American "exceptionalism" has its limits. “Our workforce is dying faster than any other wealthy country,” a Journal of the American Medical Association article^[1] from Virginia Commonwealth University stated last year, as reported by USA Today.

 

For the first time in its history, life expectancy in America decreased for three consecutive years (2015-2017) driven by increasing deaths of despair. Talk about exceptional. Life expectancy in seventeen other high-income countries increased during the same period. Bottom line: America spends the most money per person on healthcare without extending life.

 

To make matters worse, life expectancy in other industrialized nations is higher than life expectancy in the U.S. Some examples include Canada at 81.9 years, Japan at 82.2 years, and France at 82.4. These nations moved ahead of the U.S. in the 1980s. U.S. life expectancy peaked in 2014 at 78.9 years and has decreased since. Mercifully, the CDC recently reported 2018 information showing a slight uptick in America’s life expectancy due to decreased deaths from drug overdoses and cancer.^[2]

 

The now overused expression, “Your ZIP code is more important than your genetic code,” should be replaced by, “Your national ID is more important than your DNA.”

 

An increased number of "deaths of despair" is the primary force driving this dismal trend. Causes of these unfortunate midlife deaths include job loss, drug and alcohol abuse, smoking, overeating, and suicide according to Virginia Commonwealth University’s expert.

 

The facts are clear. Between 1999 and 2017 mortality in the 25 to 64 age group from drug overdoses increased 386.5%, from hypertension-related causes 78.9%, and from suicide 38%.

 

Most experts agree that healthcare accounts for only 10 to 20% of health outcomes. A person's life radius—the place where individuals live, work and play—has a far greater influence on life quality and duration. Many additional examples abound of the importance of one’s community on health outcomes and life satisfaction.

 

The Centers for Disease Control and Prevention recently released disquieting information^[3] about the levels of inactivity in America today. Depending on the state, between 17.3% and 47.7% of folks have not participated in any leisure-time physical activity such as walking, running, gardening, or general exercise during the past month. Colorado citizens are the most active and Puerto Ricans the least. 

 

Regionally, the south (28%) was the least physically active followed in order by the Northeast (25.6%), Midwest (25%), and West (20.5%). Race and ethnicity showed Hispanics were least likely to engage in physical activity (31.7%), trailed by blacks (30.3%), and non-Hispanic whites (23.4%). Cultural norms and perhaps socio-economic stresses also contribute to the variation in physical activity.

 

Inactivity is a major contributor to obesity which, in turn, ruins health. “Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity,” published in December 2019 in the New England Journal of Medicine^[4] predicts that half of Americans will be overweight or obese by 2030.

 

The south again and low-income households (those with annual incomes below $20,000) are leading America's march toward a majority obese population. Generally, non-Hispanic white adults are less obese than non-Hispanic blacks and Hispanic adults.

 

It's time to get active about getting active. Americans need to start moving—literally. More parks, playgrounds, green spaces, and recreational opportunities are vital components when building healthier communities. Other essential elements of healthy communities include access to healthy foods, safe streets, home ownership, health insurance coverage, and education.

 

Transforming the "built environment" within communities changes everything. Enlightened communities in all economic strata are redesigning their infrastructure to encourage moving naturally, forming friendships, and connecting with family. These types of preventative “therapies” extend life expectancy by simultaneously addressing physical, emotional, and spiritual well-being.

 

Turning to traditional healthcare solutions focused on a repair shop mentality adds to the frustration. America is the best in the world at treating complex disease but among the worst at preventing chronic illnesses.

 

“Moon shots” and other advancements for better health exist. An historic moonshot is Salk’s innovation of a vaccine to prevent polio. A current example of a new metric is Brandeis University and Ohio State University’s development of a “comprehensive and useful tool for people who are working to improve the lives of vulnerable children and promote racial/ethnic equality” entitled Child Opportunity Index 2.0^[5].

 

Additionally, over 3.5 million folks in 51 Blue Zones Project communities across North America are on a trajectory to become healthier. The Blue Zones Project has almost ten years of experience sharing proven methods focused on policy, places, and peoples to nudge entire communities to better health. Objectively extending life expectancy while lowering obesity, smoking, and other deleterious behaviors are the result of nine basic principles—moving naturally, having purpose, downshifting, consuming a plant-slant diet, eating until 80% full, having wine at five, putting family first, belonging to a right tribe, and participating in a faith based organization—gleaned from five locales around the world where more people live to age 100. 

 

In 1961 JFK challenged, “I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man to the moon and returning him safely to earth.” To amplify JFK, I believe that this nation should commit to extending life expectancy for all Americans before this new decade is out.

 

Sources

1. Woolf, Steven H. “Life Expectancy and Mortality Rates in the United States, 1959-2017.” JAMA. American Medical Association, November 26, 2019. https://jamanetwork.com/journals/jama/fullarticle/2756187.
2. Jiaquan Xu, M.D., Sherry L. Murphy, B.S., Kenneth D. Kochanek, M.A., and Elizabeth Arias, Ph.D., “Mortality in the United States, 2018,” January 2020. https://www.cdc.gov/nchs/products/databriefs/db355.htm#ref1
3. “CDC Maps America’s High Levels of Inactivity.” Press Release January 16, 2020. https://www.cdc.gov/media/releases/2020/0116-americas-inactivity.html
4. Zachary Ward, M.P.H., Sara Bleich, Ph.D., Angie Cradock, Sc/D., Jessica Barrett, M.P.H., Catherine Giles, M.P.H., Chasmine Flax, M.P.H., Michael Long, Sc.D., Steven Gortmaker, Ph.D., “Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity” NEJM, December 19, 2019. https://www.ncbi.nlm.nih.gov/pubmed/31851800
5. “DiversityDataKids,” Heller School for Social Policy and Management at Brandeis University. http://www.diversitydatakids.org/child-opportunity-index