Life expectancy in the US UU. rises for the first time in 4 years as drug overdose and cancer deaths decrease

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Opioid addiction: pharmaceutical companies reach an agreement (2019) 2:58

(CNN) - Life expectancy in the United States increased for the first time in four years as the number of fatal drug overdoses and six of the ten leading causes of death declined, according to two new government reports from the Centers for Control and US Disease Prevention. UU. (CDC) and the National Center for Health Statistics (NCHS).

Life expectancy in the United States in 2018 was 78.7 years, an increase of 0.1 years compared to life expectancy of 78.6 years in 2017, the NCHS reported in a study published Thursday. The 2018 estimate remains below the 78.9 year peak in 2014.

At the same time, the number of drug overdose deaths decreased from 70,237 in 2017 to 67,367 in 2018, a 4.1% decline, and the first such decline in decades. In 2018, the rate of overdose deaths in the United States was 4.6% lower than in 2017.

"We tried to determine why life expectancy increased and, in reality, we can break it down by the causes of death that contributed most to the increase," said study author Kenneth Kochanek, an NCHS researcher in Hyattsville, Maryland.

"That decrease in drug overdose mortality definitely contributed to the increase in life expectancy," he said, adding: "He was not the main contributor. The main contributor was cancer. Cancer really contributed more to that increase in life expectancy. The drug overdose would be the second. ”

What is killing people in the United States?

The new mortality report, based on death certificate data from the National Vital Statistics System, found that the ten leading causes of death in 2017 remained the same in 2018:

The top 10 causes of death accounted for 73.8% of all deaths in the United States in 2018, the most recent year for which data were available.

From 2017 to 2018, mortality rates decreased for six of the leading causes of death, falling by 0.8% for heart disease, 2.2% for cancer, 2.8% for unintentional injuries, 2.9% for chronic diseases of the lower respiratory tract, 1.3% for strokes and 1.6% for Alzheimer's disease, according to the new report.

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The report also found that, between 2017 and 2018, mortality rates increased for two causes of death, increasing by 4.2% for influenza and pneumonia and by 1.4% for suicide. The rates of diabetes and kidney disease did not change significantly, according to the report.

The new statistics also revealed differences in mortality rates according to age.

Between 2017 and 2018, mortality rates decreased 5.1% for people between the ages of 15 and 24; 3% for ages 25 to 34; 1.4% for ages 45 to 54; 0.4% for ages 65 to 74; 1.9% for ages 75 to 84 and 0.9% for ages 85 and older, according to the new report.

The data showed that mortality rates for ages 35 to 44 and 55 to 64 did not change significantly.

Among infants, the report found that the infant mortality rate in the United States decreased by 2.3% from approximately 579 babies who die per 100,000 live births in 2017 to approximately 566 deaths per 100,000 in 2018.

"That is another positive aspect," Kochanek said.

“We have an increase in life expectancy. We have six of the 10 leading causes of death that show decreases, the overdose report shows a decrease in drug overdose deaths and child mortality also decreases, ”he said. "We are giving positive news right now."

The states with the highest rates of drug overdose mortality

The new report on drug overdose deaths, also based on data from the National Vital Statistics System, found that the number of drug overdose deaths in the United States dropped from about 22 deaths per 100,000 people in 2017 at a rate of approximately 21 per 100,000 in 2018.

When examining data by state, the report found that the states with the highest rates of drug overdose deaths in 2018 were:

According to the report, the states with the lowest drug overdose mortality rates in 2018 were:

Factors that lead to decreased deaths

A decrease in drug overdose deaths in 2018 was probably “a large part” of the increase in life expectancy that year, “but it also joined the fact that we had improvements in cancer deaths and, in particular, the cardiovascular mortality, which has been declining, ”said Dr. Georges Benjamin, executive director of the American Public Health Association in Washington. Benjamin did not participate in the new mortality reports.

He added that, somehow, these leading causes of death are interrelated.

"In particular, tobacco causes cardiovascular disease and cancer, and obesity is also a determining factor," said Benjamin, adding that if life expectancy trends continue to improve, it suggests that part of the work being done to address The nation’s leading causes of death, such as heart disease and cancer, are proving successful.

"What we do see is almost a general improvement in mortality," he said. "I am cautiously optimistic, but after having had four years of decreased life expectancy, I worry if this is just an anomaly."

After decades of increases, life expectancy in the United States stagnated after 2010, then began to fall in 2014 and had been declining since then, and some experts point to drug overdose deaths and suicides as drivers of the decline.

Now, “after years of stagnation and decreased life expectancy in the United States, this one-year increase is certainly good news. However, we need a much more detailed assessment over time to judge whether declining trends are reversing steadily, ”said Dr. Howard Koh, a professor of public health leadership at Harvard TH Chan School of Public Health. and the Harvard Kennedy School in Boston, which did not participate in the new mortality reports.

Specifically, he said more research is needed to determine if the improvement in life expectancy in the United States affects large populations across the country or specific demographic data.

The overall decline in drug overdose deaths "is remarkable and must continue," Koh said.

He added that the decrease reflects the impact of several factors, including the increasing availability of the naloxone drug, which can reverse an opioid overdose, and increased attention to treatment and care as part of public health.

READ : Deaths from drug overdoses in the United States decreased slightly in 2018

"However, the rise in deaths from synthetic opioids, as well as cocaine and methamphetamine, represents the next disturbing wave of the current challenge of substance use in the nation," Koh said.

Mortality rates from opioid overdoses such as heroin, oxycodone and methadone decreased from 2017 to 2018 in the United States. But the overdose death rate with synthetic opioids other than methadone, medications such as fentanyl and tramadol, increased 10% between 2017 and 2018, according to the report. The cocaine overdose death rate more than tripled between 2012 and 2018, and the death rate with psychostimulants such as methamphetamine increased 30% per year between 2012 and 2018, the report said.

'Progress in health is very possible'

The new data represents something "important" to Dr. Joshua Sharfstein, director of the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health in Baltimore, who was not involved in the new mortality reports.

"This shows that progress in health is very possible," he said.

When it comes to the decrease in drug overdose deaths, “since 2014, most states have expanded their Medicaid program, allowing millions of people to access addiction treatment. In 2016, the federal government began sending additional funds to the states for a wide range of services, ”said Sharfstein.

"These investments are beginning to show some results in some areas, but mortality rates are still much higher than a few years ago," he said. “Most people with opioid addiction do not yet have access to harm reduction services or the most effective forms of treatment. Our attitude should be that we are just beginning this fight, we have much more to do and we will not stop until the epidemic has receded. ”

Life expectancy