could also narrow the gap between the US and the rest — gun deaths (both homicide and suicide) and elevated rates of road accidents account for an additional 9 and 6 lost months respectively, relative to peer countries. But these gaps have remained stubbornly large for decades now.
Governments and businesses threw their biggest brains and untold billions at battling the pandemic over the past two years. Those efforts saved countless lives and should continue to provide downward pressure on the toll Covid exacts. The lack of imagination and resources being shown in facing up to the rapid emergence of a huge new drag on mortality is alarming.
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