Contrary to media hype and the posturing of politicians, Ebola and ISIS are very unlikely to cause our early deaths. More likely to shorten American lives are some unhealthy behaviors that are actually somewhat under our control, like overeating to the point of obesity and overdosing on drugs.
A new study by the National Bureau of Economic Research offers good news and bad news. First the good: Americans are smoking less, driving more safely and have reduced their alcohol consumption, leading to longer lives. On the downside, these gains in life expectancy have been nearly completely offset by increasing rates of obesity, increased death by firearms and a significant spike in death by poisoning (mostly, prescription drug overdoses.) In a nutshell, between 1960 to 2010, Americans gained 1.82 years of life expectancy. During the same timeframe, increases in obesity rates and poisonous substance deaths cut life expectancy by 1.77 years.
When so much seems out of ordinary people's control, it's nice to know that by modifying our behavior, we can make a real impact on leading longer, fuller lives. But the success stories of reduced smoking rates and safer cars and driving are in large part due to vigorous public health campaigns which have helped, and even compelled people to make healthier choices. For instance, according to the report, the reduction in traffic fatalities "is believed to result from many successful public health interventions, including safer automobiles and roads and enforcement of seat belt laws, motorcycle helmet laws, graduated driver licensing, and impaired driving laws and penalties."
Reductions in smoking rates did not come easy either. A multi-faceted, multi-year public education campaign about the dangers of smoking, as well as taxes on cigarettes were needed. By far the biggest and most widespread threat to public health is rampant obesity. In a time when the Surgeon General position remains vacant because Congress is blocking the appointment, it seems fairly unlikely that we will see a campaign against the public health threat of rising obesity like that. Michelle Obama is doing what she can to combat childhood obesity—and being bizarrely criticized by right-wing media, pols and pundits for doing so. But the obesity epidemic is fiendishly complicated, intertwined with poverty and not likely to change with an easy fix. According to the study:
Prevention of obesity, particularly among children, has been a key focus in recent years, but it has been difficult to combat the roots of obesity, including sedentary lifestyles, insufficient physical activity, widespread availability of high-calorie food in large portions, and reduced time available for food preparation in the home. Those with low incomes face unique challenges in adopting healthful behaviors, including reduced or inconsistent access to affordable healthy food of good quality, greater availability of fast food restaurants, reduced physical activity resources, reduced access to quality health care, and greater exposure to advertising of obesity-promoting products.55 Continued efforts to address these problems will be essential in order to reduce death and disability resulting from high BMI.
Another factor in healthier eating is nutrition labeling. The Food and Drug Adminsitration has been waging a battle against Big Food and Big Sugar to get better labeling of this most insidious and widespread food ingredient. Subsidies for the soda industry have also greatly increased obesity rates.
The rise in deaths by poisoning is a curious part of the public health picture. According to the study, deaths due to poisoning have increased dramatically over the past 20 years. "The vast bulk of this is overdose of drugs, particularly prescription opioid medications, which has more than quadrupled since 1999," the authors state. "This increase overwhelmed a decline in infant and child poisoning since the 1960s." Poisoning deaths, the authors note, do not include intentional suicides or deaths due to accidents of undetermined intent, which are measured separately by the CDC.
One alarming stat is that, while heavy drinking (defined as 15 drinks per week for men, and 8 drinks per week for women) decreased in the last few decades, deaths by alcohol poisoning has suddenly spiked, among all age groups. The reasons given include, "increased frequency of binge drinking during the Great Recession of late 2007 to mid-2009,47 and increased use of caffeinated energy drinks containing alcohol; these energy drinks increase consumption of alcohol during binge drinking by masking the depressive effect of alcohol."
As for firearms, these deaths contributed only slightly to the overall early death rate, and have actually declined since their peak in the early 1990s (the height of the crack-cocaine drug epidemic.) But even minor regulation of guns—fought tooth and nail by the gun lobby, would help reduce this preventable cause of death and severe injury. Suggestions in the report include: "...regulation, taxation, safety training, and identification and counseling of at-risk individuals." Will politicians and leaders heed any of the common sense, totally non-partisan and seemingly uncontroversial policy suggestions in the report? Not likely. Making it all the more important for people to be informed and enabled to make their own healthy decisions.