Drop in U.S. Life Expectancy May Have Wide-Ranging Causes

The recent decline in the average life expectancy of working-age white Americans cannot be explained solely by the rise in suicide and substance abuse, an issue brief from the Commonwealth Fund finds.

Based on new data released by the Centers for Disease Control and Prevention, the brief, The Shortening American Lifespan, found that life expectancy in the United States dropped from 78.9 years in 2014 to 78.8 years in 2015, the first such decline since the height of the AIDS epidemic. Although  increases in overdoses and suicides played a role in Americans' shorter life expectancy, the CDC data found that they account for only about 30 percent of the overall uptick in mortality from 2014 to 2015.

The brief also found the mortality rate among working-age white Americans flatlined after 1999 — even as those of African Americans and Latinos continued to decline — with most of the "excess deaths" attributable to other causes, including heart disease, cerebrovascular diseases, and chronic lung disease. The increase in suicides and opioid abuse- and alcohol-related deaths has coincided with adverse mortality trends for a wide variety of diseases and conditions, the brief argues, which may indicate a general deterioration in the health of the U.S. public, particularly among working-age whites. Although these trends may be rooted in factors such as economic dislocation, cultural fragmentation, and social isolation, income-based disparities in life expectancy also are wide and growing rapidly.

"Targeting improvement efforts at our most vulnerable groups," the brief concludes, "remains the most promising approach to confronting our national mortality crisis."

David Squires. "The Shortening American Lifespan." Commonwealth Fund Issue Brief 01/04/2017.