Public Health

Ronald Bailey | 1.8.2024 5:30 PM

"America has a life expectancy crisis," asserted a recent headline in The Washington Post. Why a crisis? Because American average life expectancy has been flat and then declining for the past decade or so.

One bit of recent good news: The Centers for Disease Control and Prevention (CDC) reported in November that average life expectancy at birth in 2022 was 77.5 years. While that is down from its 2014 peak of 78.8 years, the CDC notes that this is a post-pandemic increase of 1.1 years from its nadir of 76.1 years in 2021. The increase from 2021 to 2022, according to the CDC, "primarily resulted from decreases in mortality due to COVID-19, heart disease, unintentional injuries, cancer, and homicide. Declines in COVID-19 mortality accounted for approximately 84% of the increase in life expectancy." While the big recent dip in American life expectancy was largely the result of the ravages of the COVID pandemic, the trend over the prior 10 years was basically flat.

The Post article correctly noted that "the United States [was] increasingly falling behind other nations well before the pandemic."

The Post asked numerous members of Congress, including all 100 Senators, what they thought about falling life expectancy. While many replied that it was a serious problem, the article concluded that it "is not a political priority." The Post did acknowledge that "there also is no single strategy to turn it around." Politics being the art of the possible, there is little that politicians can do at this point in biomedical history to significantly increase average life expectancy.

Public health efforts beginning the the late 19th century to provide access to clean water and improved sanitation, improve food safety, and champion widespread vaccination against infectious microbes were chiefly responsible for the increase in average American life expectancy from just 47 years in 1900 to the mid-70s in that late 20th century. "In 1900, one in 40 Americans died annually. By 2013, that rate was roughly one in 140, a cumulative improvement of more than two thirds," reported a 2016 analysis by University of Pennsylvania researchers.

Today the leading causes of the deaths that mainly afflict older Americans are cardiovascular diseases, cancers, unintentional injuries, lower respiratory illnesses, and diabetes. Nostrums prescribed by politicians are not likely to have much effect on them.

Among other policies, the Post reported that many of the public health officials and lawmakers with which it spoke decried, "a health-care payment system that does not reward preventive care." And why not? After all, an ounce of prevention is worth a pound of cure, right? Not necessarily, according to a comprehensive analysis of preventive care studies published in the Journal of the American Medical Association (JAMA) in 2021. "General health checks were not associated with reduced mortality or cardiovascular events," noted the researchers. This bolstered the findings of a similar analysis in 2019 by researchers associated with the non-profit medical evidence review collaborative Cochrane that concluded that "health checks have little or no effect on total mortality."

The Post article also suggested that fighting between congressional Democrats and Republicans has stymied "legislation linked to gains in life expectancy, including efforts to expand access to health coverage and curb access to guns." As it turns out, various studies........

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