Comment and
Health
If the US had the lowest life expectancy among high-income countries a decade ago, why are things still getting worse? This question is posed by Laudan Aron
By Laudan Aron
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People wait in line to receive a vaccine at a pop-up covid-19 vaccination site in Orlando, Florida, US.
SOPA Images/LightRocket via Gett
People in the US are observing with growing alarm the advancing age of their elected leaders in Washington DC: the two current leading candidates for the 2024 presidential election are now 81 and 77 years old. But the longevity of the leadership class is in sharp contrast with realities in the rest of the country. Americans are sick and dying – literally.
Ten years ago, I directed a study for the National Academy of Sciences (NAS) that documented for the first time a US disadvantage in health and survival among high-income countries. Our report showed that the US had the lowest life expectancy among peer countries, and higher rates of morbidity and mortality for dozens of causes. This shortfall in health and survival had been growing over four decades and was pervasive – affecting both sexes, young and old, rich and poor, and all races and ethnicities.
Life expectancy
In the intervening years, other studies have confirmed these trends, along with worsening conditions of life and death. After plateauing for several years, life expectancy in the US declined for three consecutive years before the global pandemic. What followed was devastating: covid-19 killed more than 1 million people in the US, pushing life expectancy down by another two years – and by twice as much among Hispanic, Black and Native American people. This was the most abrupt drop in life expectancy since the second world war, and nothing remotely comparable occurred in other wealthy nations.
During the pandemic, eight of the ten leading causes of death also increased, including maternal and child and adolescent mortality. Given these stark realities, an urgent question is why are Americans so unwell? In a New Scientist commentary 10 years ago, I observed that the reason is simple and yet deceptively complex: it is almost everything.
Even a casual glance at life in the US today reveals conditions that are hard to believe. The country is entering the third decade of a deadly nationwide opioid epidemic – unleashed by the pharmaceutical industry – that claimed 110,000 lives in 2022 alone. And alongside the drugs are the bullets. In 2020 and 2021, guns killed more US children aged 1 to 17 than any other cause of death.
The conditions that cause poor health,