U.S. life expectancy has taken a tumble, but here’s a to-do list that could help

Published on: December 06, 2022 6:00 AM EST|Updated on: December 06, 2022 6:59 AM EST

A general view of The Johns Hopkins University on March 28, 2020 in Baltimore, Maryland.
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When COVID-19 and other more long-running maladies contributed to a drop in life expectancy not seen in a century, a group of researchers at Johns Hopkins University set out to develop a punch list to address the damage to the nation.

The 10 ideas, expected to be released Tuesday, are not expected to be an immediate fix, report authors acknowledge. Many require significant funding, legislation or policy shifts. But in several of the worst areas, including gun violence, addiction, auto crashes and heart disease, many programs and policy changes are already underway from federal to local levels.

“There has been a historic loss of life expectancy; it’s just one number, but behind the number is so much suffering that people around the country have experienced,” said Dr. Joshua Sharfstein, director of the Bloomberg American Health Initiative, which is based in the Johns Hopkins University Bloomberg School of Public Health and produced the report.

“When any individual gets sick it could be an act of fate,” he said “What an entire country’s life expectancy drops it reflects choices. We have to do what we can to help people be healthier overall.”

Federal statistics show there was a three-year drop in life expectancy from the peak in 2014 to the current figure, which is just over 76 years — a decline not seen since World War I and the flu pandemic of 1918. The declines are universal among races and ethnicities, although there are significant disparities, with Black, Native American and Hispanic people suffering far larger drops in life expectancy.

The report addressing the drop is being released Tuesday morning at the initiative’s annual summit in Philadelphia.

Sharfstein said it includes specific ideas culled from research underway at the university. The first recommendation is fully funding COVID-19 vaccination, treatment and research, which Sharfstein said should contribute significantly to reversing the biggest declines in life expectancy.

More than a million people have died from COVID infections across the country, and more than 15,800 in Maryland, since the pandemic began in 2020.

Another idea included in the report involves policies to address opioid use disorders. One change includes making medications to treat opioid use disorders standard medical care. Another is expanding harm reduction services, which includes increasing supplies of clean needles and the overdose remedy naloxone to drug users.

There were more than 100,000 deaths from drug overdoses nationwide in 2021, federal data shows. The pandemic appears to have made matters worse when access to services was disrupted as people suffered from illness and increased emotional and financial strain.

Gun violence is another area where policy and legal changes could save lives, the report authors say. They include adopting extreme risk protection orders, also known as red-flag laws, which allow law enforcement to take weapons from people who may harm themselves or others. Many states, including Maryland, have already adopted such laws.

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Also suggested in the report are permits for gun purchases, which polling shows is popular with the public.

Mental health care is another area, and a big policy change suggested is making health care more universally available in schools so adolescents can more easily access services. This could have a big impact on teen suicide, which has increased by more than 25% since 2014, the report says. Rates are higher for LGBTQ youth and other minority groups.

Next on the list are initiatives aimed to reduce traffic deaths. Researchers suggested adding driver impairment detection technology to cars that could reduce intoxication-related deaths that account for a quarter of the fatalities. In 2021, there were more than 42,000 motor vehicle-related deaths, the highest number in 15 years, per the report.

Other ideas target some of the biggest killers of Americans: heart disease, stroke and diabetes.

One method that research shows could dramatically reduce deaths is mandating that manufacturers reduce the salt they add to processed food. Consumers get two-thirds of their sodium from this food, the report said.

Research shows that high levels of sodium can lead to higher blood pressure, which is tied to an increase chance of heart disease and strokes. Reducing the amount by 40% over a decade could save more than 50,000 lives, researchers found.

The report also calls for improving access to healthy foods, especially fruits and vegetables. That means growing more food locally and routing it to schools, hospitals and underserved areas.

The last area in the report revolves around climate change, especially extreme heat, which is increasingly associated with deaths. The report calls for local communities to develop action plans that include reducing air pollution, adding tree canopies and implementing educational campaigns to keep people safe.

Sharfstein said there are other areas that could help improve life expectancy. This report is meant to be “illustrative and not exhaustive,” he said.

“It’s meant to counter the malaise when hear about health problems, that it can never get better,” he said. “It can get better and here are 10 ways.”