An Angel of Death Stalks America

Few would be surprised to learn that life expectancy for male children in Russia and Ukraine has deteriorated dramatically this year.

Life expectancy, a statistical measure of the average number of years a newborn child has to live, is falling significantly, not least because it is young people who are dying, and each death therefore represents a huge loss of potential years of life.

When we first mapped Danish life expectancy in the mid-1990s, it turned out that men’s poor life expectancy was, among other things, affected by the high suicide rate among young men. The COVID-19 pandemic has affected mortality rates in a similar fashion, so that life expectancy has decreased in most of the world. The U.S. is among the hardest hit, and new mortality and life expectancy figures underline the human cost of the American pandemic strategy. Average life expectancy in the U.S. fell sharply in 2020, and the decline continued last year.

The last two years reflect the biggest drop in life expectancy in a hundred years, and life expectancy has been knocked back to what it was more than 25 years ago, to levels last seen in the mid-1990s.

There is no other developed country in the world that is even close to experiencing the kind of demographic catastrophe that is unfolding in the United States right now.

COVID-19 has been the third leading cause of death in the U.S. over the past two years, after cancer and cardiovascular disease. This is due to a population that is either already in poor health, or that has not been vaccinated or received booster shots. Mortality rates from COVID-19 are therefore high among ethnic minorities, who have poorer than average health, as well as among conservative whites, whose physical health is better but who tend to include higher numbers of vaccine skeptics.

If you compare American life expectancy between 2019 to 2021 with that of Denmark and Sweden, you will see that life expectancy at birth in the U.S. has, on average, been reduced by 2.4 years. In both Denmark and Sweden, life expectancy remains the same as before the pandemic.

In 2021, life expectancy in the U.S. was 76.4 years, while in Denmark it was five years more — 81.4 years — and in Sweden almost seven years more at 83.2 years.

One might be tempted to say that this trend will draw to an end, as natural immunity to the coronavirus builds up. With more than 1.1 million COVID-19-related deaths in the U.S., it seems natural at this point to assume that the annual number of deaths will begin to decrease in the coming years, and average life expectancy will thus recover.

More Disease, More Abuse

But this does not change the underlying picture, which is that the U.S. has fallen dramatically behind other Western countries.

As recently as the turn of the millennium, life expectancy in Denmark was the same as in the United States, and at that time, both countries were at the bottom end of the international scale.

Since then, there has been a dramatic improvement in Denmark, while the numbers in the U.S. have remained almost unchanged.

In 2019, life expectancy in the U.S. was two years more than in 2000. In Denmark, it increased by 4.6 years. The poor performance in the U.S. is due in part to the rampant prevalence of lifestyle diseases, little focus on prevention and huge disparities in access to health care — between rich and poor, between Black and white — which means that many diseases that could be treated, are not.

But there is also a quite different and tragic reason.

The U.S. is being devastated by drug-related deaths. {https://www.cdc.gov/nchs/products/databriefs/db457.htm}

This is not the traditional story of ethnic minorities in big cities struggling with heroin and crack.

Over the past 20 years, the abuse of highly addictive painkillers (opioids) has exploded, leading to millions of Americans becoming addicted to increasingly stronger drugs.

The crisis had its epicenter in the old coal mining areas of West Virginia but has since spread like a prairie fire. It began in rural areas, where a typical drug user was white, male and middle-aged, and therefore it affected the life expectancy of white people more than of Black people.

It then found its way to the suburbs and cities, and with the explosion of fentanyl abuse, the crisis has reached its climax thus far.

In the years before the pandemic, the number of deaths from synthetic opioids surpassed the number of deaths in the entire Vietnam War.

In 2021, the total number of deaths exceeded 100,000 for the first time and drug-related deaths have now overtaken diabetes as a cause of death.

It could be that the pandemic — with its shutdowns and sense of crisis — worsened the situation, but the addiction crisis continues to be a silent and stigmatizing killer despite increased awareness.

It remains the angel of death in rural America.

There are now 50 times more people per 100,000 dying from opioids than there were in 2000.

For cocaine it is five times as many people, while the death rate for heroin addiction has fallen significantly in the last seven years.

The decline in life expectancy has nothing to do with the other population crisis that the U.S. is also going through, namely that the birth rate in the U.S. just keeps falling and is now at only a third of what it was before World War I.

More deaths, fewer births and a slowdown in immigration have given the U.S. its lowest population growth since the combined factors of World War I and the Spanish flu.

The addiction crisis and high mortality rates associated with lifestyle diseases are symptoms of a health care system that — although the most expensive in the world — is only as good as your insurance. This means that more and more people are being left behind.

It is a symbol of the social decay in a country that was once a beacon of progress, and there is no sign of recovery underway.

On the contrary, fentanyl, mainly used as an anesthetic in surgery, has now become a street product and many die from using contaminated products.

There is no evidence of an increased effort in the U.S. health care system, which has had its attention rigidly fixed on COVID-19 in recent years and where resources are already stretched in many places.

No one has really figured out how to stop drug abuse and the concomitant “wave of death.”

Donald Trump understood that this was a crisis at a time when Democrats in Washington preferred to look the other way.

It will likely take many more deaths in the politically important suburbs before the addiction crisis moves higher up the political agenda.

Meanwhile, the U.S. will continue to have many more deaths than necessary.

Ulrik Harald Bie is the economic editor of Berlingske Tidende