Imagine you are walking down a street.
A stranger approaches. “Would you answer a question,” he asks.
“Maybe,” you say.
“Would you choose more money for yourself if it meant a shorter life for someone else?”
You wouldn’t think long about your answer. We all like money. We like the idea of more of it. But there are limits. Few would choose more money if they knew it meant a shorter life for someone else.
And you’d be aghast if the offer was more money for you, but shorter lives for your children.
It’s not clear when, or how, we made that bargain — or who made it for us — but apparently, that’s the deal our country has pursued for more than two decades. The clear implication of recent health and income statistics is that many Americans have more money, but more American children and young adults are dying young. Indeed, the death rate among young people is the major factor propelling our declining life expectancy statistics.
The most striking expression of this was in a recent Financial Times article by John Burn-Murdoch. In “Why are Americans dying so young?” he makes this shocking observation:
“… One in 25 American 5-year-olds today will not make it to their 40th birthday. No parent should ever have to bury their child, but in the U.S., one set of parents from every kindergarten class most likely will.”
That’s gut-punch stark. It tells us that our 21st century is reversing the amazing life expectancy progress of the 20th century. Nor can we blame this all on COVID-19. While COVID caused many deaths, particularly among elderly people in poor health, if you look beyond the recent COVID period, a disturbing pattern emerges.
The two major killers of old people, heart disease and cancer, are in retreat. One recent report, for instance, found that the overall death rate for heart attacks dropped by more than half between 1999 and 2020. Cancer, a more varied and intractable disease, also has a declining death rate, with the largest improvement in lung cancer.
But it takes a huge reduction in death rates for people over 65 to offset the damage done to overall life expectancy by rising death rates among the young. The math here is simple. If a medical advance saves the life of a 75-year-old and overall life expectancy is 80, only five potential life-years are gained. Save the life of a 5-year-old and 75 potential life-years are gained.
Disease isn’t killing our young. The cause is violence. It’s a combination of rising homicides and suicides, opioid overdoses, and more accidental deaths. Higher infant mortality rates play a role, too. Ditto, obesity. That’s what’s killing our life expectancy.
You can explore this in-depth by visiting ourworldindata.org, a nonprofit website funded by grants and reader donations. Here are some staggering facts from the site:
-- Murder. We look good compared to Haiti (28.4 murders per 100,000 people). And we still look good compared to Russia (15.2), but at 5.4 we’re close to Uganda (5.8) and a murderous league ahead of Canada (1.5), Germany (0.7), Japan (0.6) or the United Kingdom (0.5). When it comes to homicide, our country is a good fit for the least-developed countries in the world.
-- Suicide. Russia was once considered one of the suicide capitals of the world. But they’re slowing down and we’re catching up. In 1990, the suicide rate for Russians aged 25 to 34 was 86.8 per 100,000. By 2017, it had dropped to 34.2. In the same time period, we went from 15.4 to 29.9, nearly doubling. In rough numbers, the United States and Russia have about three times the suicide rate among the young as Great Britain.
-- Opioid overdoses. We led the list of comparable countries back in 1990, but today we are far and away the world leader in the death rate from opioid overdoses. In 2019, we had 13.69 deaths per 100,000 people. Canada trailed with 4.67 and countries like France (1.38), Italy (0.61) and Japan (0.17) seemed to have it under control.
-- Road accidents. Young people dominate fatal road accidents, and it’s one area where the death rate has been in decline. France had more road fatalities than we did in 1990, but its rate is now far lower. Today, we lead by a wide margin, 11.14 deaths per 100,000 compared to 5.93 for Canada, 5.75 for France and 5.73 for Australia.
The result? We had a life expectancy on par with other wealthy nations in 1980. Back then, U.S. life expectancy at birth was 73.7 years. The comparable country average was 74.5 years. That’s a gap of less than a year.
By 2021, U.S. life expectancy was a bit higher at 76.1 years. But the comparable country average had risen to 82.4 years. Our peer group isn’t developed Europe. It’s countries like Croatia, Uruguay, Albania and Estonia.
So, in 41 years, we went from being a bit below average to having a yawning life-gap of 6.3 years. Even the United Kingdom, the next worst of the group, famous for issues with its National Health Service and far poorer than the U.S., beat us with a life expectancy of 80.4 years, a life-gap of 4.3 years.
Our decline appears to have started in 2014. That’s when U.S. life expectancy peaked at 78.9 years. Looking backward, the last time U.S. life expectancy was at its current level was 1996. That’s nearly prehistoric, by internet standards.
We’ve lost about 26 years of progress toward the only goal most humans can agree on: longer and healthier lives.
It’s also clear that we can’t solve this problem by throwing money at it. More of what we’re already doing won’t fix anything. We already spend more on health care than any of the other wealthy nations. The results are dismal except for the expanding wealth and power of what some call the “Medical-Industrial Complex.”
To demonstrate the point, Burn-Murdoch points out that even the poorest people in the poorest parts of Blackpool, the poorest area in Britain, live five years longer than the poorest people in the U.S. Indeed, aligning comparable income levels, he found that Brits with similar incomes to the U.S. had life expectancies five years longer.
So, given a choice of “your money or your life,” it appears we chose money.
