TCA, vol. 17: Longevity in the USA
Life expectancy has gone down in the United States. What you can do to increase your odds of living a long life.
Life expectancy had been increasing steadily in the United States since the Civil War (with a few significant blips… I’m looking at you Influenza pandemic of 1918). Most of those blips were eliminated in the 1940’s and longevity then saw a steady, smooth increase. Advances in disease treatment and prevention (antibiotics and vaccines) were responsible for much of this improvement.
Now, for two years in a row, the life expectancy in America has declined. This is the biggest drop in life expectancy since that of 1921-1923 and its affecting all demographics and both genders.
Here are the important findings from this National Vital Statistics Report:
Life expectancy for women dropped from 79.9 to 79.1 years between 2020-21 (with a total loss of 2.3 years between 2019-21)
Life expectancy for men dropped from 74.2 to 73.2 years between 2020-21 (with a total loss of 3.1 years between 2019-21)
The causes of the drop for women were attributed to: COVID-19 (51.2%), unintentional injuries including overdoses (14.8%), heart disease (5.7%), stroke (3.5%), chronic liver disease and cirrhosis (2.4%)
The causes of the drop for men were attributed to: COVID-19 (49.5%), unintentional injuries including overdoses (19.1%), suicide (3.6%), chronic liver disease and cirrhosis (3.4%), and homicide (2.5%).
The good news: the drop in longevity would have even been worse if there hadn’t been a decrease in death due to chronic lung disease, pneumonia, influenza and Alzheimer’s.
While all demographics saw a decrease in longevity, American-Indian Alaska-Native (AIAN) persons saw the biggest decrease in longevity.
If we look at the main causes of this decline in longevity, we can see that the COVID-19 pandemic and overdoses (which make up the majority of unintentional injuries) were the biggest driver in this loss of life. “Deaths of despair” also inlcude loss of life by suicide and alcohol related injuries, and we can see this as well in the loss of longevity for men (suicide 3.6%) and liver disease/cirrhosis (2.4% for women, 3.4% for men).
In order to ensure that all Americans can live long and healthy lives, its important to tackle these modern threats. Making sure that everyone has access to vaccines (COVID-19, influenza and others) and taking care of mental health and substance abuse issues is paramount.
What you can do.
Stay up to date on your vaccines. Seriously, I cannot emphasize this enough. Infectious disease was the major killer of humans in the pre-vaccine/antibiotic era, and we are still susceptible.
Avoid opioid-medications if at all possible, or stay on prescription pain killers for the shortest time reasonable. The rise in drug-overdose deaths in America has been fueled by the opioid epidemic (or people switching to heroin/other street drugs as an alternative to prescription opioids).
Manage mental health and assess your level of alcohol consumption. While moderate amounts of alcohol may be associated with heart health, any amount of alcohol is associated with an increased risk of cancer.
Cultivate healthy relationships with friends and family (see below).
Another really important aspect of longevity is cultivation of social relationships, and this has certainly been suffering in modern life, particularly during the pandemic. Susan Pinker discusses the 10 characteristics of people who live long healthy lives in this Ted talk. While some have criticized her data (particularly the effect of exercise on longevity) the data about longevity and social connections is well supported by the prolific work of Julianne Hold-Lunstad.
The 10 most important contributors to longevity, according to Pinker and Hold-Lunstad are, from most important to least (this work was done pre-COVID):
Social integration (feeling a part of a community)
Close personal relationships
Quitting smoking (or not smoking)
Reduction of alcohol (or abstaining)
Influenza/pneumococcal vaccinations
Cardiac rehab for those with Chronic Heart Disease
Exercise/physical activity
Maintenance of healthy weight
Control of blood pressure
Air quality (absence of air pollution)
I was not surprised to see vaccination, exercise, blood pressure/heart health and reduction of smoking/alcohol on this list. I was floored to see the appearance of social connections on the list at all, let alone in the top two spots. But considering the influence of “deaths of despair” on longevity, maybe this makes perfect sense.
Close personal relationships and community engagement are important for healthy functioning at every age. Loneliness reduces our immune system function (I’ll cover this in a future podcast!). Isolation is connected to feelings of depression and despair. Being disconnected from others contributes to addiction. Having others to look after you and support you may help you recover from illness, infection and disease. Being actively engaged in your community keeps your mind and body active.
Even health insurance companies are taking note, calling loneliness an “epidemic” in America and working to combat loneliness as a strategy to improve physical health. The data below was gathered by Cigna AFTER the COVID pandemic.
The HotTake: Longevity in America is decreasing across the board. COVID-19 infections, and “deaths of despair” top the list of factors contributing to this decline. In order to protect your long life, stay up to date on your vaccinations, manage mental health and drug/alcohol intake, and cultivate positive relationships.
Stay happy, healthy and informed!
Jessica at TCA
Vital Statistics Rapid Release: Provisional Life Expectancy Estimates for 2021
The US Just Lost 26 Years Worth of Progress on Life Expectancy
Why Life Expectancy in the US is Falling
Deaths of Despair and the Future of Capitalism
Dietary Guidelines for Alcohol (CDC)
The Secret to Living Longer Might be Your Social Life (TED Talk)
Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review
The Loneliness Epidemic Persists: A post-pandemic look at the state of loneliness among U.S. adults