U.S. Life Expectancy is Circling the Drain

A new study on the dismal mortality rate in the United States is out, and it’s bleak. The analysis from Virginia Commonwealth University’s Steven H. Woolf investigates life expectancy and age-based mortality from 1999 through 2023, gleaned from data gathered by the U.S. Centers for Disease Control, the Organization for Economic Cooperation and Development, and other sources.

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The chasm between life expectancy in the United States and other developing countries has been widening for some time, and it appears to be getting worse. In 1980, only 13 countries with a population over a million ranked higher than the United States in life expectancy. But decade by decade that number ratcheted up. According to data from 2023, we’re now 38th on that list.

The scope of the problem is staggering, with different issues plaguing Americans of different ages. Young adults (age 25-44) suffered the steepest decline in life expectancy, with an over 70 percent increase in mortality between 2010 and 2021, primarily caused by deaths from drug overdoses and early onset diseases including hypertensive disease, endocrine and metabolic disorders, and alcoholic liver disease. In the youth (ages 1-24), rising causes of premature death include sudden unexplained infant deaths, car accidents, homicide, and even suicide. As it stands now, people living in 60 countries now have a lower risk of dying before age 40 than we do.

Middle-aged adults aren’t faring much better, succumbing at higher rates to similar diseases as young adults, along with nervous and genitourinary system disorders. According to the study, COVID-19 hit middle-aged Americans particularly hard, becoming their third leading cause of death in 2020, then tripling in 2021 (a time period when vaccines were available). And older Americans suffered the highest COVID-19 death rates of all.

So why are Americans so much worse off than people living in similar countries?

Woolf says there are several proximate causes to consider, like the opioid epidemic, access to firearms, and high-calorie diets. However he stresses that focusing on these issues obscures the larger story of why the United States has been falling behind other developed countries for so long.

“The pervasiveness of the U.S. health disadvantage and the rise in mortality rates across so many causes of death call for consideration of systemic factors,” he writes. These include our broken healthcare system, a sky high poverty rate, and a lax regulatory environment that invites pollution and allows the sale of dangerous products. Woolf adds that our federalist system causes these problems to be exacerbated in certain states, leaving people living in the South, Appalachia, and rural communities at even greater risk of premature death.

“We know how to solve this. Other countries that have outperformed the United States for decades have demonstrated that better health outcomes are possible,” Woolf said in a statement. “What we lack in the United States is not solutions but political will.”