Americans are coping ourselves to death
Our low life expectancy is partly a function of the ways we deal with stress.
As you know, I’m typically an optimist, especially about the United States. So far, since I started writing this blog, my optimism has been borne out in a number of dimensions. Our economy has been phenomenally robust, we’re in the middle of multiple technological revolutions, unrest is slowly ebbing, and we’re starting to successfully push back against authoritarian power around the world.
But as an American optimist, I’d be doing my country a disservice if I didn’t point out the things that aren’t going right. We need to celebrate our successes and strengths, but we also need to shore up our weaknesses. And one of America’s biggest weaknesses is life expectancy. Compared to other rich countries, Americans die much younger. Our life expectancy has been lagging for years, but since the start of the pandemic the gap nearly doubled in size:
Only a little bit of this is from higher U.S. Covid deaths. In fact, almost none of the difference comes from deaths in old age; it’s young Americans, not older ones, who die at higher rates than their peers in other countries.
An American 29-year-old has a chance of dying that’s four times higher than a British 29-year-old.
The difference between the U.S. and other countries is more severe at lower income levels, but there’s a gap at every point in the income distribution. And while Black Americans have the highest mortality rates, White Americans also die at much higher rates compared to the inhabitants of other rich countries. In other words, our unique mortality problem is pervasive throughout our society.
What makes Americans die at such higher rates? Well, it’s pretty simple to break down the international mortality differences into specific causes. Basically, the answer boils down to some combination of:
obesity-related diseases (cardiovascular disease, diabetes, etc.)
drugs and alcohol
I’ll save murder and car accidents for future posts (though I’ll touch on the latter briefly). For now I want to focus on the lifestyle factors that are killing young Americans. My basic theory is that Americans are doing things that kill them — hard drugs, legal drugs, overeating, and suicide — as ways of coping with the stress of their lives. Which means to bring down American death rates, we should do more than just fight drugs and suicide and obesity directly; we should figure out why Americans are so desperate for coping mechanisms in the first place.
Americans choose lifestyles that kill them in large numbers
First, let’s illustrate how all of these lifestyle choices lead to America’s weirdly high death rates.
In terms of hard drug overdoses, we often think of either prescription opioids or heroin as the problem. Those do kill a fairly substantial number of Americans, and they probably do serve as a “gateway drug” to the biggest killer. But the biggest killer, by far, is fentanyl.
Don’t count out stimulants, either. Meth and cocaine had low overdose rates until about a decade ago, but they both now kill more Americans than heroin.