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Life Expectancy Drops Again As Opioid Deaths Surge In U.S.

Dec 21, 2017
Originally published on December 21, 2017 2:44 pm

Life expectancy in the U.S. fell for the second year in a row in 2016, nudged down again by a surge in fatal opioid overdoses, federal officials report Thursday.

"I'm not prone to dramatic statements," says Robert Anderson, chief of the mortality statistics branch at the National Center for Health Statistics. "But I think we should be really alarmed. The drug overdose problem is a public health problem, and it needs to be addressed. We need to get a handle on it."

The trend is especially concerning because life expectancy is considered an important indicator of the general well-being of a nation.

"It gives you sort of an overall sense of what's going on," Anderson says.

Life expectancy, which is the average time someone is expected to live, generally has been rising steadily for decades in the United States, with only occasional downward ticks.

The last time the U.S. life expectancy dropped was in 1993 because of the AIDS epidemic. Life expectancy hasn't fallen two years in a row in the U.S. since the early 1960s.

"This is quite concerning," Anderson says.

According to the latest analysis, U.S. life expectancy fell from 78.7 in 2015 to 78.6 in 2016. That follows a drop from 78.9 in 2014 that researchers hoped would be an aberration.

"For any individual, that's not a whole lot. But when you're talking about it in terms of a population, you're talking about a significant number of potential lives that aren't being lived," Anderson says.

Many factors are probably playing a role, including an apparent plateau in the reduction of deaths from heart disease, Anderson says. But a significant factor is the upswing in deaths from opioid overdoses.

Tens of thousands of Americans have died from opioid overdoses in recent years. A report released Thursday found drug overdoses jumped significantly in 2016 to more than 63,600, and more than 42,200 of them were attributed to opioids. In 2015, more than 52,400 deaths were attributed to overdoses, and 33,000 of them involved opioids.

The rate of drug overdose deaths involving synthetic opioids also jumped significantly, from 3.1 per 100,000 in 2015 and 6.2 per 100,000 in 2016.

"It's just really dramatically increased," Anderson says, noting the latest increase is "far and above greater than any of the one-year increases that we've seen to this point."

The upsurge suggests the epidemic "appears to be accelerating," he says.

"I was pretty shocked to see that our life expectancy has declined for the second year in a row," says Arun Hendi, a demographic and sociologist at the University of Southern California. "I think we should be very worried."

Hendi says the nation "urgently" needs to cut off the supply of drugs flooding the market, "particularly heroin and fentanyl." The U.S. also needs to increase the availability of treatment for addicted Americans and improve access to high-quality health care, he says.

Some researchers studying mortality trends say the opioid epidemic is just part of a larger problem.

"It's also a crisis in which people are killing themselves in much larger numbers — whites especially," says Anne Case, an economist at Princeton University who has been studying what she and her husband and fellow Princeton economist Angus Deaton call "Deaths of Despair."

"Deaths from alcohol have been rising as well. So we think of it all being signs that something is really wrong and whatever it is that's really wrong is happening nationwide," Case says.

The decline of well-paying jobs with significant yearly salary increases, job security and good benefits may be fueling a sense of frustration and hopelessness, Case says. That may be one reason fewer people are getting married and more people are having children outside of marriages, Case says.

"They don't have a good job. They don't have a marriage that supports them. They may have children that they do or don't see," Case says. "They have a much more fragile existence than they would have had a generation ago."

As a result, "it may be the deaths from drugs, from suicide, from alcohol are related to the fact that people don't have the stability and a hope for the future that they might have had in the past," Case says.

Other ethnic groups also appear to be suffering from the same issues, too, including African-Americans.

"Rates of mortality for Africans-Americans have risen after a fairly long period of decline, and that is concerning and disturbing and it may reflect a wider array of harms arising from drug issues," says Jonathan Skinner, a professor of economics at Dartmouth College.

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RACHEL MARTIN, HOST:

The federal government has just released the latest statistics on life expectancy in the United States, and the news isn't good. In fact, it's pretty grim. NPR health correspondent Rob Stein has details.

ROB STEIN, BYLINE: For decades, America was a place where each generation tended to do better than the one before it. Many parents watched their children grow up to be richer, better educated, healthier, and Robert Anderson of the National Center for Health Statistics says, for the most part, live longer.

ROBERT ANDERSON: Life expectancy measures sort of the overall status of a population, and it gives you sort of an overall sense of what's going on. And life expectancy's been increasing pretty steadily since 1950.

STEIN: But not anymore. Life expectancy dropped in 2016 again. That means it's now fallen for two years in a row.

ANDERSON: Any decline in life expectancy is pretty significant - doesn't happen very often.

STEIN: The last time was 1993 because of the AIDS epidemic. And life expectancy hasn't dropped two years in a row since the early 1960s.

ANDERSON: Prior to the '60s, you know, you have to go back to the 1920s to see life expectancy decline in two years in a row.

STEIN: But from 2014 to 2016, life expectancy fell from 78.9 years to 78.6.

ANDERSON: For any individual, that's not a whole lot. But when you're talking about it in terms of a population, you're talking about a significant number of potential lives that aren't being lived.

STEIN: So why is this happening? A big reason is the opioid epidemic. Another new report out today shows that more than 63,000 Americans died from overdoses in 2016 alone.

ANDERSON: It's just really dramatically increased. The increase from 2015 to 2016 is far and above greater than any of the one-year increases that we've seen to this point.

STEIN: Which means that not only is the opioid epidemic bad and not getting any better, it's actually getting worse. It's accelerating.

ANDERSON: I think we should be really alarmed. I mean, I'm not prone to dramatic statements, but the drug overdose issue I think is a public health crisis, and it really needs to be addressed. We need to get a handle on it.

STEIN: Other experts agree.

ARUN HENDI: I was pretty shocked to see that our life expectancy has declined for the second year in a row.

STEIN: That's Arun Hendi of the University of Southern California.

HENDI: I think we should be very worried. We need to cut off the supply of drugs flooding the market, particularly heroin and fentanyl. Second, we need to provide better treatment and more resources for people in those areas that are most affected by the drug overdose epidemic. And third, we need to improve access to high-quality health care.

STEIN: But some experts say the opioid epidemic is just part of a larger problem. Anne Case is a researcher at Princeton who's been studying what she calls deaths of despair.

ANNE CASE: It's also a crisis in which people are killing themselves in much larger numbers - whites especially - and where deaths from alcohol have been rising, as well. So we think of it all being signs that something is really wrong. And whatever it is that's really wrong is happening nationwide.

STEIN: And whatever's happening nationwide may be a sense of frustration and hopelessness about crummy jobs with no raises, security or decent benefits and everything that comes with that.

CASE: They don't have a good job. They don't have a marriage that supports them. They may have children that they do or don't see. They have a much more fragile existence than they would've had a generation ago. It may be that the deaths from drugs, from suicide, from alcohol are related to the fact that people don't have stability and a hope for the future that they might have had in the past.

STEIN: Rob Stein, NPR News.

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