Life Expectancy in the U.S.: Why the Numbers Are Falling | Chris Kresser

Life Expectancy in the U.S.: Why the Numbers Are Falling

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How can you gauge the health and well-being of a population? Overall life expectancy is one key measure.

Though life expectancy in the U.S. is falling, active, healthy seniors—like this grandfather gardening with his grandson—can still enjoy long, fulfilling lives.
While the chronic disease epidemic is taking its toll on life expectancy in the U.S., embracing an active, ancestral lifestyle could make the difference for many older Americans. iStock/eclipse_images

As you’d imagine, year-over-year gains in this calculation are the goal and are indicative of a healthy society. Stagnations are cause for concern, while declines are, to put it mildly, alarming. Falling national numbers can signal the deterioration of a country’s healthcare infrastructure, especially in the quality of healthcare services it provides its citizens.

To my mind, this is exactly what’s happening in America today. Although life expectancy in the U.S. was on an upward march for decades, preliminary data for 2017 suggests the average lifespan in the United States dropped for the third year in a row. The only other time life expectancy decreased three consecutive years was in the late 1910s, and that was due to the worst flu outbreak in recorded history.

So why is it on the decline today, 100 years later? Because chronic disease is now the biggest threat to our longevity, and because conventional medicine has failed to slow this epidemic. But there is good news: a Functional Medicine approach to health and healthcare, influenced by an ancestral perspective, can turn the tide.

The last time life expectancy in the U.S. fell for the third consecutive year, it was due to the worst flu outbreak in recorded history. Why are the numbers falling today? Check out this article to find out. #healthylifestyle #functionalmedicine #kresserinstitute

What the Latest Statistics Say about Life Expectancy in the U.S.

Based on early data from the National Center for Health Statistics, the U.S. death rate is up and life expectancy is down—again. The disturbing trend began in 2015, when the average overall life expectancy in the U.S. dropped from 78.9 years of age to 78.7. In 2016, it fell to 78.6. (1, 2, 3)

Before you dismiss the decrease as small and insignificant, consider this: the United States now has the lowest life expectancy levels among high-income developed countries, including Western Europe, Australia, and Japan. To illustrate the gravity further, if somehow we could freeze the life expectancy calculations in these other countries and increase our numbers at the rate we did pre-2015 when the downward slide began, it would take American men 16 years just to match the average of the other populations. American women would need a whopping 18 years. (4)

But let’s get back to why statisticians predict a continued downturn. In addition to increases in deaths from “diseases of despair” (drug abuse, fueled largely by opioids, alcoholism, and suicide), they’re seeing significant, even dramatic, increases in death from chronic diseases, including:

Seven of the current top 10 causes of death are chronic diseases. The same stat applies to number of deaths as well: chronic disease is responsible for seven out of 10 deaths each year.

It now appears the onset of chronic illness is earlier than it once was, and chronic disease is even on the rise in children, with the rate doubling between 1994 and 2006. (Sadly, there has been a sharp increase in the number of kids and teens diagnosed with type 2 diabetes, once rare among children—probably due to the rise in obesity among this group.)  (5, 6, 7, 8, 9)

Chronic Disease: The Country’s Big Challenge

We didn’t just arrive at a three-year slump overnight.

A major 2014 study sounded the alarm bells. (10) It pointed out that not only was chronic disease on the rise, but so too was the number of older Americans living with multiple chronic conditions—a shocking four out of five people. It also showed that the more ailments a person has after retirement age, the shorter their lifespan and the nation’s overall lifespan.

Researchers determined that, on average, a person’s life expectancy at age 67 decreases 1.8 years for each additional chronic disease they have, ranging from 0.4 fewer years with the first condition up to 2.6 fewer years with the sixth diagnosis. They also found that the outlook is much worse for those with certain diseases, especially Alzheimer’s, incidences of which are only climbing. According to the study’s lead author:

The balancing act needed to care for all of those conditions is complicated … Our system is not set up to care for people with so many different illnesses … It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy. (11)

I have to guess that many people didn’t hear the red alert go off when this study was released because the conventional approach to medicine remains deeply anchored in this country—and millions of patients believe this approach to healthcare is effectively treating their chronic disease.

It’s not.

There’s a Simple Answer—for You and the Nation

What these researchers said in 2014 is what I’ve been saying for years: conventional medicine can’t and will never solve chronic disease. We need to do things differently.

And here’s another compelling fact to motivate us all: while overall life expectancy is an important measure of a nation’s well-being, it’s only one assessment. The study findings shared here highlight the fact that we’re not just living shorter lives; we’re also living sicker lives. Of the 78 years we can expect to live, most of us only get to enjoy 67.7 of them free of illness and disability. In Europe, this statistic is called Healthy Life Years, or HLY. America’s HLY number has only risen 2.4 years since 1990. (12, 13)

Here’s where Functional Medicine comes in. It’s the answer to increasing both our overall life expectancy and our HLY expectancy. But to understand why it works, you first need to understand the main reasons why the current model is failing us all.

Why Conventional Medicine Can’t Heal Chronic Disease

Big Reason 1. It’s the Wrong Medical Paradigm

Conventional medicine evolved during a time when acute (sudden onset, as opposed to slow-developing) infectious diseases were the leading causes of death, like a deadly flu outbreak. Most other problems that brought people to the doctor were also acute, like appendicitis. Treatment in these cases was relatively simple: the patient developed pneumonia, went to see the doctor, received an antibiotic (once they were invented), and either got well or died. One problem, one doctor, one treatment.

As we’ve established, things today aren’t that straightforward. The average patient sees the doctor for one or more chronic issues, which are difficult to manage, expensive to treat, require more than one physician, and typically last a lifetime. They don’t lend themselves to the “one problem, one doctor, one treatment” approach of the past.

It’s the application of the conventional medical paradigm to the modern problem of chronic disease that’s gotten us into our current conundrum. It’s led to a system that emphasizes suppressing symptoms with drugs (and sometimes surgery and an endless cycle of “procedures”), rather than addressing the underlying cause of illness.

This is not the way to reverse or prevent chronic disease, more than 85 percent of which is caused by environmental factors like diet, behavior, and lifestyle. (14) More specifically, chronic disease is the direct result of a mismatch between our genes and biology on one hand and the modern environment on the other.

Big Reason 2. It’s the Wrong Delivery Model

How care is delivered is also a huge problem. The system isn’t structured to support the most important interventions.

As I mentioned above, the primary causes of the chronic disease epidemic are not genetic, but behavioral. It boils down to people making the wrong choices about diet, physical activity, sleep, etc.—over and over again, throughout a lifetime. In fact, a recent Harvard study found that successfully implementing just five healthy habits (eating a healthy diet, exercising regularly, maintaining a healthy body weight, moderate alcohol intake, and not smoking) could add up to 14 years to your life. (15, 16)

This makes it clear that one of the most important roles healthcare providers should play is supporting people in making positive behavior changes. Unfortunately, the conventional medical system undermines this, making it extremely difficult, if not impossible.

The average patient visit with a primary care provider lasts 10 to 12 minutes, which barely leaves a doctor time to prescribe a drug for any new symptoms a patient presents with, much less an in-depth discussion of diet and lifestyle factors that might be contributing. (17)

As a result, 87 percent of doctors agree the healthcare profession is in decline, while 82 percent of physicians believe they have little ability to change the current system. (18) These are just a few reasons why burnout is so common in the healthcare field.

Why Functional Medicine Is the Answer

I hope this article serves as a gentle shake to conventional practitioners, and to you (as their potential patient) as well, because there is a better way, and things can change—they already are. Hundreds of clinics across the country (including my own, the California Center for Functional Medicine) have begun to implement a Functional Medicine model, which works for addressing chronic disease. Here’s why.

Big Reason 1. It Makes Room for Longer Medical Visits

More time allows doctors the chance to uncover and then address the root cause of a patient’s symptoms, as well as discuss prevention strategies. This is how health and healing happen.

Big Reason 2. It Emphasizes Collaborative Care

In Functional Medicine, the doctor–patient relationship is a partnership. What’s more, patients have access to a collaborative care team, which includes nurse practitioners, nutritionists, health coaches, and others. The team provides another layer of care between appointments.

This is just the beginning of a long list of reasons. For more, check out my book, Unconventional Medicine.

How Do You Live—and Help Others Live—a Longer, Better Life?

If you’re in healthcare, make the switch to Functional Medicine. And if you’re not yet in the field but want to be part of the revolution, now’s the time to consider becoming a health coach.

If you’re a patient, seek out Functional Medicine practitioners, preferably a team that looks at health through an evolutionary lens. Together, Functional Medicine and ancestral wisdom are unstoppable at slowing the chronic disease epidemic, as they address the mismatch between our genes and current environment (the cause of modern disease) by encouraging the time-tested healthy lifestyle choices noted above. Although eating a nutrient-dense ancestral diet and exercising seem like simple mandates, they can be difficult to follow through on without the proper support. Functional Medicine is the support you need.

As the latest science shows, there’s no biological cap to human longevity. (19, 20) Let that sink in. We don’t have to accept living shorter, unhealthier lives.