Member-only story
Make America Healthy Again
America is experiencing the beginning of a catastrophe. For the first time ever, life expectancy is declining (Graphic from Axios based upon government data.) It is not for lack of medical advances but is rooted in the social determinants of despair and disease and the linked epidemics of obesity and type 2 diabetes.
After more than 150 years of a rapid and steady rise of life expectancy, longevity in the United States has declined for three consecutive years which for most of us is certainly unexpected; it is the first of four interrelated surprises.
For thousands of years life expectancy was about 35 years, an average of infant deaths, childhood infectious deaths, trauma deaths and maternal childbirth deaths, all balanced by those fortunate enough to live longer.
Shortly after the Civil War, longevity began to climb and by the late 1800’s and early 1900’s was rising rapidly. Safe water, sanitary sewers, pasteurization of milk, obstetrical care of mother and infant all combined to lift the average age of death. Vaccinations soon prevented many childhood deaths; aseptic technique in the operating room eliminated most surgical and traumatic wound infections. Beginning in the 1920’s, insulin meant that diabetes could be treated and by the 1950’s antibiotics and rapid advances in surgery further improved life expectancy. More recently has been the introduction of drugs to treat high blood pressure and high cholesterol which combined have reduced the prevalence of heart disease. Aggressive measures to reduce tobacco smoking has had a major impact on heart disease, cancer, stroke and other diseases. All of these and more meant that average life expectancy continued to climb from 45 years in 1900 to reach the high 70s by 2014.
The increase in life expectancy even recently has been substantial — from 69.9 years in 1959 to a remarkable 78.9 years in 2014. The rise was most rapid in the first ten years, it slowed in the 1980’s and then flattened in the decade before starting to fall.
Despite these advances, not everyone has benefited equally. White women’s life expectancy is about 82 years, white men and black women…
