According to a new study in JAMA, life expectancy (LE) at birth stopped increasing since 2010 and actually decreased in the US for three consecutive years. To put this in perspective, the last time we saw three consecutive years of declining LE was 100 years ago, coinciding with the flu epidemic of 1918.

Perhaps surprisingly, increased mortality rates in midlife—defined rather broadly as 25-64 years old—are driving the stall, and eventual decline, in LE. Within this group, the largest increases in mortality rate occurred in the subset of people aged 25-34, and it was the increase in drug overdoses, suicides, and alcohol-related diseases that were identified as three key causes of death in this group. Between 1999 and 2017, midlife mortality from drug overdoses increased by nearly 400% (from 6.7 deaths/100,000 to 32.5), alcoholic liver disease increased by 40.6% (from 6.4 to 8.9), and suicide rates increased by 38.3% (from 13.4 to 18.6). This triad is referred to as “deaths of despair” by one research group.

While I certainly can’t do justice to the analysis provided in the 21-page review in a short email, I do believe it is difficult to ignore the relationship between mental and emotional health and declining quantity (and quality) of life. The review is somewhat surprising because many people think if we can just focus on reducing mortality from cancer, cardiovascular disease, and dementia, we’ll increase LE. There was certainly a day when I only focused on those causes of mortality.

I’ve had many guests on the podcast explore their struggles with mental and emotional health. (Click here to find podcasts and posts on the site related to this topic.) I highly suggest people listen to at least one of them, and I suspect that most will relate to the guest on some level. 

This recent study is a sober reminder that morbidity and mortality take many forms, and supports a point that we must be willing to accept: in today’s world, in the US at least, the deterioration of emotional health can often be more deleterious than the decline of physical health when it comes to longevity.

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