Annual Numbers of Excess Deaths in the US Relative to Other Developed Countries Are Growing at an Alarming Rate

Yves here. This article looks at why Americans are dying at a high rate compared other advanced economies. The author does not give Covid a leading role, but IMHO he underweighs the toll Covid takes on heath generally. For instance, a big study using VA data (and very well stratified, even by variant) found that every repeat case increased the odds of dying in the next six months. So Covid imposes a health toll, and it’s like to be higher with those with underlying health problems. The generally poor state of American health and health care is likely to be interacting with our Covid indifference in a nasty way.

Having said that, another bad differentiating US feature is our high level of opioid, and specifically, fentanyl, abuse.

But Lambert saw this coming years ago with his first two rules of neoliberalism:

1. Because markets.

2. Go die!

By Patrick Heuveline, Professor of Sociology, University of California, Los Angeles. Originally published at The Conversation

The Big Idea

People in the U.S. are dying at higher rates than in other similar high-income countries, and that difference is only growing. That’s the key finding of a new study that I published in the journal PLOS One.

In 2021, more than 892,000 of the 3,456,000 deaths the U.S. experienced, or about 1 in 4, were “excess deaths.” In 2019, that number was 483,000 deaths, or nearly 1 in 6. That represents an 84.9% increase in excess deaths in the U.S. between 2019 and 2021.

Excess deaths refer to the actual number of deaths that occur in a given year compared with expected deaths over that same time period based on prior years or, as in this study, in other countries.

In my study, I compared the number of U.S. deaths with those in the five largest countries in Western Europe: England and Wales, France, Germany, Italy and Spain. Those five countries make for a good comparison because they are nearly, if not quite, as wealthy as the U.S. and their combined population is similar in size and diversity to the U.S. population.

I also chose those countries because they were used in an earlier study from another research team that documented a 34.5% increase in excess deaths in the U.S. between 2000 and 2017.

The acceleration of this already alarming long-term trend in excess deaths in the U.S. was exacerbated by the fact that the U.S. experienced higher death rates from COVID-19 compared with similar countries. However, COVID-19 alone does not accountfor the recent increase in the number of excess deaths in the U.S. relative to comparison countries.

Why It Matters

Rising living standards and medical advances through the 20th century have made it possible for people in wealthy countries to live longer and with a better quality of life. Given that the U.S. is the largest economic power in the world, with cutting-edge medical technology, Americans should have an advantage over other countries in terms of life span and death rates.

But in the last 50 years, many countries around the world have outpaced the U.S. in how fast death rates are declining, as revealed by trends in life expectancy.

Life expectancy is an average age at death, and it represents how long an average person is expected to live if current death rates remain unchanged throughout that person’s lifetime. Life expectancy is based on a complex combination of death rates at different ages, but in short, when death rates decline, life expectancy increases.

Compared to about 20 other high-income countries, since around the mid-1970s the U.S. life expectancy has been slipping from about the middle, or median, to the lowest rungs of life expectancy. So the relative stagnation in life expectancy in the U.S. compared with other countries is directly related to the fact that death rates have also declined more slowly in the U.S.

The U.S. has higher death rates than its peer countries due to a variety of causes. Cardiovascular disease prevalence has been an important driver of life expectancy changes across the globe in recent decades. But while death rates from cardiovascular disease have continued to decline in other parts of the world, those rates have stagnated in the U.S..

A key reason for this trend is the rise in obesity, as research shows that obesity increases the risk of death from cardiovascular disease. High prevalence of obesity in the U.S. also likely contributed to the relatively high death rates from COVID-19.

Another cause is that the U.S. has disproportionately high death rates from intentional injuries in the form of homicides, in particular those caused by firearms. Moreover, it also has high death rates from unintentional injuries, in particular drug overdoses.

People are being exposed to fentanyl without knowing it, and because the synthetic opioid is so highly potent, people are dying in unprecedented numbers.
What Other Research Is Being Done

While these specific causes of deaths should clearly be health policy priorities today, there might be more fundamental causes to the elevated U.S. death rates.

In the early 1990s, young people in the U.S. between the ages of 15 and 34 were already dying at higher rates than their peers in other countries from a combination of homicides, unintentional injuries – in large part from motor vehicle accidents – and deaths from HIV/AIDS.

Research is underway to understand the more fundamental societal causes that may explain the vulnerability of the U.S. population to successive epidemics, from HIV/AIDS and COVID-19 to gun violence and opioid overdoses.

These include racial and economic inequalities, which combined with a weaker social security net and lack of health care access for all may help explain larger health and death disparities compared to European countries.

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  1. John R Moffett

    The US has pushed its soul-crushing neoliberal vulture capitalist policies on the world for years, but we are still way ahead in how negatively it is impacting people’s lives. Nothing is going to change until something is done about the ultra-wealthy who have orchestrated the entire mess. Until their ill-gotten money is stripped away from them, things will only get worse.

  2. JonnyJames

    I would bet that another factor is because the US does not have a health care system, and 10s of millions don’t have proper access to regular health care. The other “advanced countries” all have modern health care systems.

    The US spends 18-19% of GDP on health extortion costs, yet has the worst health outcomes of the OECD.

    Cuba apparently now has a higher average life expectancy than the US, despite the illegal economic blockade.

    1. IM Doc

      This is meant to be no offense to you at all.

      Your comment above is a good example of the culmination of years of propaganda.

      10s of millions don’t have proper access to regular health care

      I will state again – ACCESS to health care is NOT health care. This phrase “access to health care” is a canard used by those trying to pat themselves on the back for bringing “universal” health care with Obamacare.

      You cannot have actual health care if your “access” to it depends on a 15K deductible and ridiculous monthly premiums and hours upon hours of forms and voice mail hell.

      It is alarming to me that the Obama/Pelosi crowd have been this successful at bamboozling this entire country.

      1. JonnyJames

        I hear you. Access is a euphemism for insurance extortion which does not mean we get real health care. The perpetuation and support of the private Health Insurance Extortion Racket is bipartisan.
        The D/R dictatorship will ensure this does not change. “Single Payer is off the Table!”

      2. BeliTsari

        Yet again; it’s such a slap in the face to folks who WERE decreed “essentials,” with multiple acute and cascading PASC “comorbidities” we’d NOT experienced previously; yet have continuously listed incrementally, as if discrete & totally unrelated; that a few million blue collar poor folks magically presented with simultaneously, while NYC imaging & diagnostics were unobtainable and all we heard, when our PCP finally returned from upstate was, “we’re ALL fucked up? It’s a NEW disease that hijacks your immune system & imaging can’t resolve, sufficiently?” When my one coworker had a case in Baton Rouge & a 2nd case, back home, in Mexico before Christmas, we’d acknowledged we’d been told, this was likely. When we’d ALL had “breakthrough” infection, followed by additional PASC after gnarly mRNA side-effects, same thing. When a few coworkers, younger than us DIED, months after working through acute infections. We’d all call or text each other. Now, we’re reticent to take calls, mostly from “minoritized,” race or ethnic friends; who’re experiencing FAR higher death rates, among family & friends. It’s slow motion, soul grinding stealth eugenics; media quickly ignored it & it’s reminiscent of AIDS, or “deaths of disparity” but we’d not ever become inured to these, so why aren’t we out in the streets about a couple million more “excess deaths” they’ve moved the goal-posts so obviously, to hide?

  3. Dan S

    I’m always suspicious of reverse engineering claims. To paraphrase Stanton Friedman, imagine dropping an iPhone off with General George Washington (of course programmed in a completely foreign language) and expecting the colonials to make anything useful of that.

    1. Even Keel

      I think I get your point. It made me think of something else. An iPhone placed anachronistically in the past would be useless. It needs an entire support system, including networks and content providers. There are only limited internally sufficient apps on it (calculator? Calendar?).

      So the iPhone individually is just a terminal extension of the web of things that support it.

      People often talk about an iPhone as if it itself some wonder tech. But they are probably wrong, or at least significantly incomplete in their descriptions.

  4. Cocomaan

    Man I’m sure glad that most of the population wasn’t stuck with an experimental vaccine, it would be so difficult to parse out if it was having an effect! Even harder if there was huge monetary incentive to ignore its effects.

    1. LinearPerk

      But we do know that most of the population was struck by a nasty virus. And we know that the virus has a laundry list of ill effects. The vaccine may have some effects that we haven’t uncovered or fully understood but the magnitute of its effect is certainly less. Much less.

      Also how would you seperate the ill effects from the vaccine from the ill effects from the virus? We failed so badly at track and trace that there’s no population that you could use as a control.

      1. IM Doc

        The vaccine may have some effects that we haven’t uncovered or fully understood but the magnitute of its effect is certainly less. Much less.

        Please provide good data to support this. I have certainly not been able to find any data to support this confident of a claim.

        When I look back over the fullness of time in my own practice, and listen to many colleagues across the country, I cannot make that claim at this time. I have more vaccine injuries in my own practice than COVID related death or disability. Again, I cannot be so assertive as to make this claim.

        1. Amfortas the hippie

          of all the HCW i know, but one, only the off-duty/friend of family nurse who was present for my Wife’s death will admit to there being a problem with the mRNA platform.
          even here, in rural and ruralish red texas…it is a faux pas.
          but, as ive related before…when Wife was first diagnosed, september, 2018, with stage 4 colon cancer…i dove into a research frenzy.
          one of the things i came across was mRNA platform for essentially cooking up a targeted vax for your particular and distinct cancer.
          it was fascinating…but all the various papers i read…including from the guy who invented it(cant remember name, atm)…all were careful to state that the technology was nowhere near ready for primetime. it induced autoimmune disorders, it turns out…and they couldnt figure out how to overcome that.
          i was learning this a full year and a half before covid emerged.
          more than 2 years before these vaccines were rolled out as a panacea.
          the mindf&ck has been really derned effective on this topic…as have the effects of the purity police/orthodoxy enforcers.
          my longtime doctor summed it thus:”well, yeah…i’m a little leery of it…but its all we got.” but with the glancing at the door caveat…”i’m not supposed to talk about this…”
          if we hadnt known each other for 23 years, he wouldn’t have, i’m sure.

        2. g kalin

          What sort of vaccine related injuries did you see?

          And, could it be that your low observance of Covid deaths and disability was due to the vaccinations?

      2. Cocomaan

        “We failed so badly…”

        Failure is not the right word when thousands and perhaps millions of Americans in public health, pharmaceuticals, and other institutions are paid to do their jobs but “accidentally” produced that failure.

        Bad incentives all the way down, from preventing people from getting sick to having your way with their immune system.

        I didn’t fail at anything. I protected my own health and man, it feels great.

        1. Arizona Slim

          Cocomaan, you posted a comment that I’ll never forget.

          ISTR that it was during early 2021, and you were listening to the radio as you were driving around suburban Philadelphia. My old stomping grounds, BTW.

          During that broadcast, the deejay was asked why he wasn’t planning on getting the vaxx. Deejay’s reply: “I don’t have Obama money if something happens.”

          Nowadays, one of my good friends is still suffering the ill effects induced by a single dose of the J&J shot. She had to take it in order to keep her job, and this was in late 2021. AFAIK, she hasn’t sought treatment for her injury, and, yes, I’ve given her the contact information for a doctor who could help her.

          Me? I protected my own health, and like you, I feel great.

          Thank you, Cocomaan, for posting that comment two years ago.

          1. rowlf

            Many of us in a safety sensitive industry that distrust anything new (like Boeing MCAS) went with J&J.

            One coworker said the side effects (which linger) was like having Lyme disease again. I concur. We are not happy with the company and the government.

    2. rtl_snk

      Did the United States get a different vaccine than all those european countries (with rebounding life expectancy) it’s compared to in the study?

  5. Paul Damascene

    Yves, any analysis that does not seriously consider the C19 inoculations is to be suspected of intellectual dishonesty and frankly indicted for journalistic malpractice–insofar as this is the one potential cause affecting the widest number of readers, now and into the future, and additionally the one most susceptible to direct remediation.

    1. cfraenkel

      These ‘blame it on the vaccines’ comments make no sense. This post was about the decline in US life expectancy relative to the other ‘advanced’ economies. Those populations got the same vaccines. Is somehow the vaccines a problem in the US but benign in ROW?

    2. Raymond Sim

      The one potential cause affecting the widest number of readers is quite clearly the virus itself.

      This is so obvious that your own analysis would oblige me to consider you a liar.

      1. Yeti

        “ The one potential cause affecting the widest number of readers is quite clearly the virus itself.”

        You are right in that the virus itself maybe the cause. It also could be people getting multiple mRNA shots, or maybe all the other interventions like throwing a couple of million out of work, stopping families and friends from gathering and seeing their loved ones dying alone. As this article explains, this decline in America has been going on for a long time. I would argue with a coworker about this very issue about 10 years ago. I said America spent twice as much per capita on health care yet had worse outcomes than Canada. It now seems maybe we are catching up to you guys. I’ve been tracking Covid-19 deaths as well as all cause deaths in Canada and here in B.C. my conclusions are scary. Here in B.C. excess deaths are up almost 20%/100,000 in 2022 over the 2017-19 average. But the top 15 causes of death have remained fairly constant. The top 3 are cancer, heart disease and dementia.
        But when you look at years lost drug toxicity goes from 4th to second. That is for 2023. It still only accounts for 5% of the almost 110 excess deaths every week. The other causes are still up 20% no mater how you look at.
        According to Dr. John Campbell other countries are seeing the same thing.

        1. Yves Smith Post author

          Campbell is not a reliable source. We’ve pointed to many instances of his providing inaccurate commentary, including an egregious case where he made repeated, unambiguous misrepresentations about a pre-print, both falsely presenting it as a WHO statement and abjectly mis-stating what it said.

          I will not approve future comments that cite him. I don’t have time to waste checking his assertions to see if he is again Making Shit Up and debunking it for the benefit of keeping the comments section an sound source of information.

          1. Yeti

            Fair enough on Dr. Campbell. The data he provided mainly comes from our world in data which I use myself. Here is another link from someone else whom is giving a similar take on Canada as well as the UK,
            I have also back checked his data and it agrees with my downloads from Health Canada. My point was to show that this excess death anomaly is not confined to the US, but occurring around the world. Why? It seems no one in power is asking this question. I have questioned my MLA as well as our Provincial Health Officer Dr. Bonnie Henry and our Health Minister Mr. Dix… response! They have the data to answer these questions. Why do they not provide the proof? It would be very simple to shut people like myself up. Simple, are the unvaccinated dying at the same rate as the vaccinated? If so then everyone claiming the vaccines are the cause are wrong. Thankfully we have a significant portion of the population that will not get this vaccine and are by default the only control group we have. There very well be something else causing excess deaths but silence from the powers that be won’t answer that question.
            I do appreciate you taking the time to respond to my points. I do try to be accurate in anything I say.

            1. Yves Smith Post author

              This is not what the post says, starting with its headline and first sentence: “People in the U.S. are dying at higher rates than in other similar high-income countries, and that difference is only growing.” The post does not say the US has a lot of excess deaths and no one else does. It says the US has a higher rate of excess deaths.

              We do not have individual data on who is vaxxed v. not and how many and what vaccines they got. No central repository for that or health data here. We can get at it only on a very crude aggregate level by how many vaccines were administered, or as mentioned, using the best data individual data we have. from the VA, as a proxy.

              Only way to do it would be tracking back from how the vaccines were paid for and that does not work well. HHS paid for the uninsured out of Covid funds, Medicare, Medicaid, VA, private insurer all paid. That would be a massive task.

  6. Louis Fyne

    people are literally addicted to sugar, factory fat, salt.

    sugar + fat light up one’s brain no differently than any other dopamine hit

    go 7+ days on a low salt, sugar diet and have your taste buds, “reset”. afterwards “regular” foods taste recoilingly too sweet and salty.

    (of course, it is easy to tsk-tsk eating habits without pricing out-of-season produce versus income)

    1. JonnyJames

      Yeah, it takes a lot of time looking at labels to avoid sugar, corn syrup (corn sugar) etc. that is added to just about everything in the US. Bread, crackers, croutons, juice, drinks, not to mention the processed food is chock full of salt and sugar.

      BigFood has ‘merkans hooked on sugar and the US has sky-high diabetes rates. It’s good for bidnez: BigPharma extorts the US public for insulin, which is orders of magnitude more expensive than in other countries. Can’t afford the insulin? Too f-in bad, merkans live in a “free” country: you are free to die young, broke and in debt.

      1. eg

        “The law, in its majestic equality, forbids rich and poor alike to sleep under bridges, to beg in the streets, and to steal their bread.”

  7. Eclair

    “Life expectancy is an average age at death, and it represents how long an average person is expected to live if current death rates remain unchanged throughout that person’s lifetime.”

    Ah, yes, but some of us are more ‘average’ than others. Income/ wealth matters. The region of the US where you live, matters, e.g., don’t get born or stay around for long in Mississippi. But, in the end, wealth cancels out most of the disadvantage of location. Wealth, of course, enables people to eat ‘better,’ join athletic clubs, pay for top notch health care, maintain a thin and fit body, avoid stress.

    Of course, some may argue that eating highly processed foods, sitting on the LazyBoy recliner watching TV, living in the Deep South, and avoiding doctors, is the main driver of their poverty. They deserve a shortened life. Live just long enough to replenish the cadre of necessary low income ‘essential’ workers and put in a couple of decades of minimum wage labor, then ‘go die.’

    1. eg

      Those of whom you speak are “surplus to requirements” and their early deaths an “externality.”

  8. Lexx

    ‘This is the way.’ I was reading ‘Pathogenesis’… the author wrote that the irony of Brexit and voters’ fury at migrants taking away jobs from alleged ‘indigenous’ Britains is that none of them are indigenous. The whole “native” population of the island 6000 years ago was wiped out by the diseases the waves of Anatolian migrants brought in with them and their descendants are miffed at feeling like supplanted supplanters. In truth most of the people on the planet are migrants or descendants of. It’s one of the things I like about this neighborhood, everyone is from somewhere else. None grew up in Colorado; several didn’t grow up in the U.S..

    The new Britains did much the same (wipe out the natives) to ‘indigenous’ people the world over in their explorations and colonization. Pick your tribal affiliations, we’re only as strong as our collective immune systems, much of it acquired from the collective immunity of others. If we manage to survive the latest virus, we get to breed and perhaps pass on our immunity to the next generation of winners. Covid is the latest challenge to the collective.

    We discuss ‘externalities’ here contributing to the excess deaths in the U.S., but I think our collective weakness is internal. It’s the Western diet and it can take a long time to kill, but first maybe it just shortens your life by a decade.

    It’s strength, if you will, is in undermining our health, from which we could recover if we knew what was happening. In ignorance though the frog jumps out of the hot water too late. The real enemy is within; it resides in Subclinical Land, where we marginalize it until is becomes profitable.

    It’s never just a crisis, it’s also an opportunity. Lambert isn’t wrong.

  9. Steve

    Misleading numbers.

    Yes, 892k / 483k is about 84.9%. What this misses is that the number of annual deaths changed.
    From a figure in the cited paper:
    2019 had 2,852,000 deaths with 483k in excess, a rate of 0.169 (483/2852).
    2021 had 3,456,000 deaths with 892k in excess. a rate of 0.258 (892/3456).
    So the rate has increased 0.258/0.169 = 52.4%

    Still nothing to sneeze at.

  10. 10leggedshadow

    The deaths of despair among the young because of drug addiction is but one factor. My pet theory is that there is no longer upward mobility in this country for the non rich, and every path to success is laden with pitfalls and debt. Jobs now pay the same of less than they did 50 years ago while costs have ballooned. There is no hope of a future for the young in this country and the rich have hollowed us out. Covid just accelerated the just die part of neo-liberalism, but this has been happening longer than just from 2019.
    To me, the 3 signs of a failing state are increasing death rate, decreasing life expectancy, and a declining birth rate. Some parts of this state are failing faster than others.

  11. Cesar Jeopardy

    The Graph: What happened in 1982? The limited data from before that showed U.S. life expectancy increasing at the same rate as other advanced countries. Then suddenly the rate or slope decreases. I’ve been aware of this for years but have no explanation. Well? What happened back then?

    Life in the U.S. is as it is designed to be according to Hobbes: “Nasty, Brutish, and Short!”

    1. upstater

      High Fructose Corn Syrup is one possible reason. It came into common use in the 70s and early 80s. The US has some of the highest consumption of sweeted drinks, almost all switched to HFCS, plus HFCS is used in many other foods. The concept of “super-sized” and big Gulp became more common. Look at photos of people in the 60s and 70s; obesity wasn’t common. Today a majority of Americans are overweight or obese.

      Of course the COVID and fentanyl deaths make USA!USA! #1.

    2. Dr. Nod

      1982 was around the time that Reaganism began to take hold. One could write volumes about the things that have changed since then, but it was a transition from the post-great-depression, post WWII paradigm in which government was valued and generally tried to do good things for people (with exceptions, of course) to a time in which unfettered capitalism was worshiped. Public sports and fitness programs were gradually cut. The President’s fitness commission faded into oblivion, fewer public service adds were required for the broadcast media. Health care became more and more expensive and more profit-directed. Corporations were able to get away with more and more (if you can save a penny a quart by using high-fructose corn syrup instead of sugar more power to you [plus downward pressure on the price of sugar hurts Cuba]). School has been dumbed down. We are now consumers instead of people. All this has contributed to sedentary life styles and obesity. So many things have been slain on the alter of unfettered capitalism. On top of that, AIDS was just beginning to hit around that time and would have effects on life expectancy for years thereafter. AIDS didn’t have a name yet, but I remember talking with my colleagues about this odd disease that was spreading through the gay community in San Francisco.

    3. earthling

      The don’t-eat-fat-eat-grains propaganda was taking hold. Backfired, created more heart disease and a diabetes epidemic.

  12. Raymond Sim

    Note that the ‘The Conversation’ article linked to regarding Covid not accounting for the rise in excess deaths merely notes that excess deaths exceed deaths determined to be due to Covid, and says the causes of the additional excess remain to be determined.

    In other words “COVID-19 alone does not account for the recent increase in excess deaths…” is rather mendacious phrasing.

  13. Matthew G. Saroff

    The biggest driver of life expectancy numbers is infant and child mortality.

    Infant and child mortality has been rising in the US for some time, particularly among the poor and minorities.

  14. David M.

    I’m reminded of O’Brien’s speech from 1984:
    “You are under the impression that hatred is more exhausting
    than love. Why should it be? And if it were, what difference would that make?
    Suppose that we choose to wear ourselves out faster. Suppose that we quicken
    the tempo of human life till men are senile at thirty. Still what difference would
    it make? Can you not understand that the death of the individual is not death?

    The party is immortal.’”

    1. LawnDart

      Either the author or editors of the original piece– we heard the alarm years ago, woke up, and haven’t been able to get back to sleep since.

  15. KidMD

    The US has no shortage of PFAS, phthalates, endocrine disruptors and unknowns in the water, soil, food and air. Issues related to negligible/selective regulation and enforcement, may also directly cause or influence medical problems.

    UK has official national data that includes vaccination status and Covid status, which is quite interesting as infection risk rose for vaccinated after various time periods (they include data by age group). Israel and many others dropped that specification early on, reportedly due to low numbers (as vax was largely mandated).

    It is difficult to decipher damage from the spike protein (produced secondary to vaccination) versus the same protein plus infection. For most studies no attempt is made, though there are many looking at subgroups. Rapidly shifting infection risk/rate/variants, related to repeat infections and variously timed vaccines makes the picture particularly blurry. This is compounded by vested interests of researchers and media.

    Here is Cleveland Clinic study with note about how more vaccine doses were related to more Covid infections, (including links to other studies with similar results) info.

    So, so sorry the authorities cancelled the vaccine control group early.

  16. Ernie

    I have to wonder if the decline in life expectancy/increase in death rate relative to other comparably wealthy countries is deliberate. Certainly, all the factors cited in the article and the readers responses are likely ingredients in the witches’ brew that has become American culture and politics and are the proximate causes of the decline in life expectancy. But underlying those factors may be some pretty gruesome motives: to develop a younger population with fewer elders to support.
    There is little to no discussion about human overpopulation and its dire effects on the planet. There is no recognition in ordinary discourse that nothing is infinite, including the resources of a planet, and by resources I also mean not just the usual minerals and vegetables, but also the things that make life happy, that are necessary for life such as clean air and clean water, living space, wild places, etc. What we do hear, and not just in the US, is that more population is necessary to maintain the current (declining) standards of living. Usually, these calls for more population are predicated on the need to support the elderly members of the various societies. Of course, supporting the elderly is a canard, since many if not most elderly work until the day they expire. In the US, this is a dirty secret that I have never heard/read discussed, because in the US we don’t want to admit that our treatment of elders is actually quite poor. The best way to deal with that is to hasten their exit from this mortal coil.
    For instance, in the article obesity is cited as a root of many health problems and early death. Reading between the lines one can see that obesity is not really a lifestyle choice so much as it is a condition pressed on people primarily by the markets, employers, and the so-called healthcare system. Especially for employees in the lower economic rungs of US society, finding time to exercise while having family obligations when employed is difficult and expensive. Obesity is considered an epidemic, yet treatment for it is rare, reserved only for the worst cases of obesity, and is often debilitating in and of itself. As an epidemic, obesity is not treated seriously. And obesity is just one of the many issues related to the declining life expectancy. And it is, in fact avoidable, and in the instances that it is not avoidable it is treatable. The problem is that the society has to demand that the private interests that foist unhealthy food, too much time at work, limited to no access to exercise time and healthcare, change their behavior and their attitude toward employees.
    What I have discussed here is just the tip of the iceberg and is an exemplar of the problems leading to life expectancy decline. Others with more knowledge and experience of this aspect of the problem will find more causes. What has to be recognized is that the causes of the decline in life expectancy are not coincidental or unintentional, but rather are the products of deliberate thoughts, policies and actions of those at the higher levels of control of the society.

  17. spud

    the deaths of despair are linked to bill clintons free trade debacles.

    “Case and Deaton were the first to note rising midlife mortality rates among Caucasian, non-Hispanic Americans aged from 35 to 54 with a high school education or less. They identified drug overdose, suicide and alcohol-related liver disease mortality as the causes of the increase and attributed these ‘deaths of despair’ to reduced economic opportunity among less educated adults.”

    “The authors take as a given that the “China shock” after its WTO entry in the early 2000s was a crippling blow to US manufacturers already in decline. And just as that policy (as well as NAFTA and successful anti-union efforts) decimated blue-collar workers, studies of variation in state policies suggests that higher minimum wages and earned income tax credits would reduce suicides (but not overdose deaths).”


    “(Reuters Health) – Opioid overdose deaths have spiked in the wake of automotive assembly plant closures across the U.S. South and Midwest, a new study suggests.

    Plant closures were associated with an 85% surge in opioid overdose mortality rates among working-age adults five years later, compared with what would have been expected if these factories had remained open, researchers report in JAMA Internal Medicine.

    “We found that automotive assembly plant closures – which led to dramatic reductions in economic opportunities in manufacturing for individuals living in those areas – were strongly associated with poor health outcomes, specifically higher opioid overdose death rates,” said lead author Dr. Atheendar Venkataramani of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

    “The fading American dream may be more than an economic problem – it may also adversely affect America’s health,” Venkataramani said by email.”


  18. spud

    “Starting in the mid 1990s, President Clinton and other Democrats embraced free trade deals – first NAFTA and then with China – despite clear warnings about the damage both would cause manufacturing America.

    As it turns out, the alarms were well placed: studies have shown that these trade deals have left many communities throughout the U.S. in poverty and deeply mired in unemployment.

    Why then were we surprised when these voters turned down Secretary Clinton considering her support for not only the trade deals but also the bankers who benefitted from them? ”

    “Let’s start with trade. For 20 years, my fellow Democrats have advanced global deals that left too many behind, particularly in rural and blue collar America. We discardeded our roots as champions of the working class in exchange for campaign contributions.

    For that, America, we are sorry. We failed you.”

  19. Allan

    All of these effects and causes were detailed in ‘The Spirit Level’ by academic epidemiologists Professors Wilkinson and Pickett more than ten years ago. It’s the level of inequality in a society that overwhelmingly but not solely determines the outcomes of such issues.

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