Over the past two years, the United States has lost more than two years of life expectancy, wiping out 26 years of progress. French daily Les Echos investigates the myriad of causes, which are mostly resulting in the premature deaths of young people.
On May 6, a gunman opened fire in a Texas supermarket, killing eight people, including several children, before being shot dead by police. Particularly bloody, this episode is not uncommon in the U.S. — it is the 22nd mass killing (resulting in the death of more than four people) this year.
Gun deaths are one reason why life expectancy is falling in the U.S. But it's not the only one. Last December, the American authorities confirmed that life expectancy at birth had fallen significantly in just two years: From 78.8 years in 2019, it would be just 76.1 years in 2021.
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The country has thus dropped to a level not reached since 1996. This is equivalent to erasing 26 years of progress.Life expectancy has declined in other parts of the world as a result of the pandemic, but the U.S. remains the developed country with the steepest decline — and the only one where this trend has not been reversed with the advent of vaccines. Most shocking of all: This decline is linked above all to an increase in violent deaths among the youngest members of the population.
Five-year-olds living in the U.S. have a one in 25 chance of dying before their 40th birthday, according to calculations by The Financial Times. For other developed countries, including France, this rate is closer to one in 100. Meanwhile, the life expectancy of a 75-year-old American differs little from that of other OECD countries.
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.
Prescription pain pills on a table.
"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.
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.