America Has a Life Expectancy Crisis

America alone among its peers of so-called advanced developed nations has a declining life expectancy even as life expectancy is increasing in other peer nations.  There are numerous causes for America's singular decline in life expectancy - gun violence and a health care system driven by health insurance companies and their bough and paid for politicians that does little or nothing for preventive care being but two.  Meanwhile, many politicians refuse to see declining life expectancy as a national crisis and offer little policy wise to turn the trend around.  Worse yet many politicians, principally Republicans are pushing an agenda that will make matters only worse as they oppose or cut programs ranging from child nutrition programs, Medicaid expansion and social safety net programs so that they can deliver ever more tax cuts to the super wealthy and huge corporations. Insanely, many working class Americans (mostly white) continue to support Republican candidates and office holders who use "god, guns and gays" and a hefty dose of racism to dupe these voters into voting against their own interests and ultimately their own life expectancy.   A long article in the Washington Post looks at this national crisis and the sad reality that few in Congress appear inclined to address the problem.  Here are excerpts:

The commissioner of the Food and Drug Administration had an urgent message last winter for his colleagues, brandishing data that life expectancy in the United States had fallen again — the biggest two-year decline in a century.

Robert Califf’s warning, summarized by three people with knowledge of the conversations, boiled down to this: Americans’ life expectancy is going the wrong way. We’re the top health officials in the country. If we don’t fix this, who will?

A year after Califf’s dire warnings, Americans’ life expectancy decline remains a pressing public health problem — but not a political priority.

President Biden has not mentioned it in his remarks, according to a review of public statements; his Republican challengers have scarcely invoked it, either. In a survey of all 100 sitting senators, fewer than half acknowledged it was a public health problem. . . . no national strategy exists to reverse a years-long slide that has left the United States trailing peers, such as Canada and Germany, and rivals, such as China.

The Washington Post spoke with more than 100 public health experts, lawmakers and senior health officials, including 29 across the past three presidential administrations, who described the challenges of attempting to turn around the nation’s declining life expectancy. Those challenges include siloed operations that make it hard for public and private-sector officials to coordinate their efforts, a health-care payment system that does not reward preventive care and White House turnover that can interrupt national strategies.

Many suggested the nation needed an effort that would transcend political administrations and inspire decades of commitment, with some comparing the goal of improving life expectancy to the United States’ original moonshot.

“We’re no longer an America that talks about building a national highway system or sending a man to the moon, and yet it’s that kind of reach and ambition that we need to have to tackle the declining longevity problem,” said Sen. Elizabeth Warren (D-Mass.).

White House officials said the president and his team were focused on combating the “drivers” of life expectancy declines, pointing to efforts to reduce drug overdoses, create an office to prevent gun violence and other initiatives. A senior health official in the Biden administration said pledging to improve life expectancy itself “would have to be viewed as something for a legacy.”

No single reason explains why America’s life expectancy has declined, with chronic disease, poor nutrition, insufficient access to care and political decisions all linked to premature deaths. There also is no single strategy to turn it around — and no agreement on how to do it. Some public health leaders and policymakers have called for sweeping reforms to how the health-care system operates, while others home in on discrete factors such as lethal drug overdoses, which have spiked in recent years and received considerable attention but are not solely responsible for the decline in life expectancy.

The paralysis over how to address the nation’s declining life expectancy extends to Congress, where a handful of lawmakers — mostly Democrats — have repeatedly portrayed the slide as a crisis, but most other lawmakers have said little or nothing.

“We don’t talk about life expectancy, because it just makes it clear what kind of failed system we currently have,” said Sen. Bernie Sanders (I-Vt.), who has repeatedly warned about the rise in premature deaths, including organizing a July 2021 Senate hearing on the issue. Just 11 of the panel’s 18 senators attended, several only briefly; just five asked questions.

Despite the flurry of legislation, the nation’s progress on life expectancy has stalled, with the United States increasingly falling behind other nations well before the pandemic. No senator has crafted a bill specifically intended to improve life expectancy or create goals for health leaders to reach.

Lawmakers have also worked at cross purposes, with Republicans fighting Democrats’ efforts to enact legislation linked to gains in life expectancy, including efforts to expand access to health coverage and curb access to guns. Sen. John Neely Kennedy (R-La.), whose state had the third-worst life expectancy in 2020, about 73 years, recently suggested that life expectancy would even go up for young Americans.

Sen. Jerry Moran (R-Kan.) has “no jurisdiction over this issue,” his office wrote in response to questions about whether Moran had views on declining life expectancy. Moran, who sits on the Senate panel that determines funding for health agencies, has cast votes on numerous health-care matters, including repeatedly voting to repeal the Affordable Care Act..

There is a notable partisan split in how members of Congress view life expectancy and whether they say urgent action is needed. Just 11 of the Senate’s 49 Republicans told The Post they believed that declining life expectancy was a public health problem.

The lawmakers who portray the recent decline as a crisis are often Democrats from states with the highest life expectancy — such as Massachusetts (79 years in 2020, according to federal data) and Vermont (78.8 years). Meanwhile, GOP lawmakers representing some of the states with the lowest life expectancy — Mississippi (71.9 years), West Virginia (72.8 years) and Kentucky (73.5 years) — declined to comment or did not respond to repeated questions about whether the issue represents a public health problem.

Sanders has repeatedly called for sweeping reforms, insisting in an interview that “a failed health-care system is tied into a corrupt political system dominated by enormously powerful corporate interests.”

Ten senators singled out the burden of chronic disease, echoing The Post’s own review, which found that among people younger than 65, chronic illness erases more than twice as many years of life as all the overdoses, homicides, suicides and car accidents combined.

Vasan and Schulman said HealthyNYC can be a template for other cities — the latest effort in New York’s long history of trying to tackle life expectancy. Under former mayor Mike Bloomberg, the city raised cigarette taxes, banned smoking in workplaces and attempted to limit sale of large sugary drinks. When Bloomberg left office in 2013, New Yorkers’ projected life expectancy was 81.1 years — more than two years longer than the national average — compared with 77.9 years when he took office in 2001.

But Bloomberg’s efforts provoked backlash from food-makers, industry groups and some elected officials. Even as New York took steps a decade ago to limit salt and soda consumption, GOP lawmakers in other states crafted legislation to prevent their own local leaders from taking similar steps.

Sanders, who has spent years pushing for sweeping changes to America’s health system and economy, said Washington’s work to boost life expectancy could begin with a simple framing device.

“The administration, the Congress should have upon their wall, a chart which says … ‘What’s our life expectancy now [and] how do we get up to the rest of the world?’” Sanders said. He pointed to Norway’s life expectancy of more than 83 years. “That should be our goal.”