- The Washington Times - Thursday, September 20, 2018

Drugs and suicide are pushing down life expectancy in the U.S.

That’s according to a special report from the Centers for Disease Control and Prevention that found rising rates of overdose deaths, suicide and chronic liver disease, even as Americans improve survival rates for the leading causes of death, such as heart disease and cancer.

Published Thursday by the National Center for Health Statistics, the report provides a snapshot of the health of the nation and points out how the opioid epidemic, mental illness, rising rates of obesity and Alzheimer’s disease are threatening lives.

“This special feature on mortality certainly was based on an interest in looking at what was happening with life expectancy,” said Renee M. Gindi, lead author of the report and chief of the Analytic Studies Branch at the NCHS, which is part of the CDC.

Specifically, U.S. life expectancy decreased from 2014 to 2016, from 78.9 years to 78.6 years — two or three years earlier than the life expectancy of almost all other developed nations.

“Life expectancy and mortality statistics can help you paint a picture of what issues might be affecting our population at the broadest scale,” Ms. Gindi said.

Among the 12 leading causes of death, researchers noted increases among five: unintentional and accidental death (driven in large part by drug overdoses), suicide, chronic liver disease and cirrhosis, Alzheimer’s disease, and septicemia, known as sepsis or blood poisoning.

An estimated 72,000 people died of drug overdoses in the U.S. last year, and more than half were attributed to opioids.

The rising tide of the opioid epidemic has gripped the nation, with the federal government spending billions of dollars under the banner of a national public health emergency and enacting legislation that directs resources toward preventing drug abuse, treating addiction, disrupting criminal networks and expanding research into nonaddictive pain medications.

On Monday, the Senate passed nearly 70 bills related to the opioid epidemic.

“This latest data points out that too many people are dying from an opioid overdose, and people shouldn’t die from preventable death when we know how to help them,” said Dr. Patrice Harris, chair of the American Medical Association Opioid Task Force.

Increasing access to evidence-based, medication-assisted treatment is critical for those who have substance use disorders, she said.

“There has been some progress, but we certainly need more resources, less red tape, and we have to reduce the stigma associated with those who have a substance use disorder,” Dr. Harris said.

The federal mortality report also highlights rapid increases in chronic liver disease and cirrhosis deaths. The highest number of deaths occurred in men ages 55 to 64 and in women 75 and older, but death rates for young people are rising rapidly.

For ages 25 to 34, death rates increased from 2006 and 2016 by an average of 7.9 percent for males each year and 11.4 percent for females.

Dr. Tinsay Woreta, a hematologist and assistant professor of medicine in the division of GI and hematology at Johns Hopkins Hospital in Baltimore, echoed the report’s findings that liver disease is increasing among patients in their 30s. While not involved in the federal study, she noted three key factors to the high rates: the obesity epidemic, ongoing infections of hepatitis C and concentrated periods of drinking.

“These are big public health issues that have to be addressed at a preventive public health level,” Dr. Woreta said. “A lot of our time is spent dealing with end-stage complications — patients with cirrhosis needing transplants, things like that — where I think we need a lot more efforts on the front end before this occurs.”

Dr. Jerry Reed, executive committee member of the National Action Alliance for Suicide Prevention, said drug overdoses, suicides and liver disease are related under the banner of “deaths of despair.”

“What I think I’m seeing over time — I’ve been doing this since the late ‘90s — really the general condition that’s present in all three of the examples we’re assessing is pain,” he said. “People are either in psychological pain, spiritual pain, emotional pain or physical pain — so they self-medicate.”

Suicide, while the 10th leading cause of death, is increasing at a rapid rate and has been since 2006. Men are more affected than women, with 21.8 male suicides per 100,000 people compared with 6.2 female suicides.

The authors of the federal report noted that gunshot wounds are the leading cause of self-inflicted death for men and poisoning is the leading cause for women.

In 2016, men 75 and older had the highest suicide rate among males, at 39.2 deaths per 100,000 people, and women ages 45 to 64 had the highest rate among females, 9.9 deaths per 100,000. Suicides among females ages 15 to 24 are increasing, from 3.2 deaths per 100,000 in 2006 to 5.4 deaths per 100,000 in 2016.

Moreover, rates of death related to Alzheimer’s disease continue to increase, from 18.1 per 100,000 people in 2000 to 30.3 per 100,000 in 2016.

About 5.7 million Americans are living with Alzheimer’s, and that number is expected to rise to 14 million by 2050, according to the Alzheimer’s Association.

“Looking at those numbers, it’s evident that research is critical,” said Cindy Leach Schelhorn, senior director of communications for the Alzheimer’s Association National Capital Area Chapter in Virginia. “Research leads the way to breakthroughs in detection, treatment, prevention — these are all critical in addressing this growing public health crisis because Alzheimer’s is also the most expensive disease in the country today.”

According to the organization’s latest report, Alzheimer’s and dementia care will cost the nation $277 billion a year.

Of the top two leading causes of death in the U.S., heart disease-related deaths stabilized from 2006 to 2016 and cancer deaths decreased. Chronic lower-respiratory diseases, the third-leading cause of death, also decreased.

The number of deaths from stroke, the fifth-leading cause of death, decreased, as did deaths from diabetes (7), influenza and pneumonia (8), and kidney disease (9).

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Corrected from earlier version: Schelhorn quote corrected to note she referred to “breakthroughs in detection…” not “protection.”


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