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Overdose, suicide rates fuel life expectancy drops for working age Americans

Analysis of U.S. life expectancy finds that risk for death among adults under 65 years of age is increasing.

By Brian P. Dunleavy
Overdose, suicide rates fuel life expectancy drops for working age Americans
Death rates are on the rise among working-age Americans due to increases in drug overdose and suicide, among other causes.Depressed businesswoman. Photo by KieferPix/Shutterstock

Nov. 26 (UPI) -- A new analysis of data on life expectancy shows declines among people in middle age, with large increases in death risk from overdose, alcoholism and suicide.

Researchers report a slight decline in the average American lifespan -- from 78.9 years in 2016 to 78.6 years in 2017 -- that has largely been fueled by a significant increase in deaths among adults between age 25 and 64, according to a study published Tuesday in the Journal of the American Medical Association.

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The increased deaths come as medical advancements have reduced the number of deaths caused by conditions such as HIV, cancer and some forms of heart disease in people 25 to 64.

"The risk of dying before age 65 is increasing in America and that's not happening in other countries," lead author Steven H. Woolf, professor of family medicine and population health at VCU, told UPI.

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To find out why more Americans are dying in "midlife," Woolf and his team broke down U.S. life expectancy data from 1959 through 2016 and cause-specific death rates from 1999 through 2017, focusing on the 25 to 64 age group. They also reviewed published research -- between January 1990 through August 2019 -- that examined relevant trends in causes of death and potential contributory factors.

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In the midlife group, fatalities caused by drug overdoses have increased by nearly 400 percent among those in this age group since 1999, and those succumbing to alcoholic liver disease increased by 40 percent over the same period, researchers say.

Similarly, suicide-related deaths have increased by roughly 40 percent in the midlife age group across the country since the start of the 21st century. And, deaths related to high blood pressure and obesity have risen by nearly 80 percent and more than 110 percent, respectively, from 1999 through 2017.

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Woolf and his team also found that Americans' risk for death before reaching old age differed by geographic region.

They identified the "largest relative increases in midlife mortality rates" in New England -- New Hampshire, 23.3 percent; Maine, 20.7 percent; and Vermont, 19.9 percent -- and the Ohio Valley -- West Virginia, 23.0 percent; Ohio, 21.6 percent; Indiana, 14.8 percent; and Kentucky, 14.7 percent. These are also the areas hit hardest by the ongoing opioid epidemic.

In all, the authors found the increase in midlife mortality between 2010 and 2017 was associated with an estimated 33,307 excess deaths in the U.S., and that nearly one third of these occurred in states in the Ohio Valley region.

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These findings, Woolf suggested, aren't "indicative of a core problem with our health system," but rather society at large. While the costs of care have put medical treatment out of reach for many "working age" Americans who are too old for the federal Children's Health Insurance Program and too young for Medicare, most of the problems highlighted Woolf's analysis have less to do with health services and more to do with how they view life prospects at present and in the future.

The new study echoes research published in late October that similarly showed people in middle ages are dying from relatively non-medical ailments, referred to as an epidemic of despair. Some has been chalked up to health care costs -- which push availability of care of reach for some -- while others are linked to modern society in the U.S.

"The trends we've documented are clearly shaped by living conditions, by what's going on in society and in our communities," Woolf said. "We need to find out why people are turning more to drugs, why they are in so much pain, why they need for self-medication. Clearly, there is something more systemic going on."

Based on these findings, Woolf urged policy-makers at the local, state and national level to consider implementing some of the same "support systems" used in other parts of the world, where life expectancy among working age adults is still on the rise, such as in Scandinavian countries.

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Programs that "prioritize education, create jobs that pay a livable wage and provide affordable housing," he added, are a good place to start.

"Here in America, we tend to allow people to fend for themselves when problems like the loss of a job or a major illness occur," Woolf continued. "But that may not be sustainable. We should be finding ways to ease the pain faced by families and communities. If we don't provide that help, Americans will continue to be sicker than their peers in other countries."

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