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Healthcare Triage often notes that lots of health metrics are improving in the US. But that is not the case with life expectancy. Life span is decreasing, and the losses are not equally distributed. The lives of the poor are getting shorter thanks to the opioid crisis and suicide.

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Life expectancy in the United States continues to drop, but not for everyone. This is Healthcare Triage News.


For the third year in a row, life expectancy in the United States has on average dropped. How bad is that? The last time this happened was during the Spanish Flu epidemic, like a hundred years ago.

Why? It's likely that drug and alcohol related deaths continue to rise. So does suicide. This really isn't good. So, yes, we need to combat the opioid epidemic, and we need to worry about fentanyl, and we need to make sure policies are put in place for these issues.

But, we also need to recognize that this isn't a story of one America, because life expectancy isn't going down for everyone. We've shown in previous episodes how increases in life expectancy rose faster for the richer half of American than for the poorer half. But, now those trends have started to diverge.

To the research! A study published in JAMA two years ago, showed that from 2001 through 2014, life expectancy for the poorest quarter of America didn't really increase at all. Life expectancy for the richest quarter, however, went up by about 5 years. 

Another study from just a few months ago focused on middle-aged, non-Hispanic white Americans. The data showed that mortality increases for the bottom 10% were unbelievably large. Mortality for the richest 30%, however, decreased.

There's now a 13 years expected life gap between the richest American men and the poorest America men. The gap for women in 14 years.

We argue here on Healthcare Triage all the time that this is the best its ever been for health in America, and perhaps we've been a bit unfair in that. Yes, our ability to cure various diseases and care for various issues has never been better, but if everyone can't access those services, then things aren't getting better for them.

Years ago, these access differences were small enough that on average we were still seeing lots of improvements overall for all kinds of metrics. And, for many metrics still, things look good. But, not life expectancy. Things are not ok. We've a divide right now between the rich and the poor which is massive, 13 to 14 years of life. If you think social determinants of health don't matter, think again.

We've got to focus specifically on the issues, again opioids and suicide, which we can see hurting people right now. But, if we're going to try and close this gap for good, we're going to have to recognize that the rich/poor divide in the United States is detrimental to health. It's also not getting better. Fixing that will be harder, but it's important.


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