Declining Destinies

Increasing Mortality and Decreasing Fertility in America In late 2016, news sources across the U.S. reported a sobering statistic: The average life expectancy of Americans had fallen for the first time since 1993. The numbers are not, in some ways, startling. For an American man born in 2015, the average life expectancy dropped from 76.5 to 76.3 years, and for the woman, from 81.3 to 81.2 years.[1] But for a developed nation, one for which such dips have happened only a few times in the last century, this is big news. This statistic comes on the heels of some other sobering numbers that came to national attention recently. Anne Case and Angus Deaton of Princeton University published a paper in 2015 pointing to a rising morbidity and mortality among a certain segment of the non-Hispanic white population, those aged 45-54—i.e., in this group, people are getting sicker, and also dying younger.[2] The paper was an immediate sensation, and although it has its limitations (some have argued the specific parameters of the study)[3], it does demonstrate that at the very least, when it comes to longevity, America is losing when compared to other wealthy countries. As Case and Deaton point out, “This change reversed decades of progress in mortality and was unique to the United States: no other rich country saw a similar turnaround.” Why the increases? Case and Deaton point to what they term “deaths of despair”—rising rates of drug overdose, alcohol poisoning, chronic liver disease and cirrhosis, and suicide. In a later analysis, the authors acknowledge a commentary on their original 2015 work, noting that increases in mortality from deaths of despair would not have been large enough to change the direction of all-cause mortality for US whites had this group maintained its progress against other causes of death. For the two major causes of death in midlife, heart disease and cancer, the rate of mortality decline for age groups 45-49 and 50-54 fell fro
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