America: Death and Affordability - Part 1

Disclaimer: I have copied, edited, rearranged the Time.com article and intercalated my own photos, philosophical references and thoughts in order to add meaning and depth to this article.?

All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident - Arthur Schopenhauer

Time.com IDEAS

BY?LAUDAN ARON* AND?GAVIN YAMEY* MAY 16, 2023 11:00 AM EDT?

The March for Our Lives?

Across the country in various cities, thousands are gathering to demand for meaningful gun laws following the recent shootings from Uvalde, Texas, to Buffalo, New York. The March For Our Lives movement was spurred by the shooting at Marjory Stoneman Douglas High School in Parkland, Florida, in 2018.

One in 25 American five-year olds will not reach their 40th birthday.

Life expectancy in America?fell sharply?in 2020. It fell again in 2021. The COVID-19 pandemic certainly played a role, but that’s not the whole story. During this same time period,?eight?of the ten leading causes of death also increased. Even?maternal?and?child and adolescent mortality?increased. In August 2022, federal health officials released?new data?showing that across all demographic groups, Americans are dying younger.

Ten years ago, a?landmark report?called “Shorter Lives, Poorer Health” documented for the first time a widespread “U.S. health disadvantage,” a shortfall in the health and survival of Americans relative to other high-income countries [Aron was the report’s study director]. On some measures, such as violent deaths among males aged 15-24, the divergence from other rich countries began growing as early as the 1950s. The report showed that the U.S. had the lowest life expectancy among peer countries and higher rates of injury, illness, and death from dozens of causes. Evidence of this disadvantage was found for young and old, rich and poor, men and women, and Americans of all races and ethnicities.

Life expectancy at birth in years, 2021

United States: 76.1

United Kingdom: 80.8

Germany: 80.9

Austria: 81.3

Netherlands: 81.5

Belgium: 81.9

Comparable Country Average: 82.4

France: 82.5

Sweden: 83.2

Australia: 83.4

Switzerland: 84.0

Japan: 84.5

Source: KFF analysis of?CDC,?OECD,?Japanese Ministry of Health, Labour, and Welfare,?Australian Bureau of Statistics, and?UK Office for Health Improvement and Disparities?data?Get the data?PNG

Another?seminal report?released in 2021, called “High and Rising Mortality Rates Among Working-Age Adults” showed that U.S. mortality rates have been increasing in mid-life (ages 25-64), the prime years for family formation, childrearing, caregiving, and employment. More surprisingly the rising mortality among U.S. children and youth between 2019 and 2021 represents a profound?crisis. Although not predictive of future mortality conditions, which are likely to change, current survival rates mean that?one in 25?American five-year olds will not reach their 40th birthday.

U.S. life expectancy continues decline

Life expectancy around the world decreased in 2020 due to COVID-19. Most peer countries rebounded in 2021, while the U.S. continued to decline.?

The reasons behind these disturbing trends are many, and one might argue, uniquely American. Here are five:

A poor start in life for many young Americans

Beyond the latest?data?on rising pediatric mortality rates, it is clear that the U.S. is failing its youngest citizens on multiple fronts. For at least a decade now,?cross-national comparisons?of child and adolescent wellbeing in rich countries show that the U.S. ranks at or near the bottom on most measures. Such measures include material wellbeing, health and safety, behaviors and risks, education, housing, family friendly policies, and social protection. Further, careful?analyses?of overall levels of social spending by country show that, compared to other high-income nations, the U.S. is distinct in how it spends, not how much it spends. American spending is much less redistributive, with fewer benefits going to children, families, and the disadvantaged. In addition to high rates of infant and maternal mortality, the?latest data?show that U.S. children are in the midst of a deepening?mental health crisis, with increased access to firearms and opioids driving up rates of suicide, homicide, and overdoses. In 2020,?firearm-related injuries?surpassed motor vehicle crashes to become the leading cause of death among young Americans ages 1-19.

*LAUDAN ARON

*GAVIN YAMEY

ARON IS A SENIOR FELLOW IN THE HEALTH POLICY CENTER AT THE URBAN INSTITUTE AND CO-DIRECTOR OF THE ROBERT WOOD JOHNSON FOUNDATION’S POLICIES FOR ACTION (P4A) RESEARCH PROGRAM.?

YAMEY IS A PHYSICIAN AND PROFESSOR OF GLOBAL HEALTH AND PUBLIC POLICY AT DUKE UNIVERSITY, WHERE HE DIRECTS THE CENTER FOR POLICY IMPACT IN GLOBAL HEALTH.

Continued with Part 2: On The U.S. Healthcare System