During 2015, renowned economist Jeffrey Sachs appeared in a video titled “The Fatal Flaw of the Anti-Vaccine Movement.” In the video, Sachs attempted to explain why Americans and people in other wealthy countries are much better off now in terms of health than they have ever been, and that this is due to technology, vaccines and other drugs.1 He said:
You know, we’re so lucky in the United States and other high income countries that we now live 80 years life expectancy. Many people can expect to live much longer than that. What a gift, compared to what life was like a century or two ago when life expectancy was 35 years or 40 years in the world, it’s doubled. And we live long and healthy lives because of the wonders of technology, vaccines and antibiotics, and knowledge about what causes disease and how to prevent it.1
In response to Sachs’ promotional video five years ago, I wrote the following comments in an article for The Vaccine Reaction:
For all of Prof. Sachs’ bravado about how fortunate Americans are to be living so long as a result of the drugs and technology, the fact is that he’s not even being completely forthright about how good we have it. Yes, Americans are living an average of almost 80 years. But of the nearly 320 million people in the U.S., about 90 million of them are living with chronic illness and disabilities. So we may be living longer, but we’re getting sicker, not healthier, as Prof. Sachs seems to imply.2
Since then, things have gotten worse. The number of people in the U.S. estimated to suffer from a chronic illness or disability is now at 133 million,3 4 which is roughly 40 percent of the country’s current population of 329 million. That figure, however, may actually be out of date. A 2016 study published in the journal Psychology, Health & Medicine estimated that 50 percent of Americans have at least one chronic health condition, mental disorder or substance-use problem.5
According to the Centers for Disease Control and Prevention (CDC), six out of 10 adults in the U.S. have a chronic disease and four out of 10 adults have two or more chronic diseases.6 That estimate is supported by a 2017 Rand study that found that “60 percent of American adults now live with at least one chronic condition; 42 percent have more than one.”7
Now, as it turns out, not only are Americans getting chronically sicker, they are also not living as long either, contrary to what Sachs suggested in his 2015 video. Ironically, by the end of 2015, it was reported by the media that U.S. life expectancy had dropped for the first time since 1993, from 78.9 years in 2014 to 78.8 years in 2015.10 11
The decline was not an aberration. As it turns out, it marked the beginning of a new trend. According to the National Center for Health Statistics (NCHS), life expectancy in the U.S. dropped for the second consecutive year in 2016 to 78.7 years. It was the first time the NCHS had registered a multi-year drop since 1962-1963.12 The downward trend continued for the third year in a row in 2017, with life expectancy dropping again to 78.6 years.13
Life expectancy data for 2018 is not publicly available yet.
So what is causing the downward slide in life expectancy among Americans? According to the CDC, it’s due largely to drug (notably opioids) overdoses and suicide.14 15 But there is also the view that the dramatically increasing rate of chronic illness may play a significant role
In an interview with Jay Bhattacharya, MD, PhD published in Stanford Medicine’s Scope, Dr. Bhattacharva was asked what he thought of the CDC’s emphasis on drug overdoses and suicide as fueling the decline in life expectancy. “My personal view is that these factors, although they might have a particular political salience right now, aren’t actually the main reasons for the decline that the CDC is reporting,” said Dr. Bhattacharva.16
Dr. Bhattacharva thinks that one way to address the life expectancy issue is to focus more on “targeting risk factors” that are behind the growth in chronic illnesses.16 He notes:
One thing that I think we need to be better at is distinguishing between primary prevention and secondary care. The latter we’ve gotten very good at, the former not so much. For instance, while chronic disease rates have risen dramatically in the U.S., disability from that chronic disease hasn’t to the same extent. We’re better at treating people who’ve had a heart attack or a stroke so that they don’t end up seriously disabled.16
In other words, modern Western medicine has been so preoccupied with dealing with acute events, like management and recovery from heart attacks and strokes, that it has paid relatively little attention to the as yet unexplained crisis of more people living with chronic illness that was in the making long before the Sachs video proclaiming everything is well due to the wonders of technology, vaccines and drugs. This crisis, however, has now become so severe that it is starting to have a negative impact on life expectancy.
LeeAnn Weintraub, a registered dietitian, would probably agree with Dr. Bhattacharva. Weintraub notes, “If we can shift from a society that puts its resources into treating the symptoms of disease to a society that considers the social, economic and environmental origins of health problems, we can make additional strides to live longer and better lives as a whole.”17
1 Fierberg E. Watch Jeff Sachs destroy the anti-vaccine movement in under two minutes. Business Insider June 25, 2015.
2 Cáceres M. Jeffrey Sachs’ Quaint Destruction of the Anti-Vaccine Movement. The Vaccine Reaction June 27, 2015.
3 The Growing Crisis of Chronic Disease in the United States. Partnership to Fight Chronic Disease.
4 Wullianallur Raghupathi W, Raghupathi V. An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health. Int. J. Environ. Res. Public Health 2018; 15(3): 431.
5 Taylor & Francis. More than 50% of Americans now have at least one chronic health condition, mental disorder or substance-use issue. Science Daily Oct. 25, 2016.
6 Centers for Disease Control and Prevention. Chronic Diseases in America. Oct. 23, 2019.
7 Rand. Chronic Conditions in America: Price and Prevalence. Rand Review July 12, 2017.
8 Focus for Health. Chronic Illness and the State of Our Children’s Health.
9 Cáceres M. Half of America’s Kids Suffer from Chronic Illness and It’s Getting Worse. The Vaccine Reaction June 27, 2019.
10 Bernstein L. U.S. life expectancy declines for the first time since 1993. The Washington Post Dec. 8, 2016.
11 Stein R. Life Expectancy In U.S. Drops For First Time In Decades, Report Finds. NPR Dec. 8, 2016.
12 Tinker B. US life expectancy drops for second year in a row. CNN Dec. 21, 2017.
13 Bernstein L. U.S. life expectancy declines again, a dismal trend not seen since World War I. The Washington Post Nov. 29, 2018.
14 American Academy of Family Physicians. CDC Data Show U.S. Life Expectancy Continues to Decline. Dec. 10, 2018.
15 Ducharme J. U.S. Life Expectancy Dropped for the Third Year in a Row. Drugs and Suicide Are Partly to Blame. TIME Nov. 29, 2018.
16 Kenway J. Why is life expectancy in the U.S. going down? A Q&A. Scope Jan. 16, 2019.
17 Weintraub L. Americans are not living longer, healthier lives. Can functional medicine change that? Los Angeles Daily News Aug. 8, 2019.