By Michael G. Beaulieu, MD
Medical Director LMASDHD
I was recently asked why, with all of the technology present today, is life expectancy going down instead of up. Well, the good news is that life expectancy is not decreasing—it’s actually increasing.
Life expectancy in the U.S. has been increasing for decades. In 1900, life expectancy was 49 years. In 2023, it was 78.4 years. Most of this increase is attributed to advances in public health and medicine, including vaccines, antibiotics, and public sanitation programs.
But this increase in life expectancy has slowed over the last 10-15 years, and in fact, decreased to 77.5 years in 2020 and 2021. The drop was largely due to the COVID-19 pandemic and the opioid abuse epidemic. Fortunately, these trends have reversed. We are seeing less deaths from COVID-19, and opioid overdoses have dropped significantly. As a result, lifespan is once again increasing.
It is concerning that in other developed countries similar to the U.S. in technologic and economic advantages, such as France, Germany, Japan and the United Kingdom, lifespan is 5 years longer than ours. These countries average about 83.4 years. What explains this large difference? Could it be that there is more to long life than technology and wealth? Let us take a deeper look.
In the U.S., the current top causes of death are heart disease, cancer, unintentional injury (accidents), strokes, lung disease, and Alzheimer’s disease. Why are we in the U.S. seeing so many more premature deaths from these causes than other developed countries? It appears to be our behaviors and choices that are driving this, rather than a lack of technology.
The top external causes of heart disease are smoking, high blood pressure, diabetes, and high cholesterol. These, in turn, are driven by poor eating habits and lack of proper exercise. It is our lifestyle and behavior, the things we choose to do or not to do, that are a major cause of early heart disease.
In the U.S. we have much higher rates of death by “external” causes, like substance abuse, accidents, suicide, and violence. The U.S. leads the world in homicide rates, largely due to firearms. While technology such as safer vehicles and roads can prevent some accidental deaths. The key to reducing many of the others will be public health policy: substance abuse treatment, mental health treatment, access to car seats, and promotion of safer firearm ownership.
Technology has been a huge contributor to a continuing decrease in cancer deaths. This technology includes screening and early detection, and improvements in available treatments. However, good lifestyle choices are also important. Lung cancer causes more deaths than any cancer; tobacco use is the top cause of lung cancer.
The major chronic diseases are diabetes, liver, heart, kidney, and lung diseases. These can often be prevented by healthy diet, proper exercise, vaccination against infection, and avoiding harmful substances. Death rates from pneumonia decreased by over 50% since 1999 due to increases in immunization and decreases in smoking.
While lifespan in the U.S. has improved with advances in technology, we can see from other developed countries that we can do better.
Technology is providing high-quality health data. That data is telling us that the U.S. needs to make healthier lifestyle choices, support public health policies and activities, and continue to improve access to preventative medicine.