American Health Is Getting Better and Worse

The latest U.S. government data release on American mortality has shown that in recent years, the health of the American people got worse. It also got better. 

The data release from the National Center for Health Statistics came with the anodyne heading, “Mortality in the United States, 2016.” It contained two statistics supporting two contradictory story lines. In one, life expectancy at birth in the United States shortened by a little over a month, from 78.8 years to 78.7 years in 2015. In the other statistic, the death rate per 100,000 people fell, from 733.1 deaths to 728.8 in the 2015–2016 timeframe.

True to the “if it bleeds, it leads” aphorism, media accounts gave almost exclusive attention to the decline in life expectancy, with the opioid epidemic being the most frequently offered explanation.

The two sets of facts offer two different perspectives. When measuring life expectancy, deaths that occur earlier in life carry a greater statistical impact, which has led to the decline in life expectancy. The death of an infant will have a much larger influence on the life expectancy measurement than the death of a 78-year-old, and the death of an 80-year-old or anyone else past the life expectancy point has none. This is why deaths associated with the opioid crisis have had a noticeable effect on life expectancy rates. In the most recent data on opioid deaths, the greatest increase in mortality occurred with young users, aged 25–34 years old. The rate of opioid-related deaths rose 16.5 percent from 2014–2015 alone.

But the death rate also reflects continued progress against the two most frequent causes of death: heart disease and cancer. In the last five years (2011–2016), the heart disease mortality rate has fallen by 4.7 percent, while the cancer mortality rate fell by 7.6 percent. When media outlets opt for the life expectancy storyline, they often neglect to mention the decline in the death rate. The two indicators move in opposite directions due to a single factor: the role of age distribution. Life expectancy cannot be calculated without it; the death rate pays it no attention.

Drug-related deaths are relatively more common among the young. Heart disease and cancer deaths are more common among the old. Thus America has divergence in death rates: Between 2015 and 2016 the death rate rose for the age groups that include those between ages 15 and 44, while the death rate decreased for all age groups over age 65. 

The question is which is more important: the total or the change? The death rate due to overdoses increased by a factor of 2.5 over the past 15 years. But deaths due to overdoses account for only 2 percent of all deaths. Deaths from heart disease and cancer, on the other hand, account for 44 percent. Those differences drive the two narratives. Continued progress against traditional killers has outweighed the influence of opioid deaths on American mortality rates. That’s the good news that did not make the headlines.

Hanns Kuttner is a Senior Fellow at Hudson Institute.