'A distinctly American phenomenon': Our workforce is dying faster than any other wealthy country, study shows

Jorge L. Ortiz | USA TODAY

Show Caption Hide Caption American deaths from alcohol, drugs and suicide highest level in years A study shows that more Americans are dying from drug and alcohol abuse and suicides than at any point in roughly the past 20 years. Veuer's Justin Kircher has more.

The life expectancy in the United States, 78.6 years as of 2017, is well off the average in Japan (84.1), France (82.4), Canada (81.9) and other high-income countries.

Midlife mortality from drug overdoses increased by 386.5% from 1999 to 2017, according to a new study published Tuesday in the Journal of the American Medical Association.

What can we do? “The prescription for the country is we’ve got to help these people. And if we don’t, we’re literally going to pay with our lives.’’

The engine that powers the world’s most potent economy is dying at a worrisome pace, a “distinctly American phenomenon’’ with no easily discernible cause or simple solution.

Those are some of the conclusions from a comprehensive new study by researchers at Virginia Commonwealth University showing that mortality rates for U.S. adults ages 25-64 continue to increase, driving down the general population’s life expectancy for at least three consecutive years.

The report, “Life Expectancy and Mortality Rates in the United States, 1959-2017,’’ was published Tuesday in the Journal of the American Medical Association. The study paints a bleak picture of a workforce plagued by drug overdoses, suicides and organ-system diseases while grappling with economic stresses.

“This looks like an excellent paper – just what we needed to help unravel the overall decline in life expectancy in the U.S.,’’ said Eileen Crimmins, an associate dean at the University of Southern California who’s an expert on the link between health and socioeconomic factors.

In a trend that cuts across racial and ethnic boundaries, the U.S. has the worst midlife mortality rate among 17 high-income countries despite leading the world in per-capita spending on health care.

And while life expectancy in those other industrialized nations continues to inch up, it has been going in the opposite direction in America, decreasing from a peak of 78.9 years in 2014 to 78.6 in 2017, the last year covered by the report.

By comparison, according to the Peterson-Kaiser Health System Tracker, the average longevity in similar countries is 82.2 years. Japan’s is 84.1, France’s 82.4 and Canada’s 81.9. They left the U.S. behind in the 1980s and increased the distance as the rate of progress in this country diminished and eventually halted in 2011.

Steven Woolf, director emeritus of the VCU Center on Society and Health and the study’s lead author, said the reasons for the decline go well beyond the lack of universal health care in the U.S. – in contrast with those other nations – although that’s a factor.

“It would be easier if we could blame this whole trend on one problem, like guns or obesity or the opioid epidemic, all of which distinguish the U.S. from the other countries,’’ Woolf told USA TODAY. “But we found increases in death rates across 35 causes of death.’’

They were most pronounced in the industrial Midwest, the 13 Appalachian states and upper New England, which Woolf attributed partly to the decline in manufacturing jobs and the opioid epidemic.

Of the top 10 states with the highest number of excess deaths in the 25-64 age range – meaning deaths above projections based on U.S. mortality rates – eight were in the Rust Belt or Appalachia. Half of the excess deaths were concentrated in the latter region.

The Ohio Valley – comprising Indiana, Kentucky, Ohio and Pennsylvania – accounted for one-third.

Some of the other numbers mined by the study, based on data compiled by the U.S. Mortality Database and the Centers for Disease Control and Prevention, are staggering:

Between 1999 and 2017, midlife mortality from drug overdoses spiked by 386.5%.

In that same age group and time period, deaths from hypertensive diseases increased by 78.9%, and those linked to obesity by 114%.

Suicides rose by 38% and climbed 55.9% among those ages 55-64.

Those are a lot of lives snuffed out in prime years, a long-range threat to an economy that ranks No. 1 globally in gross domestic product.

“Not only are employers more likely to see premature deaths in their workers, but also greater illness rates and greater disability, and that puts U.S. businesses at a disadvantage against businesses in other countries that have a healthier and more productive workforce,’’ Woolf said, adding that employers here are already saddled with high health care costs.

US mortality rate 'root causes' include lack of education and living wages

The report showed mortality rates among those younger than 25 and older than 64 have decreased. That might point a finger at the country’s dysfunctional health care system for working adults, because many in those other age groups can be covered by either the Children’s Health Insurance Program (CHIP) or Medicare.

Woolf disputes that notion, saying only 10% to 20% of health outcomes can be attributed to medical care. He said the bigger culprit is a lack of social programs and support systems more common in other wealthy countries for when working families run into difficult times.

Those rough spells, often associated with a job loss, can lead to the kind of unhealthy behaviors – drug and alcohol abuse, smoking, overeating, suicide attempts – that result in what have become known as “deaths of despair.’’

Woolf said a noticeable increase in those is yet another indication of the seriousness of the problem the U.S. faces, one he said will require investment from the public and private sectors to address.

Even if Americans were to reverse their recent backward trend, one estimate says that at its rate of longevity growth from the past several years it would take the U.S. more than 100 years to catch up to the average life expectancy other wealthy countries reached by 2016.

“We’re making a huge mistake if we don’t step back and look at the root causes,’’ Woolf said, including a lack of educational opportunities and living wages among the likely causes. “The prescription for the country is we’ve got to help these people. And if we don’t, we’re literally going to pay with our lives.’’