Opioid crisis
The causes of this collapse are many. Among them is a sharp rise in overdose deaths. In San Francisco in 2020, 697 people died from a lethal dose of drugs, usually fentanyl. That's more than double the number of COVID-related deaths during the same period.
Behind this crisis are powerful drugs, including Oxycodone. Over-prescribed by doctors and promoted by an unscrupulous pharmaceutical industry, they have resulted in hundreds of thousands of Americans falling prey to addiction. Fentanyl overdoses are now the leading cause of death for 18-49 year-olds in the U.S., according to an analysis by The Washington Post.
According to the CDC, the Centers for Disease Control and Prevention, drugs claimed 564,000 Americans' lives between 1999 and 2020. And this trend has clearly accelerated in recent years. By 2021, the CDC expects more than 100,000 overdose deaths nationwide.
"Deaths of despair"
More generally, researchers are worried about a rise in "deaths of despair" in the U.S. This category includes overdose deaths, alcohol-related deaths and suicides. In their book Deaths of Despair: The Future of Capitalism, Anne Case and Angus Deaton analyze this disturbing trend, which mainly affects poorly educated white men, but also women with no formal education— two categories of the population particularly affected by globalization and the automation of certain tasks.
It reflects a certain indifference to danger.
Instead of hiring full-time employees, companies are increasingly turning to flexible contracts. This takes away the opportunity for people with no formal education to climb the corporate hierarchy.
"The pillars that structured life and helped give it meaning — a job with prospects for advancement, a secure family life, a voice in the community — have all disappeared," writes the author.
Racial injustice
The decline in life expectancy in the U.S. also reflects a certain indifference to danger. For example, Americans drive more than Europeans. But this does not entirely explain the increase in fatal accidents on American roads. In 2021, in the European Union, 19,800 people died in road accidents. Despite having a smaller population than the EU, over 43,000 Americans died in the same way that year.
According to a study by The New York Times, pedestrians and cyclists in particular are affected by this increase. Between 2000 and 2020, the number of fatal accidents fell for motorists, but rose for everyone else. A worrying trend, which particularly affects African-Americans and Latinos.
The higher vulnerability of American pedestrians and cyclists can be explained by the way cities are organized around the car. Everything is done to ease the circulation of motor vehicles at the cost of other users. The lack of infrastructure encourages speeding, while the SUV craze makes these accidents more deadly.
Misplaced belief in American exceptionalism
Although the poorest people are the most affected, they are not the only ones concerned by this fall in life expectancy. On the contrary, all strata of American society — right down to the wealthiest 1% — appear to be living shorter, less healthy lives than the populations of comparable countries. In a landmark study published 10 years ago, a group of researchers examined the causes of this American exception.
There has been a little more research, but there has been no political reaction.
In their conclusions, the authors recommended that American authorities "thoroughly study the public policies and approaches that other countries with healthier populations have found useful and that could be adopted, with adaptation, in the United States".
But, 10 years on, "very little has happened", says the report's lead author. Eileen Crimmins, a professor of gerontology at the University of Southern California who took part in the study, agrees: "There has been a little more research, but there has been no political reaction." At a meeting in Washington, she observed that experts from other countries were not listened to in the name of a misplaced belief in American exceptionalism.
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