What's Wrong in America: Declining Life Expectancy

Map of those overweight and obese by state. 

Life expectancy is continuing to rise in other advanced, wealthy nations, including the liberal European nations so derided by American conservatives. Such is not the case in the United States where life expectancy is falling, with sharp decreases in age brackets often considered the prime time of one's life.  A report published in the Journal of the American Medical Association looks at the unwanted reality and where the death rate has risen the most: mostly in mid-western "swing states" and the South, regions where Republican political rule predominates. While no one cause explains the phenomenon, there are a number of factors noted in the report, particularly, America's obesity problem.  Go to Europe and walk around almost any city and you will NOT see the large numbers of overweight people and those you do see will most often be American tourists. My own thoughts on this particular problem of obesity focuses on (i) Americans' poor diet and addiction to high calorie fast food and (ii) vastly over-sized portions at American restaurants (things you do not see in Europe).  Then, of course, most other advanced nations have some version of universal health care, something lacking in the USA.  The Washington Post looks at the report and the dire outlook for the future.  Here are article highlights:

Death rates from suicide, drug overdoses, liver disease and dozens of other causes have been rising over the past decade for young and middle-aged adults, driving down overall life expectancy in the United States for three consecutive years, according to a strikingly bleak study published Tuesday that looked at the past six decades of mortality data.

The report, published in the Journal of the American Medical Association, was immediately hailed by outside researchers for its comprehensive treatment of a still-enigmatic trend: the reversal of historical patterns in longevity.

Despite spending more on health care than any other country, the United States has seen increasing mortality and falling life expectancy for people age 25 to 64, who should be in the prime of their lives. In contrast, other wealthy nations have generally experienced continued progress in extending longevity.

[T]he broad trend detailed in this study cuts across gender, racial and ethnic lines. By age group, the highest relative jump in death rates from 2010 to 2017 — 29 percent — has been among people age 25 to 34.

The findings are sure to fuel political debate about causes and potential solutions because the geography of rising death rates overlaps to a significant extent with states and regions that are hotly contested in the run-up to the 2020 presidential election.

About a third of the estimated 33,000 “excess deaths” that the study says occurred since 2010 were in just four states: Ohio, Pennsylvania, Kentucky and Indiana — the first two of which are critical swing states in presidential elections. The state with the biggest percentage rise in death rates among working-age people in this decade — 23.3 percent — is New Hampshire, the first primary state.

“It’s supposed to be going down, as it is in other countries,” said the lead author of the report, Steven H. Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “The fact that that number is climbing, there’s something terribly wrong.”

He said many factors are at play. The opioid epidemic is a major driver of the worrisome numbers but far from the sole cause. The study found that improvements in life expectancy, largely because of lower rates of infant mortality, began to slow in the 1980s, long before the opioid epidemic became a national tragedy.

“Some of it may be due to obesity, some of it may be due to drug addiction, some of it may be due to distracted driving from cellphones,” Woolf said. Given the breadth and pervasiveness of the trend, “it suggests that the cause has to be systemic, that there’s some root cause that’s causing adverse health across many different dimensions for working-age adults.”

The average life expectancy in the United States fell behind that of other wealthy countries in 1998, and since then the gap has grown steadily. Experts refer to this gap as the United States’ “health disadvantage.”

Princeton professors Anne Case and Angus Deaton, whose much-publicized report in 2015 highlighted the death rates in middle-aged whites, published a paper in 2017 pointing to a widening gap in health associated with levels of education, a trend dating to the 1970s. Case told reporters their research showed a “sea of despair” in the United States among people with only a high school diploma or less.

Obesity is a significant part of the story. The average woman in the United States today weighs as much as the average man half a century ago, and men now weigh about 30 pounds more. Most people in the United States are overweight — an estimated 71.6 percent of the population age 20 and older, according to the CDC. That figure includes the 39.8 percent who are obese, defined as having a body mass index of 30 or higher in adults (18.5 to 25 is the normal range). Obesity is also rising in children; nearly 19 percent of the population age 2 to 19 is obese.

“These kids are acquiring obesity in their early teen years, sometimes under the age of 10,” said S. Jay Olshansky, a professor of public health at the University of Illinois at Chicago. “When they get up into their 20s, 30s and 40s, they’re carrying the risk factors of obesity that were acquired when they were children. We didn’t see that in previous generations.”

Trump Hands Democrats a Gift with Effort to Kill Obamacare

I often make the statement that Trump and the Republican Party want to create a new Gilded Age where the wealth of the richest Americans soared to obscene levels - thinks of the Rockefellers, Goulds, Vanderbilts, etc. - while the majority of Americans struggled to survive.  One study found as follows as to what happened to life expectancy during the rise of the Gilded Age:

"an average white ten-year-old American boy in 1880, born at the beginning of the Gilded Age and living through it, could expect to die at age forty-eight. His height would be 5 feet, 5 inches. He would be shorter and have a briefer life than his Revolutionary forebears.” “Infant mortality worsened in many cities after 1880.”

Part of the problem of the Gilded Age was a lack of safety and environmental regulations - things that were eventually remedied.  Yet now, Trump and the GOP are steadily rolling back such regulations so that big business can reap larger profits. Now, Trump has declared war on the Affordable Health Care Act and seeks to deprive millions of access to healthcare.  Even before this latest action, as a Washington Post story reported, the USA was going backwards in terms of diminished life expectancy and infant mortality.  Here are excerpts:

The Centers for Disease Control and Prevention, for example, reported in November [2018] that life expectancy for the average American ticked downward for the third year in a row. The news attracted a storm of attention . . . . Other trends, however, passed by more quietly. In health care, for example, maternal deaths inched up slightly this year to 20.7 per 100,000 live births, according to data from the United Health Foundation. In fact, giving birth in the United States has become increasingly deadly over the past few decades, placing our country in the same category as developing nations such as Afghanistan and Swaziland. And the rates are even worse for mothers of color.

The latest CDC data released this year shows that U.S. infant mortality rates, after steadily falling over the past few decades, haven’t decreased significantly for five years. Today it stands at 5.9 deaths per 1,000 births, far higher than the average rate of 3.9 deaths for developed countries. Again, it’s even worse for infants of color.

Given these statistics, increasing access to health care would be the moral thing to do.  Sadly, to Trump and Republicans (and evangelical Christians), most of us simply do not matter.  Indeed, it appears that they'd prefer that Americans - especially minorities and the poor - simply die while the rich rake in an ever larger share of the nation's wealth. How else to explain the Trump administration's latest effort to destroy health care access for millions.  A piece in Politico looks at this disgusting development and the Democrat response to such immorality.  Here are highlights:

House and Senate Democrats on Tuesday seized on the Justice Department’s endorsement of a federal court ruling to eliminate Obamacare in its entirety, immediately renewing attacks on the GOP for trying to gut the law’s popular protections and rip health coverage from more than 20 million Americans.

The administration’s surprise decision — a shift from its prior stance that only parts of the Affordable Care Act should be thrown out — offered a unifying moment for Democrats still grappling with the news that Mueller would not charge President Donald Trump with any crimes and comes as the party readies a fresh legislative offensive on health care.

“It’s disgusting. It’s horrible,” said Rep. Ben Ray Luján of New Mexico, the No. 4 House Democrat. “It’s what they were trying to do during the repeal of the Affordable Care Act, it’s what Republicans were doing when they filed the lawsuit. The president’s been clear about his position the whole time.”

And even as Democrats decried the move, they also saw it as a political gold mine.

[L]awmakers were privately ecstatic about the Trump administration’s decision to essentially to trample all over its own good news cycle and turn the attention back to an issue that Democrats used to win back the House.

“It’s really outrageous. I don’t understand if Republicans weren’t present for the last election, but if there was an issue that was deeply critical, it was health care,” Rep. Pramila Jayapal (D-Wash.), co-chair of the Congressional Progressive Caucus, said after the meeting. . . . It’s “not only immoral, it’s a really bad political decision for them,” she added.

“We’re going to introduce a bill to protect and strengthen the ACA. That’s the responsible thing to do,” said Rep. Donna Shalala (D-Fla.). “They’re being irresponsible, and they’re putting 20 million people in this country at risk.”

Indeed, House Democrats had planned a pivot to health care even before the Trump administration late Monday announced its support for a federal judge’s December ruling that the entire ACA should be invalidated because Congress eliminated its individual mandate penalty in the GOP tax law.

Democrats are rolling out a wide-ranging Obamacare package aimed at shoring up the law’s benefits while reversing several of the Trump administration main health priorities — a bid to follow through on the campaign-trail vows that helped propel them into the House majority.

The package is largely a rehash of policies that Democrats pitched last year, like expanding the Obamacare subsidies meant to help Americans afford health coverage and restoring outreach funding that Trump slashed over the past two years. It would also rescind regulations expanding cheaper, skimpier health plans that the administration has touted for providing greater choice, but Democrats have derided as “junk” insurance.

Their plan gained new significance in the wake of the Trump administration’s legal action, providing vulnerable Democrats with concrete legislation to hype for their swing-district voters and a powerful tool to use against Republicans who refuse to endorse any Obamacare-related measures even as they insist they want to protect patients with pre-existing conditions.

For Republicans, meanwhile, the Justice Department’s move threatens to put them back on the defensive just days after what was arguably their biggest victory of the Trump era.

[M]ost Republicans have so far remained fairly quiet in the aftermath of the DOJ filing in a case that few view as politically advantageous — even as Trump appeared to celebrate the decision. . . . GOP lawmakers who did have an initial reaction expressed exasperation at the disconnect between the Trump administration and the Hill on health care.

[T]he issue is a new headache given the new Senate map: Democrats have gone from defending 10 states that Trump won in 2018 to launching campaigns against incumbents in places like Colorado, Iowa, North Carolina and Maine. Sen. Susan Collins (R-Maine) has been particularly outspoken in opposition to the administration’s support of the lawsuit.

[N]either the Trump administration nor Republicans in Congress have any ready replacement for Obamacare if it is ultimately wiped out. . . . with a serious battle for Senate control developing in purple and blue states, Democrats say they have the political upper hand on an issue their House counterparts used to devastating effect in 2018.

This move by the Trump administration to take away health care will prove far more detrimental to the administration and the Republican Party than any gains they might have made by the [findings] of Mr. Barr’s letter,” said Senate Minority Leader Chuck Schumer (D-N.Y.).

Even Doug Jones of Alabama, by far the most endangered Senate Democrat next year, was singing the same tune as party leaders. “I’m outraged. It’s going to hurt my state really bad if that were to go forward,” Jones said in an interview. “They couldn’t do in this chamber what they wanted to do, which is completely dismantle and disintegrate it. So they’re trying to blow it up in any way possible.”

Being a Republican and being a decent and moral person are becoming increasingly mutually exclusive.