The US longevity gap is becoming a chasm.<\/p>\n
For decades, life expectancy in the States has lagged behind wealthy nations like Japan, Switzerland and Australia, with Americans consistently dying younger than their peers abroad.<\/p>\n
Now, a landmark \u201cpopulation autopsy\u201d analyzing more than 63 million deaths has identified two key factors fueling shorter lifespans nationwide, as experts warn the trend is only getting worse.<\/p>\n
On average, Americans die younger than their peers in other wealthy nations. A new study uncovered the two major reasons why. Photographee.eu \u2013 stock.adobe.com<\/p>\n
In the study<\/a>, researchers compared the US to 17 peer nations and found that between 1999 and 2022, nearly 12.7 million American deaths could have been avoided if death rates matched those countries.<\/p>\n And the problem isn\u2019t easing up. Annual \u201cexcess deaths\u201d in the US more than tripled over the 23-year period, rising from about 346,000 in 1999 to 905,159 in 2022.<\/p>\n The top two factors: rising rates of cardiovascular and metabolic disease<\/a>, along with a growing number of \u201cdeaths of despair,\u201d or those linked to drugs, alcohol and suicide. <\/p>\n Digging deeper, researchers found that circulatory diseases like heart attacks and strokes<\/a> were the leading driver of excess deaths in nearly every year they studied.<\/p>\n Those death rates actually improved for a time, falling between 1999 and 2009. But while rates continued to decline in other wealthy countries, the trend reversed in the US, climbing sharply from 2009 through 2022.<\/p>\n Breaking the numbers down further, the researchers found that the rise in circulatory disease deaths among adults aged 45 to 64 began a full decade earlier than in older adults.<\/p>\n The findings suggest that long-term, population-wide factors, including higher obesity rates<\/a> and shifts in diets<\/a>, may be playing a major role.<\/p>\n The rise in cardiovascular and metabolic diseases are fueling lower life expectancy in the US. Halfpoint \u2013 stock.adobe.com<\/p>\n \u201cAs we\u00a0look into\u00a0this,\u00a0we\u2019re\u00a0finding, and this paper appropriately points out, that as compared to older adults, the level and amounts of cardiovascular disease and mortality\u00a0are\u00a0starting earlier,\u201d Dr. Neil Shah<\/a>, a cardiologist with Northwell Health, told The Post. <\/p>\n \u201cIn order to tackle this, I think as a country, from a policy standpoint,\u00a0we need to\u00a0figure out how we are going to get patients into preventive care\u00a0and\u00a0preventive screening, so that we can use the medications and the counseling that truly make a difference early on to prevent these later cardiovascular outcomes.\u201d<\/p>\n A similar pattern showed up in diabetes<\/a>, kidney disease and other metabolic conditions, which saw relatively stable excess deaths through the 2000s before rising sharply after 2010 and continuing through 2022.<\/p>\n By 2022, US death rates from circulatory and metabolic diseases were 1.63 and 2.25 times higher than in other wealthy countries, respectively \u2014 and together, these conditions made up more than half of all excess deaths. <\/p>\n \u201cAll of this is\u00a0rather a\u00a0shared cardiometabolic continuum rather than separate isolated diseases,\u201d said Shah, who was not involved in the new research. \u201cOr in other words, each of these things affects the other.\u201d<\/p>\n While circulatory and metabolic diseases accounted for the largest share of excess deaths over the study period, the fastest-growing category was \u201cdeaths of despair,\u201d especially among men.<\/p>\n \u201d \u2018Deaths of despair\u2019 is an umbrella term for\u00a0a number of\u00a0behavioral, psychological and social factors that are driving individuals to some unhealthy behaviors and less than healthy coping strategies that then have health consequences, including death,\u201d explained Dr. Xavier Jimenez<\/a>, director of consultation psychiatry, addiction medicine and chronic pain at Northwell Long Island Jewish Medical Center.<\/p>\n \u201cThis can be a range of things. It could be substance use to check\u00a0out of\u00a0their realities. It could be poor eating.\u00a0It could be poor social decisions, not seeking mental health care, maybe escaping through a variety of other behaviors that then catch up.\u00a0And that\u00a0eventually leads to\u00a0death, unfortunately.\u201d<\/p>\n In the US, deaths from drug poisonings<\/a>, alcohol-related causes<\/a> and suicide<\/a> rose from levels similar to peer countries in 1999 to more than 130,000 excess deaths in 2022 alone.<\/p>\n \u201cDeaths of despair\u201d were the main reason for the widening mortality gap among those under 45.<\/p>\n \u201cThis study is remarkable. I,\u00a0frankly, am not\u00a0surprised by the findings,\u201d Jimenez said. \u201cBehavioral health concerns that go unaddressed catch up with individuals and contribute to an enormous slice of mortality via overdoses, impulsive behaviors, suicide, violence and accidents.\u201d<\/p>\n Deaths from drugs, alcohol and suicide are driving an increase in early deaths among young Americans, with men disproportionately affected. Halfpoint \u2013 stock.adobe.com<\/p>\n Taken together, deaths from cardiometabolic diseases and from drugs, alcohol and suicide accounted for about 24% of the increase in excess deaths over the study period \u2014 and for most of the rise among those under 44.<\/p>\n The COVID-19 pandemic also drove a sharp spike in excess deaths<\/a> in 2020 and 2021, with coronavirus accounting for roughly 1 in 5 excess deaths during that period.<\/p>\n Researchers found that other causes were also pushed higher during the pandemic, including circulatory disease, metabolic conditions, drug poisonings, alcohol-related deaths and suicide.<\/p>\n This, they suggested, may reflect disruptions in medical care, worsening mental health<\/a>, broader social stressors and in some cases, misclassification of COVID-related deaths as other causes.<\/p>\n \u201cCOVID-19\u00a0really only\u00a0jet-fueled the despair that was already being experienced even before that pandemic,\u201d Jimenez said.<\/p>\n \u201cIf you remember, we had opioid crises, we had political shifts, economic recessions, and then COVID-19 came and isolated individuals<\/a>, reduced access to care, created enormous burdens and stress<\/a>, not to mention the physical effects,\u201d he continued.<\/p>\n \u201cSo, it only makes sense that during the pandemic and a few years thereafter, you see it contributing to the despair that was already being felt and\u00a0accelerated by\u00a0these processes.\u201d<\/p>\n Looking ahead, Jimenez and Shah advocate for expanding access to routine preventive care, addressing physical, behavioral and psychiatric conditions early before they lead to downstream effects.<\/p>\n \u201cWe always say an ounce of prevention is worth a pound of cure,\u201d Shah said.<\/p>\n