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You are here: Home / Key health indicators are trending the wrong way. Here’s what we all can do

Key health indicators are trending the wrong way. Here’s what we all can do

Regular folks know that fortitude and resilience are required in demanding circumstances. When things head south, we buck up and try to fix what’s broken. That can-do spirit is getting a sharp test as discouraging measurements pile up about the state of the nation’s health.

Health-wise, our country is limping in the wrong direction. The expected length of our lives is going down. Going up are bad items like substance abuse, road deaths, and chronic and infectious diseases.

We have good ways to battle back. We can get back on track on previously positive health trends. Still, 2022 is racing to a close, and the nation is struggling with what now has become years of a lethal coronavirus pandemic. This is a good time to take a deep breath, examine a dashboard of select health metrics, and consider what the numbers tell us and how we individually and collectively can move forward to improve our health. So let’s dive in.

1.  A brutal erosion in how long we live

How long the average person is expected to live tells a lot about the nation’s health. Alas, U.S. life expectancy has plunged recently, falling to the lowest level in a quarter-century, experts say.

Here is how the New York Times described this negative trend:

“The average life expectancy of Americans fell precipitously in 2020 and 2021, the sharpest two-year decline in nearly 100 years … In 2021, the average American could expect to live until the age of 76, federal health researchers reported … The figure represents a loss of almost three years since 2019, when Americans could expect to live, on average, nearly 79 years. The reduction has been particularly steep among Native Americans and Alaska Natives, the National Center for Health Statistics reported. Average life expectancy in those groups was shortened by four years in 2020 alone.”

Stat, a science and medical news site, reported on why demographers and public health officials zero in on life expectancy numbers:

“Life expectancy isn’t really a prediction for a single individual. It’s more like a check engine light — an indicator for the health of society as a whole. When more people die than would be expected, or when they die at younger ages than expected, then life expectancy will decline.”

The major causes for falling life expectancy are unsurprising, the New York Times reported:

“While the pandemic has driven most of the decline in life expectancy, a rise in accidental deaths and drug overdoses also contributed, as did deaths from heart disease, chronic liver disease, and cirrhosis …”

Don’t just fret, try this: While it may seem overwhelming to take steps to improve the span of life — one’s own, as well as that of others or the nation — little steps add up. A growing body of research emphasizes that sustained, common-sense efforts can help people to live longer and healthier. We obsess about these well-known beneficial behaviors around the new year, but why not incorporate them year ‘round?

A quick checklist of the top seven proven health boosters:

  • Eat healthfully — not too much, and more plants, nuts, and fish.
  • Exercise regularly — at least get up and move around much more.
  • Work on getting a good night’s sleep.
  • Don’t smoke (or vape).
  • Be moderate with intoxicants (alcohol and marijuana).
  • Get out and socialize, being with family and making friends.
  • Aim to reduce modern life’s relentless stress.

2. Crisis worsens with opioid abuse and overdoses

The opioid abuse and overdose crisis in this country is worsening. This is occurring even as the struggle grows to deal with the health harms of non-opioid drugs like alcohol, tobacco, marijuana, methamphetamines, and more.

The New York Times reported this about the opioid and drug overdose crisis:

“Overdoses are now the leading cause of preventable death among people ages 18 to 45, ahead of suicide, traffic accidents, and gun violence, according to federal data. Although experimental drug use by teenagers in the United States has been dropping since 2010, their deaths from fentanyl have skyrocketed, to 884 in 2021, from 253 in 2019, according to a recent study in the journal JAMA. Rates of illicit prescription pill use are now highest among people ages 18 to 25, according to federal data.”

The newspaper reported earlier on the crisis’s ever-mounting toll:

“After a catastrophic increase in 2020, deaths from drug overdoses rose again to record-breaking levels in 2021, nearing 108,000, the result of an ever-worsening fentanyl crisis, according to preliminary new data published … by the Centers for Disease Control and Prevention [CDC]. The increase of nearly 15% followed a much steeper rise of almost 30% in 2020, an unrelenting crisis that has consumed federal and state drug policy officials. Since the 1970s, the number of drug overdose deaths has increased every year except 2018.”

The CDC estimated that the opioid crisis claimed more than 560,000 lives between 1999 and 2020.

In recent months, law enforcement and public health officials have sounded alarms as drug overdoses, especially deaths, increasingly have involved fentanyl, an easily manufactured synthetic opioid. Criminal dealers are too often spiking their wares with it, notably in sales to young people of all manner of pills and supposedly lesser drugs like marijuana.

And while many folks would like to be dismissive about increasingly potent and legalized pot, Generation Z and young millennials have become the nation’s leading group of stoners, setting record highs for their use of marijuana, hallucinogenic drugs, nicotine, and booze.

This has occurred even as federal regulators have gotten called out for failing to crack down, after chest-thumping promises to do so, on the noxious but popular practice of vaping among the young.
 

Try this:  Don’t worry, moms and dads, about young folks thinking you’re a fuddy-duddy. Talking to them calmly and straightforwardly about risky drugs, especially dangerous opioids like fentanyl, could save their lives. Caleb Banta-Green, a researcher with the Addictions, Drug and Alcohol Institute at the University of Washington School of Medicine, told the New York Times that grownups should open a sustained, relaxed, nonjudgmental, and evidence-based conversation with youngsters about drugs. Kids need to know they might take drugs accidentally or to deal with mental health and other problems that should be addressed in more appropriate and effective ways. Adults should inform themselves and share with kids important information about treating overdoses, including where supplies of the reversal agent naloxone (Narcan) might be stored. School districts and other public facilities like libraries and firehouses are stocking naloxone, but it must be administered pronto.

3. Road deaths and injuries accelerate

Though some braking has been detected in this unhappy trend, road deaths and injuries have zoomed in recent times in the wrong direction — upwards. Concern persists about this threat, especially to bicyclists and pedestrians.

Here is how the Associated Press reported earlier this year about the startling numbers of vehicle wrecks, injuries, and deaths:

“Nearly 43,000 people were killed on U.S. roads last year, the highest number in 16 years as Americans returned to the roads after the coronavirus pandemic forced many to stay at home. The 10.5% jump over 2020 numbers was the largest percentage increase since the National Highway Traffic Safety Administration began its fatality data collection system in 1975  … Preliminary figures released … by the agency show that 42,915 people died in traffic crashes last year, up from 38,824 in 2020 …Forty-four states as well as the District of Columbia and Puerto Rico had increases in traffic deaths in 2021 compared to the previous year, led by Texas, California and Florida .. Americans drove about 325 billion more miles last year, 11.2% higher than in 2020, which contributed to the increase. Nearly 118 people died in U.S. traffic crashes every day last year, according to the agency’s figures.”

Later in 2022, the news and information site Axios reported this about the latest available data on vehicular fatalities and injuries from the National Highway Traffic Safety Administration:

“Overall, U.S. traffic deaths increased 0.5% during the first half of 2022, in comparison to the same period in 2021 … Approximately 20,175 people died from traffic accidents during the first half of 2022 — the highest number of deaths during that period since 2006. Preliminary data from the Federal Highway Administration also shows that vehicle miles traveled during the first half of 2022 increased by about 43.2 billion miles, or 2.8%.”

Axios also noted this in its news article:

“The number of deaths from traffic accidents declined during the second quarter of 2022 — after seven consecutive quarters of year-to-year increases, [NHTSA] said.”

Officials greeted the slight decline in vehicle wrecks in 2022 as a positive. But NPR also has reported that bicyclist injuries and deaths have spiked to distressing levels, as have fatal and injurious incidents involving pedestrians, Axios says:

“Pedestrian deaths reached a 40-year high last year, according to preliminary data from the Governors Highway Safety Association … Drivers struck and killed more than 7,400 people in 2021, and the percentage of children killed by speeding drivers more than doubled since 2018.”
 

Try this: Yes, the federal government has ambitious plans to improve road safety as part of the huge, bipartisan infrastructure spending plan approved in Washington, D.C. But as individuals, we also must tackle bad habits that fuel the rising destructiveness of our vehicles. It is unacceptable to speed and to disregard proven safety measures, including personal restraints, and common-sense conduct behind the wheel while flying down the highway in several tons of metal, glass, and plastic. It is unacceptable to be distracted (by electronic devices, especially for texting, or loud music or conversation), or to be drugged (with intoxicants like alcohol or marijuana or prescription medications). If you are sleepy, angry, or frustrated, don’t work out your difficulties by driving and putting yourself and others at risk. 

4. As contagions surge again, vaccines need a booster of public confidence

Vaccines have proven themselves as nothing less than a scientific miracle, allowing humans to make giant advances in combating lethal infectious diseases. But even with the latest breakthroughs with the shots against the coronavirus, public health experts have major worries about a recent marked rise in preventable contagions.

Polio is resurgent in this country, as are cases of measles. The advanced, industrialized world — including the United States — has battled a rapid, perhaps surprising spread of monkeypox, a disease more familiar in the developing world. Florida officials have dealt with a rare killer outbreak of meningitis. After several years in which public health measures (heightened hygiene, distancing, and face covering) slashed the prevalence of seasonal influenza, public health experts are warning of its early return this year.

And, of course, the pandemic persists. A reminder: The coronavirus has killed 1.1 million Americans and infected 97 million of us. Those figures likely are underestimates. The disease’s damages persist, too, hospitalizing 27,000 patients daily on average and killing 400 people daily on average. The debilitating toll of long covid also hangs over as many as 4 in 20 of those infected with the virus.

Influenza and pneumonia, federal officials say, kill more than 50,000 people on average each year. The flu and its related lung and heart complications hospitalize on average 200,000 patients annually, studies indicate.

While all medical interventions carry some risks, vaccines — as their use by billions around the planet attests — are relatively safe and have helpful levels of effectiveness. They are not foolproof. But the coronavirus shots, for example, have demonstrated that they can keep patients from the illness’s most serious consequences, including hospitalization and death.

For a variety of reasons (see sidebar), Americans — notably vulnerable older people — are forgoing the safeguards that sustained vaccination efforts can provide. Pediatric vaccination rates have stayed steadier, though they have taken a slight, worrisome drop.

The jabs aren’t always pleasant, but consider the alternatives. It can’t be said loud and long enough: It’s a terrible thing to have a very sick child. It’s worse when parents know that a youngster’s illness could have been prevented. How awful will it be if the grownups must see the damage that a contagion can inflict on a tot for a lifetime? Millions of us already are experiencing terrible, avoidable losses due to the pandemic, with experts saying that each death touches nine people and problematic grief afflicts 7% of those in mourning.

One more thing: The pandemic and recent increases in infections also has led to a scary surge in another peril in the U.S. health system: the overuse, abuse, and degradation of antibiotics, accompanied by a spike in antibiotic-resistant pathogens.
 

Try this: The CDC provides helpful guidance online about vaccines and their scheduling — for toddlers, older kids, and grownups, too. This newsletter has reported on vaccinations, too, and our past issues can be viewed by clicking here or here.
 

5. An epidemic of gun violence and suicides

The pandemic triggered an unprecedented, coast-to-coast weapons-buying spree. This has only further inflamed an unchecked epidemic of firearms-related violence, including relentless rises in deaths by suicide.

Here is how an editorial in the JAMA medical network described this nightmare:

“Firearm violence in the U.S. is an unrelenting clinical, public health, societal, and political concern of major proportion. The morbidity and mortality attributed to firearms have continued to increase; have adversely and profoundly affected individuals, families, and communities; and have exceedingly important consequences for all of society. The frequent occurrence of firearm violence and the repetitive episodes of mass shootings highlight the pervasiveness of firearms and the accessibility of assault weapons and serve as grim reminders that every person in the U.S. is potentially vulnerable to firearm violence. According to data from the [CDC], more than 45,000 firearm-related deaths occurred in the U.S. in 2020, representing the highest reported rate … since 1994, with more than half of deaths due to suicide and more than 40% due to homicide. Provisional data indicate that these deaths have increased in 2021, reaching more than 48,000 firearm-related fatalities in the U.S., which would reflect nearly the same number of deaths as those attributable to influenza and pneumonia (53,000) and kidney disease (52,000) in 2020.”

The editorial notes the huge disparity in damage to black versus white Americans, adding: 

“The number of nonfatal firearm injuries also is substantial. From 2018 through 2021, an estimated 100 000 persons experienced fatal or nonfatal firearm injuries each year, with nonfatal injuries thought to represent more than twice the number of fatal injuries, although the ratio of nonfatal to fatal injuries may be higher. For example, in Chicago, 797 homicides were reported in 2021, along with more than 3,500 reported shooting incidents, representing one of the most violent years on record.”

Respect for individual constitutional rights is a must, of course. But consider the counterpoint of reality and the sweeping, stunning damage due to gun violence, notably as reported this summer by the Washington Post:

“The spate of shooting attacks in communities such as Highland Park, Ill.; Uvalde, Tex.; and Buffalo has riveted attention on America’s staggering number of public mass killings. But the rising number of gun deaths in the United States extends beyond such high-profile episodes, emerging nearly every day inside homes, outside bars and on the streets of many cities, according to federal data. The surge in gun violence comes as firearm purchases rose to record levels in 2020 and 2021, with more than 43 million guns estimated to have been purchased during that period, according to a Washington Post analysis of federal data on gun background checks. … There is not one clear answer as to what is driving the rise in bloodshed, experts said, but possible factors include the stress of the coronavirus pandemic, fraying ties between the police and the public, mounting anger, worsening mental strain, and the sheer number of guns in America … Local leaders, law enforcement officials and anti-violence workers say they have seen a worrisome trend recently, in which disputes that would have previously led to fistfights instead escalated rapidly to gunfire.”

Congress this summer broke a years-long stalemate on gun regulation, and President Biden signed a limited law to tighten some background checks and increase sums to support mental health care and “red flag” measures to keep weapons out of the hands of the demonstrably disturbed.

Biden has said he wants much more work done, including bans on assault weapons and increases in age limits for gun buyers. Republicans have rejected any further legislative gun-control efforts.
 

Try this: Serious, rigorous researchers — with a congressional ban lifted on federal funding for such work — are slowly amassing evidence about what works and what does not with gun-control measures. Advocates long have hoped for such efforts because discussions about firearms too often deadlock without real facts to support strongly held opinions. A few powerful insights already are emerging: If you don’t own weapons, don’t bring them into the house because their mere presence raises the odds of bad occurrences. If you have guns, keep them in locked boxes or other safe storage — this reduces the risk of harms to youngsters and provides the time for those who want to harm themselves to reconsider. Federal officials have launched a new 988 number for callers with suicidal thoughts or other mental health emergencies. The National Suicide Prevention Lifeline, which those in distress could reach by calling 800-273-TALK (8255) or texting HOME to 741741, will keep operating for a time.

Diabetes needs radical approaches

Politicians in Congress waged a ferocious battle in recent months over the affordability of insulin, the crucial medication to treat diabetes. That disease is exploding in the U.S. population, and a blue-chip panel of experts has advised Congress that radical action, far beyond worrying about one increasingly expensive therapy, must be undertaken.

The scope of the problem is significant, the New York Times reported:

“One in seven American adults has Type 2 diabetes now, up from one in 20 in the 1970s. Many teenagers are developing what was once considered to be a disease of older people; 40% of young adults will be diagnosed with it at some point in their lives.”

Here are more data points to consider from the newspaper’s article:

“Each patient with Type 2 diabetes faces a cascade of risks, including painful nerve damage, vision loss, kidney disease, and heart disease, as well as foot and toe amputations. (Type 1 diabetes, once called juvenile diabetes, carries many of the same risks but is believed to be an autoimmune condition.) As of 2019, more than 14% of Native American and Alaska Native adults had diabetes, according to the Centers for Disease Control and Prevention. The figure for Black and Hispanic adults was about 12%, compared with 7.4% for white adults.

“One in four health care dollars goes to treat diabetes, and that costs the nation $237 billion annually (most of it paid for by government health plans), along with $90 billion in reduced productivity.”

Patients, their advocates, doctors, and many others cheered the limited political response that Democrats won in Congress this summer, capping the out-of-pocket price that older Americans on Medicare will pay for insulin at $35. This benefits millions of seniors. But staunch Republican opposition blocked the insulin price cap for others who need the drug, which has skyrocketed in price even though the familiar medication costs Big Pharma relatively little to make.

The real issue, however, is not just insulin and its extreme pricing, experts have advised Congress. Instead, as the New York Times reported:

“Researchers who study Type 2 diabetes have reached a stark conclusion: There is no device, no drug powerful enough to counter the effects of poverty, pollution, stress, a broken food system, cities that are hard to navigate on foot and inequitable access to health care, particularly in minority communities. ‘Our entire society is perfectly designed to create Type 2 diabetes,’ said Dr. Dean Schillinger, a professor of medicine at University of California, San Francisco. ‘We have to disrupt that.’

“Dr. Schillinger and nearly two dozen other experts laid out a road map for doing so earlier this year in a comprehensive national report to Congress on diabetes, the first of its kind since 1975. It calls for reframing the epidemic as a social, economic, and environmental problem, and offers a series of detailed fixes, ranging from improving access to healthy food and clean water to rethinking the designs of communities, housing, and transportation networks. ‘It’s about massive federal subsidies that support producing ingredients that go into low-cost, energy-dense, ultra-processed and sugar-loaded foods, the unfettered marketing of junk food to children, suburban sprawl that demands driving over walking or biking — all the forces in the environment that some of us have the resources to buffer ourselves against, but people with low incomes don’t,’ Dr. Schillinger said. ‘We feel impotent as doctors because we don’t have the tools to tackle the social conditions people are grappling with,’ he added.”

But it will be a giant challenge to win public and political support to tackle “social determinants” of Americans’ health, getting them to fund more parks and walkable neighborhoods, fewer subsidies for Big Sugar, Big Agriculture, and Big Food, and big taxes on sugary drinks or highly processed and salt-laden foodstuffs, the experts concede.

They argue that a new, different approach must be tried because the current situation is only getting grimmer. It also is less expensive to educate people about diet and exercise than to fork over giant sums for their medical treatment.
Still, the published, innovative approaches to diabetes — and its related and whopping problem of obesity — will run smack into the giant bankroll powers of Big Pharma. Drug makers are not only profiteering with insulin. They also are seeing dollar signs dancing alongside new diabetes treatments with a highly desirable secondary outcome — they help many users lose weight by taking a drug. This Hollywood fad already is causing shortages of the drug for diabetics who need it, media organizations have reported.

Anti-science disinformation has become a big sickness

The World Health Organization calls it an “infodemic” and warned of its viral spread just as the pandemic began to sweep the globe. Other respected institutions have labeled it “truth decay.”

Whatever it is named, the virulent spread of toxic misinformation, disinformation, and falsehoods has become a weaponized threat to U.S. society, including Americans’ good health, the New York Times and other news organizations have reported.

Congressional Democrats have documented the calamitous increase in politicized, inaccurate, and deliberately deceptive meddling in the former administration as part of its shambolic response to the pandemic. Suffice to say it was as miserable as news organizations and critics described it almost at the same time it was occurring.

It might have been far too optimistic to think that the noisy presence of the anti-science, counterfactual crowd would diminish with a definitive defeat in the U.S. electoral system. That has been far from the case, with a popular broadcast “entertainment” network and a sprouting patch of new social media sites giving platforms to not just those with wrong information but also wild conspiracy claims, the New York Times says.

The language of too many politicians running for office (and especially on the GOP’s far right) also has become extreme in tone and content, the newspaper found.
The pandemic provided a handy cause for all manner of fact-free advocates to coalesce, especially around opposition to vaccinations that have proven to be safe and effective. The concerns of the “anti-vax” crowd continue to mutate and to tie its members to other dubious, anti-authority, and extreme groups, researchers have found.

Doctors who have peddled medical bunk, especially about the pandemic, have faced relatively few consequences. California lawmakers, seeking to protect individuals’ First Amendment rights, have stiffened the penalties for professionals with medical licenses who push false information about vaccines and the coronavirus.

Courts across the country have slapped down lawyers who have filed extreme claims and failed to meet legal standards in providing bona fide evidence for judges to consider. Lawyers and Bar groups have acted against some of those who violated professional norms to publicly push nonsense, especially when it damages the legal and judicial systems. (Full disclosure: I filed formal complaints with the D.C. Bar seeking disciplinary action against lawyers in the District of Columbia for their frivolous attempts to overturn the 2020 presidential election).

The persistent parade of medical charlatans has put more pressure than ever on regular folks to find good, reputable doctors and other medical professionals, to ask good questions and be skeptical (not cynical or nihilistic) about their care, and to educate themselves about the complexity, uncertainty, and huge array of prescription drugs and therapies now available. We all need to tame our cognitive biases. Rigorous science cannot be discarded in favor of “what about-ism” or cherry-picked “facts,” or for listening to pop-up folks who sound authoritative but might as well be standing on a peach basket, wearing overalls, and opining from a farmer’s almanac.

In the wealthiest nation in the world, health care cannot be a privilege for the few. It must be a right for all. We deserve medical services that are safe, accessible, affordable, efficient, and excellent. We may have to work to get it in new ways. Here’s hoping you and yours stay healthy through ’22 and beyond!

Recent Health Care Blog Posts

Here are some recent posts on our patient safety blog that might interest you:
 

  • Colorectal cancer remains the third most commonly diagnosed form of cancer in this country. It kills tens of thousands of Americans annually. Although detection of the illness is declining overall, and especially among older adults, specialists have expressed growing concern about its rising rates in younger patients. This has prompted experts to push for more screenings to discover this cancer earlier. But a new, decade-long European study involving 80,000 participants has given experts in the field at least a pause and may be forcing a more nuanced consideration of colonoscopies — long considered a pricey, inconvenient, intrusive, but “gold standard” test in the battle against colorectal cancer.
  • The nation’s biggest health insurers are gaming a giant program to provide health coverage to seniors, exploiting the privatization of Medicare Advantage plans to rake in profits with schemes that have drawn fire from federal prosecutors. The sustained, costly campaign by insurers to maximize their profits not only leaves older, vulnerable patients at risk of reduced care, it also imperils the overall health of the entire Medicare system, the New York Times  found in its investigation
  • The Biden Administration has tackled the “family glitch” in Obamacare, issuing new eligibility rules that will open up more affordable health insurance for many more poor, working poor, and middle-class Americans who otherwise might struggle to pay for coverage, even as provided by their employers. This change in health care regulation is taking effect, even as tens of millions of people roll into an important period to protect their well-being — the annual “open enrollment” months for health coverage under the Affordable Care Act, by many employers, as well as for those eligible for Medicare.
  • The national disgrace of expectant moms and infants suffering excessive, preventable injuries and death can’t be blamed on mysterious causes. Indeed, a leading advocacy group has put out yet another of its damning research studies, reporting on the disturbing increase in what it terms “maternity care deserts.” The March of Dimes says it has analyzed data county by county to discover that too many areas of this country have “no hospitals providing obstetric care, no birth centers, no obstetrician/gynecologist, and no certified nurse midwives.”
  • Patients have hit a red-letter day in the long, too-difficult struggle to win control of a crucial part of their care — their electronic medical care records. Hospitals and other caregiving institutions no longer can block access to these documents, with federal law now holding them accountable for any runarounds they may try. As Stat, a medical and science news site,  reported: “Under federal rules taking effect [Oct. 6,2022], health care organizations must give patients unfettered access to their full health records in digital format. No more long delays. No more fax machines. No more exorbitant charges for printed pages. Just the data, please — now. ‘My great hope is that this will turn the tide on the culture of information blocking,’ said Lisa Bari, CEO of Civitas Networks for Health, a nonprofit that supports medical data sharing. ‘It’s a ground level thing to me: We need to make sure information flows the way patients want it to.’”
  • The Biden Administration, already locked in a long battle with the coronavirus and committed to a “moonshot” campaign against cancer, has announced it will tackle yet more persistent harms to the health of regular folks in this country — hunger, poor nutrition, and pernicious (but heavily marketed and highly profitable) foods. The White House rolled up these issues and pledged at the first White House conference on them in a half century that this country will end U.S. hunger in a decade, the New York Times and other media organizations reported.
HERE’S TO A HEALTHY (REST OF) 2022!

Sincerely,

Patrick Malone
Patrick Malone & Associates