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Why Is U.S. Life Expectancy Down for a Second Year in a Row?

Life expectancy in the US has declined for the second year in a row as the opioid crisis continues to ravage the nation.

It is the first time in half a century that there have been two consecutive years of declining life expectancy.

Drug overdoses killed 63,600 Americans in 2016, an increase of 21% over the previous year, researchers at the National Center for Health Statistics found.

Americans can now expect to live 78.6 years, a decrease of 0.1 years. The US last experienced two years’ decline in a row in 1963, during the height of the tobacco epidemic and amid a wave of flu.

“We do occasionally see a one-year dip, even that doesn’t happen that often, but two years in a row is quite striking,” said Robert Anderson, chief of the mortality statistics branch with the National Center for Health Statistics. “And the key driver of that is the increase in drug overdose mortality.”

Especially disconcerting, said Anderson, was preliminary data researchers received about overdoses in 2017: “It doesn’t look any better.” Together, the drug overdose epidemic and a plateau in improved mortality rates from cardiovascular disease are “affecting the entire national picture”.

“We haven’t seen more than two years in a row in declining life expectancy since the Spanish flu – 100 years ago,” said Anderson. “We would be entering that sort of territory, which is extremely concerning.”

Widely available prescription painkillers opened the gates for a new universe of legal and illegal opioid abuse beginning in about 1999. The number of Americans killed by overdoses has increased each year since then. As of 2015, more than half a million Americans had died from drug overdoses.

The new data from NCHS shows that powerful synthetic opioids such as fentanyl have emerged as the latest threat. Between 2015 and 2016, the rate of deaths from synthetic opioids doubled, from 3.1 deaths per 100,000 to 6.2.

In 2015, 16.3 people for every 100,000 living in the US died of a drug overdose. That rate increased by 21% in 2016, when 19.8 people for every 100,000 died of a drug overdose.

“What we’re seeing now is the second wave of this epidemic,” said Anna Lembke, a behavioral sciences professor at Stanford University and an addiction expert. “The first wave started with physicians overprescribing … The second wave has translated into widespread, increased use of illicit opioids, of heroin, of fentanyl, of heroin laced with fentanyl.”

Those numbers vary widely by age and geography. For example, while drug overdose death rates increased in every age demographic in 2016, people between 25 and 54 had the highest rates of overdoses, at 35 deaths per 100,000 people.

The five states with the worst death rates topped even those numbers. West Virginia nearly tripled the national average – 52 people for every 100,000 died of an overdose there. Ohio, New Hampshire, Washington DC and Pennsylvania followed: all hovered around 38 overdose deaths for every 100,000.

The life expectancy of men was especially affected in the US. Women’s life expectancy at birth remained at 81.1 years in 2016, but life expectancy for men declined by 0.2 years, to 76.1 years. It also made accidental death the third-leading cause of death in the US, replacing chronic lower respiratory disease.

“This is going to take a good 10 to 20 years to really turn around,” said Lembke.

“We’ve got multiple generations of people that are already addicted, and it’s going to be a real struggle to help those people.”

Despite years of warnings about the growing epidemic, congressional leaders have often failed to do more than convene commissions and panels and draw up white papers. Most recently, Donald Trump declared America’s overdose epidemic a public health emergency, but little new funding has materialized. Further, Republican proposals threatened to gut government health programs, such as Medicaid, that treat a disproportionate number of opioid addicts.

“One-time grants are ultimately not going to change the course of this epidemic,” said Lembke. “It’s going to require systemic changes, infrastructure changes, changes in the ways that healthcare delivery happens.”

Data in the latest NCHS report was collected from death certificates in all 50 states, and compiled into the National Vital Statistics System.

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