Life Expectancy Numbers Shift

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Drug poisoning (overdose) deaths more than doubled in the U.S. from 2000 to 2015, while deaths from opioid overdoses more than tripled in the same period. Increases in poisoning deaths, which are classified as subsets of unintentional injuries, suicides, homicides, or events of undetermined intent, have reduced the life expectancy of non-Hispanic white individuals in the U.S. from 2000 to 2014. Overall life expectancy at birth for the general population increased from 76.8 years in 2000 to 78.8 years in 2015. From 2000 to 2015, death rates related to heart disease, cancer, cerebrovascular disease (stroke), diabetes, influenza and pneumonia, chronic lower respiratory disease, and kidney disease decreased, adding a gain in life expectancy of 2.25 years. During the same period, death rates related to unintentional injuries, Alzheimer’s disease, suicide, chronic liver disease and serious infections increased, which caused a loss of 0.33 years in life expectancy.

The National Vital Statistics System Mortality file, which uses information from death certificates from all 50 states and the District of Columbia, lists the leading causes of death in the U.S. In descending order, the top 12 causes of death are heart disease, cancers, chronic respiratory illness, unintentional injuries, cerebrovascular disease, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease, suicide, infections, and chronic liver disease. In 2000, there were 97,900 unintentional injury deaths, which included overdoses. In 2015, this number rose to 146,571. Drug overdose deaths, which are included in unintentional injury deaths, rose from 17,415 in 2000 to 52,404 in 2015. The age-adjusted death rate per 100,000 population increased from 6.2 to 16.3, mostly due to opioid overdoses, during the same period.

The negative effect of opioid overdose deaths on the change in life expectancy is likely underestimated because the accuracy and completeness of information recorded on death certificates affects cause-specific death rates. A specific drug is not listed on the death certificate in as many as one quarter of overdose deaths. Increases in U.S. life expectancy at birth have leveled off from a mean of 0.20 years gained annually from 1970 to 2000 to 0.15 years gained annually from 2014 to 2015, and is now lower than most high-income countries, and this gap is predicted to continue to increase. These findings strongly suggest that finding ways to prevent opioid-related overdose deaths will be important to once again begin achieving healthy increases in life expectancy in this country.

Incidentally, recently NYC announced a lawsuit against opioid manufacturers. This is akin to suing the manufacturer of a pistol because someone committed suicide with it. While it may be commendable that the City is trying to do something about the opioid epidemic, it’s my opinion (I admit I’m not a lawyer) that this lawsuit will have a difficult uphill battle. I believe the City would have better success by tracking opioid prescriptions and going after healthcare providers that overprescribe or inappropriately prescribe them.

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