Friday, September 2, 2022

Opinion Today: The future of American life expectancy is at a crossroads

Can voters reverse the decline?
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By Alexandra Sifferlin

Senior Staff Editor, Opinion

Life expectancy in the United States declined by nearly one year from 2020-21, according to new government data. The National Center for Health Statistics says that the decline brings U.S. life expectancy at birth to the lowest level since 1996. "Is there a more fundamental barometer of the health of our nation?" asks Dr. Dave Chokshi, the former New York City health commissioner, in a guest essay this week. "The stagnation in life expectancy reflects deep‌‌ societal challenges — not just in our health system but also in our economic and political systems."

As Chokshi points out in his essay, life expectancy is not a literal estimate of how long a newborn is expected to live. Rather, it signals mortality trends for adults in a given year. It's likely that Covid-19 greatly affected life expectancy, but other factors weigh in, including a high prevalence of drug overdose deaths and chronic illnesses.

The bright side is that these projections are not set in stone. And it's here where Chokshi argues for a better way forward. "America is at a fork in the road with respect to the health of the nation," he writes. One path is for public health to remain business as usual. The other path, he argues, models the public health response to 19th-century outbreaks of typhus, smallpox, dysentery and cholera, where sanitation and health disparities were tackled.

Chokshi makes the case that one way to get buy-in for real public health reform is to focus on children, and push forward policies that will improve the world they will inherit. He argues this requires leaning on voters' identities as parents and grandparents.

"Organizing to get them to the polls and giving them a reason to vote on the social and economic policies that shape health may be the key to reversing the decline in life expectancy in the United States," he writes. "I care about that as a doctor, but even more so as a father."

What Our Readers Are Saying

National single payer health care. Not linked to employment. No pre-existing conditions excluded. That's how you change U.S. life expectancy. — Chris Gerhard, Cambridge, Mass.

If I recall correctly from my research for my 1990s masters thesis on inequality, if you want to get a fairly clear idea of the state of health in a country, look at its level of wealth and income inequality. Inequality in the United States is about as bad as it gets in advanced countries around the world. — Deborah Slater, Yellow Springs, Ohio

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