Americas

US 'Falling Behind' on Life Expectancy Since 1950s

A new academic paper highlights the longer-term trend of declining life expectancy in the United States, noting the problem is not recent, but dates to the middle of the last century.
Sputnik
The paper is titled "Falling Behind: The Growing Gap in Life Expectancy Between the United States and Other Countries, 1933–2021" and was published on Thursday in the peer-reviewed journal American Journal of Public Health. The authors found that US life expectancy reached its highest ranking among world powers in the mid-1950s, after which time it began to slow its growth as well as steadily lose ground to newer industrializing nations, resulting in its middling position today, behind dozens of other nations.

"The scale of the problem is bigger than we ever thought . . . older than we thought [and] the number of countries outperforming the United States is much larger than we thought," said study author Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University.

As with many industrialized countries, the US saw dramatic increases in life expectancy in the early 20th century thanks in large part to medical advances such as vaccines, sanitation, and antibiotics. The US was also spared from most of the destruction of the two World Wars, which killed tens of millions in Europe, the Middle East and East Asia, while several hundred thousand American troops were killed, nearly all on overseas battlefields.
By the 1950s, life expectancy in the US had reached 12th in the world, but by 1968 it had already slid to 29th place.

"When asked 'when did this problem begin', we cited the 1980s... Because we haven’t gone back far enough in the historical data to see what happened before," Woolf said. "That there was a decline in the 1950s raises questions about what was going on then."

Life expectancy continued to increase though, albeit slightly, but the rate again intensified in 1974, slowing again in the mid-1980s.
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By 2014, US life expectancy had peaked at 78.84 years, declining slightly for several years until beginning a more marked decline in 2020 - the year the COVID-19 pandemic hit. Within two years, the respiratory virus had killed at least 1 million people in the US, although some estimates place the number of dead much higher.

Causes of Death

The report passes on trying to diagnose factors behind the decline in life expectancy, but some trends noted elsewhere include a steady increase in drug overdose deaths since the mid-1970s and a dramatic spike in suicide deaths in the 21st century. In 2022, roughly 110,000 deaths were attributed to drug overdoses. In the year prior, the most recent year for which the CDC has statistics, 48,183 people died by suicide in the US - roughly twice the number of homicide deaths.
In all, more than 3.2 million people died in the US in 2022, with the four leading causes of death being heart disease (699,659), cancer (607,790), unintentional injury (218,064), and COVID-19 (186,702).

Geographic Context

In part, the academics made their discovery by expanding the international scope of their study beyond the few large industrialized "peer" countries to which the US is typically compared, and including all countries with populations above 500,000, excluding only small city-states.
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However, they also found that some parts of the US have seen substantially slower growth than others, with US states in the northeast and the west seeing the fastest growth in life expectancy, while the south, central, and midwestern states lagged behind.

"This cluster of states really played an outsized role in producing these poor rankings for the United States," Woolf said. "States doing very well like Hawaii, New York and other high performers are ranked among some [of] the same life expectancy as some of the healthiest countries in the world."

Indeed, other studies on which Woolf has worked have found that Americans die younger in red states, with suicide, drug overdose, and unhealthy habits driving the death rate up.
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