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Last week, the former Treasury secretary Larry Summers called the deepening life expectancy crisis, documented in recent surveys and studies, “the most disturbing set of data on America that I have encountered in a long time” and “especially scary remembering that demographics were the best early warning on the collapse of the U.S.S.R.” In many ways this feels like hyperbole. And yet, by the most fundamental measures of human flourishing, the United States is moving not forward but backward, at unprecedented speed, and now the country’s catastrophic mortality anomaly has spread to its children.
The new life expectancy studies pick up the thread of work by Anne Case and the Nobel laureate Angus Deaton, economists who, beginning in 2015, suggested that a broad social malady was visible in the growing mortality rates of non-college-educated white men in middle age. Their research into what they called “deaths of despair” offered a sort of data-based corollary to a narrative about the country’s left behind, stitched together in the aftermath of Donald Trump’s rise, in part to make sense of it. In the years since, the same data has invited a whole competitive roster of divergent analyses: that such deaths reflected social dysfunctions driven by ballooning income inequality; that they illustrated health disparities that frequently tracked those inequalities, from obesity and cigarette smoking; that they showcased the country’s threadbare social safety net, which briefly expanded during the pandemic and then abruptly shrank; that they arose from striking declines in what conservatives often call prosocial values like patriotism and religiosity.
The new data tells a somewhat different story. In the big picture, opioids still play a large role, and suicide contributes, too. But that pattern of elevated middle-aged mortality is giving way to a growing crisis of juvenile death. The demographics are shifting away from those narrow markers of class and race identified by Case and Deaton, as well.
Mortality is still increasing more quickly for those without a college degree, but as John Burn-Murdoch demonstrated vividly in The Financial Times, except for a few superrich Americans, individuals at every percentile of income are now dying sooner than their counterparts in Britain, for instance. For the poorer half of the country, simply being an American is equivalent to about four full years of life lost compared with the average Brit. For the richer half, being an American is not quite as bad but is still the equivalent of losing, on average, about two years of life. And this is even though an American earning an income in the 75th percentile is much richer than a Brit at the same income percentile, since American incomes are much higher.
This is not to say that longevity declines are uniform, exactly. Black Americans, on average, can expect to live five fewer years than white Americans; Black American men have lower life expectancies than men in Rwanda, Laos and North Korea. White Americans, in turn, can expect to live seven fewer years than Asian Americans. Life expectancy in the Black Belt of the Deep South is as much as 20 years lower than it is north of the Mason-Dixon line and west of the Mississippi, according to the American Inequality Project. And there is even a notable difference between counties that supported Joe Biden in 2020 and counties that supported Trump.
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