On the demographic front, the news out of the USA in the last few years has not been that rosy. Since 2015 the country saw its life expectancy (the average number of years a new born baby is expected to live at any one point in time) decline; this was an extremely rare event for a developed country not in the midst of a major war. The decline was due to a number of factors: the opioid epidemic; the rise of “deaths of despair” (alcoholism, suicide, overdoses); and the stagnation of improvement in treating heart disease and cancer. This decline was in sharp contrast to the longterm trend that the USA had experienced since the 1960s. Between 1968 and 2010 the average life expectancy went up by two years every decade, until it peaked at 78.9 years in 2014. Then it slowly declined, until it reached 78.6 years in 2017.
However, according to the New York Times, the 2018 data shows that life expectancy is increasing again: it ticked up slightly to 78.7 years. It is not clear yet if this is the start of a new trend upwards, but at least the downward trend has been reversed. The increase means that the USA now has the same life expectancy that it had in 2010. As Dr Samuel Preston, a demographer at the University of Pennsylvania notes, this means that there has been nearly a decade of stagnation when it comes to life expectancy in the USA – a rare occurrence for a wealthy nation. The USA has the same life expectancy as Portugal, and lags behind much poorer nations such as Cuba, Costa Rica and Slovenia.
Having said that, there are a number of pleasing statistics within the increase. 2018 saw the first decline in drug deaths in 28 years. Deaths from drug overdoses dropped by 4.1 percent in 2018 to 67,367. This was largely due to a decline in the number of deaths from prescription opioid painkillers, probably because of restrictions placed on prescribing such drugs. Other measures such as expanded access to opioid addiction medications, clean needles and naloxone (the drug used to revive people overdosing on opioids) have also helped. The improvement should not be overstated: the number of deaths in 2018 is still the highest number on record, except for 2017. Further, the death rate from fentanyl (nasty stuff which we have written about before on this blog) rose 10 percent in 2018. The drug overdose rate dropped in 14 states in 2018 and climbed in five: California, Delaware, Missouri, New Jersey and South Carolina.
The drop in drug overdoses and other unintentional injuries (like car accidents) accounted for 25 per cent of the life expectancy gain in 2018. The biggest single cause was improvements in cancer mortality rates: this accounted for about 30 per cent of the gain. The over cancer death rate dropped by 2.2 per cent in 2018. This continued a trend from the year before: 2017 saw the largest overall drop in cancer mortality rates since records began in the 1930s. Mortality rates declined for lung cancer (the leading cause of cancer deaths) due to continued drops in smoking rates and advances in treatment.
On the other side of the coin, there was rising mortality due to influenza and pneumonia (up 4.2 percent). Alcohol consumption is rising. Of perhaps more concern, the suicide rate continued to climb, up by 1.4 percent in 2018 to 48,344 people. The suicide rate among adolescents was at its highest level in 20 years.
So while the trend in 2018 in life expectancy is a positive one, there are still some depressing demographic trends that the USA has to deal with.
Marcus Roberts is co-editor of Demography is Destiny, MercatorNet’s blog on population issues.