Life expectancy in the United States is projected to fall to 66th in the world in the coming decades, according to a major new study.
Despite being one of the wealthiest nations, Americans already die younger than their counterparts in nearly 50 countries.
But the “alarming trajectory of health challenges,” including rampant obesity, drug use and firearm suicides, will widen that gap, according to research by The Lancet.
The researchers found that life expectancy for men and women in the US is expected to increase from 78.3 years in 2022 to 79.9 years in 2035 and 80.4 years in 2050 for both men and women.
The slight projected increase is related to medical advances and doctors’ improvement in detecting and treating chronic diseases such as cancer and heart disease. But it is relatively small compared to other countries.
For their analysis, researchers at the University of Washington assessed the impacts of hundreds of diseases and other health risks in the U.S. and individual states and compared them to more than 200 other countries.
Their models show that by 2050, Americans will die younger on average than people in several sub-Saharan African nations such as Nigeria, Kenya and South Africa, as well as war-torn countries such as Syria, Afghanistan and Yemen.
Dr. Stein Emil Vollset, who led the new study, said: “The rapid decline of the United States in global rankings from 2022 to 2050 raises the alarm for immediate action.”
Nationally, the United States has a life expectancy of 77.5 years, according to the latest estimates from the CDC.
Figure A shows where the United States ranks in global life expectancy compared to other countries. Life expectancy in the United States will increase modestly from 78.3 years in 2022 to 80.4 in 2050, and the world ranking will fall from 49th to 66th. Figure C shows the global life expectancy rankings of US states .U.S. with the highest and lowest rankings (plus Washington, DC) compared to 203 countries in the Global Burden of Disease Study. CA=California. Hello=Hawaii. MA=Massachusetts. MN=Minnesota. MS=Mississippi. New York = New York. West Virginia = West Virginia
He added that the United States “must change course” and develop new, more effective health strategies and policies that “reduce the decline in future health outcomes.”
Even in scenarios where best health practices are adopted and almost all key health risks disappear completely in the United States, it would still lag behind other countries like Canada, India and China, even if they don’t change anything.
The United States leads the world in obesity, a major risk factor for a long list of chronic and deadly conditions, from cardiovascular disease and stroke to cancer and kidney disease.
Rising obesity rates will play a critical role in shaping the trajectory of life expectancy in the United States over the next three decades and beyond.
Dr Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, said: “Despite modest increases in overall life expectancy, our models predict that improvements in health will slow. due to rising rates of obesity, which is a serious risk factor.” to many chronic diseases and is expected to reach levels never seen before.
The IHME has projected that 260 million Americans will be overweight or obese by 2050, “indicating a public health crisis of unimaginable scale,” Dr. Murray said.
Although life expectancy will increase modestly over time, many Americans will spend those additional years in poor health, “with particularly poor outcomes predicted for U.S. women compared to those in other countries,” according to the study.
Several states, including Kentucky and West Virginia, are expected to have worse health outcomes in 2050 compared to 1990, and female health expectancy, or the number of years you can expect to live in good health, is projected to decline between 1990 and 2050 in 20 states.
The graph above shows life expectancy in the US by year from 1980 to 2022. There has been a slight increase in the most recent year for which data is available, according to a study from the National Vital Statistics System and estimates from National Center for Health Statistics population
They predicted that West Virginia will have the lowest life expectancy for both men (about 73) and women (about 78) by 2050.
On the other hand, New York is expected to have the highest life expectancy for men (81.0 years), while Hawaii is expected to have the highest for women (85.5 years).
When comparing life expectancy and health in the best and worst performing states to other countries and territories, the rankings are expected to decline over time.
Hawaii, which was the top-performing state for life expectancy in 2022, will drop from 29th to 41st by 2050, while West Virginia, the worst-performing state, will drop from 102nd to 140th.
The researchers said: “Our findings show a worrying trajectory for the future of US health, in which the US will not be able to keep pace with health advances around the world unless concerted efforts to reduce exposure to key modifiable risk factors,” such as the body. mass index, high blood pressure, high sodium intake, smoking and drug use.
The current opioid epidemic is a uniquely American problem that arises from the actions of American pharmaceutical companies. While there are positive signs that the crisis may be improving, researchers said it poses a “monumental challenge” to addressing public health problems.
The United States saw an 878 percent increase in the national death rate between 1990 and 2021 (from 2.0 deaths to 19.5 deaths per 100,000) due to opioid use disorder, amphetamine use disorder, due to cocaine use and a group of other drug use disorders.
The death rate is projected to rise another 34 percent between 2022 and 2050. This is the highest drug-related death rate in the world and more than double that of the second-highest country, Canada.
Figure A: The baseline scenario projects future health outcomes based on current trends, assuming no significant interventions or efforts are made to reduce key health risks. Shows life expectancy projections for the US, its states, and other countries/territories based on the reference scenario. Figure B: Life expectancy projections for the US, its states, and other countries/territories under the combined risk elimination scenario (which includes efforts to eliminate a variety of key health risks, such as BMI and rates of smoking)
This tells researchers that progress made since the overdose crisis was declared a public health emergency in 2017 must accelerate significantly to make a measurable difference.
Dr Ali Mokdad, IHME epidemiologist and lead author of the study, said: “The stark contrast predicted for the next 30 years comes after a concerted effort by federal, state and local government agencies and health systems. released after the emergence of opioids. The crisis was declared a public health emergency in 2017.
“The opioid epidemic is far from over and greater effectiveness and continued expansion of programs to prevent and treat drug use are still needed.”
The researchers projected what could happen if the United States eliminated the major health risk factors (high BMI, high fasting plasma glucose, high systolic blood pressure, high sodium intake, and smoking) by 2050.
More than 12 million deaths could be avoided. Death rates from diabetes, heart disease and chronic kidney disease could be 85 to 100 percent lower compared to what they would be without making those changes.
But if other countries did the same, the number of lives saved would eclipse that of the United States, which is already struggling to catch up.
The researchers said: “Increases in these scenarios would not substantially improve the United States’ world ranking in 2050.”