I confess that, as I drove along and digested this headline, my immediate mental reaction was not a worthy one, but I'll share it here: "If people aren't living as long, that means that Obamacare has failed."
Having subsequently had a chance to read up on the story a little bit, I don't believe the facts bear out this assumption about Obamacare. Nevertheless, it wouldn't surprise me if there is a conservative pundit somewhere trying to connect those dots. But it won't be me.
The actual story, as reported here in the Washington Post, goes in a direction I wouldn't have predicted: the primary reason given for the decline is that opioid-related deaths have been increasing dramatically. The Centers for Disease Control reports that drug-related deaths have jumped 21%.
Two other factors are identified as being major contributors to the decline in life expectancy: increases in Alzheimer's disease deaths, and increases in suicide. But the drug-related deaths are the single biggest reason. The life expectancy numbers improved for some of the more traditional causes of death, such as heart disease, cancers, strokes and diabetes.
In addition to viscerally pinning the blame on Obamacare, I made a couple of fact-free, pre-research demographic assumptions: that the increases would be disproportionate for people living in poverty, and disproportionate for people of color. It's possible that the data will bear out those guesses, but it's interesting that the WaPo story paints a different demographic picture:
The story also notes that apparently there is controversy among drug-treatment specialists regarding how opioid-addicted patients should be helped.While drug mortality has been increasing among all age groups since 1999, it’s highest among those ages 25 to 54. Their fatal overdose rate for all drugs was roughly 35 cases per 100,000 individuals in 2016, compared with 12 deaths per 100,000 for people under 24 and six deaths per 100,000 among seniors 65 and older.Men of all ages (26 deaths per 100,000) are twice as likely to die of a drug overdose as women (13 per 100,000). At the state level, West Virginia stands alone as the epicenter of overdose mortality, with 52 deaths per 100,000 residents in 2016. The next two states, New Hampshire and Ohio, each saw 39 deaths per 100,000 last year.
[Former Rhode Island congressman Patrick] Kennedy said medication-assisted therapies, including newer injectable drugs that block opioid cravings, are crucial to curbing the crisis. But there is “a bias in recovery circles” against such treatments, with the attitude that “you’re not supposed to take medications — that’s not called sobriety,” he said.As the headline notes, this is the second year in a row that overall life expectancy has declined. The causes identified for the previous year's decline were so-called "diseases of despair": drug addition, alcoholism and suicide. So it seems that Alzheimer's is the new factor for this year.
The diseases of despair are prevalent among whites, especially those with little education. They are likely to support Trump.
ReplyDeleteActually despair is not prevalent among blacks, and Hispanics are doing quite well.
It's all about expectations which have been rising for blacks, Hispanics and Asian Americans, and declining among white Americans, especially those with little education, e.g. working class.
See my previous post:
The Opiod Epidemic and Lake County, Ohio
Jack, many thanks. I had missed your previous post. A lot of very good information there, both in the post and in the comments. I now have a number of links to read up on this more.
DeleteIt seems that this crisis leverages the legal drug distribution chain, rather than the illegal distribution networks set up for illegal substances like cocaine and heroin. Is that true?
I heard the report sitting down, and my first thought was not "Obamacare" but "suicide." The NPR report quoted Princeton U. researcher Ann Case on "deaths of despair":
ReplyDelete"They don't have a good job. They don't have a marriage that supports them. They may have children that they do or don't see. They have a much more fragile existence than they would have had a generation ago."
You don't OD on drugs which is a form of suicide, if you are expecting a regular paycheck. We are reaching payback time for our long flirtation with the so-called job creators. We held down the minimum wage; got unions off their backs; encouraged -- hailed! -- as-needed employees who work when the boss needs them and stand by unpaid when he doesn't; bailed out banks but expected individuals to find their own way back to work; cut the NLRB off at the knees and ate the whole burrito of magical thinking that underlies the Republican pay-for-itself tax cut. We eliminated welfare "as we knew it," and next year we are going to "reform entitlements as we know them." In short, we have produced a mean, low economy that we finally can see is killing people.
I am not surprised.
The reporting I have seen has not mentioned brain cancer, but there has been a veritable wave of it in the past couple of years. We had a flap about an area of the county a few years ago where it appeared brain cancer was rampant. The experts found that it walked like an epidemic and quacked like an epidemic but was a statistical anomaly. All I know is I used to go to funerals of lung cancer victims, and now all the funerals I know are for brain cancer.
I wonder if there is any link between brain cancer and electronic devices, particularly cell phones?
DeleteChristianity should be an antidote for despair - at least if we disciples are doing our jobs.
DeleteOne of my worries about the church, perhaps more pronounced in a suburban area like mine, is that it runs the risk of becoming a church for the middle class and upper-middle class. Those are the communities whose parishes are able to afford to pay large staffs running many programs, and also able to sustain a Catholic school.
The challenge is that Jesus came to preach Good News to the poor. As dioceses continue to go through rounds of parish and school closings, it is often the parishes and schools who serve the poorer populations, both in urban areas and in small rural towns, that are the ones that are not able to sustain themselves financially and so are targeted for closure.
That's a whole 'nother thread, Jim.
DeleteI've been working with a friend's store front evangelical church in Flint. These folks are living the Gospel whatever I might think about some of their liturgical and theological ideas.
DeleteBut "Jesus loves you," a hot meal, warm mittens, dry socks, and some referrals aren't making a dent in addiction.
Addiction requires medical and psych intervention. The Good News can't sink in until the addict is in treatment.
There aren't always rational "reasons" for addiction, though we want there to be. The fact that so many people are OD'ing might have more to do with price and availability as much as hopelessness.
ReplyDelete“you’re not supposed to take medications — that’s not called sobriety."
AA and related programs have kind of a stranglehold on our attitudes about addiction, and frustration with it is reflected in Kennedy's snip above. Statistics are hard to come by. Drop-out rates in the program are high--probably higher when mandated by a court. It may be that AA in combination with other methods might help with the problem, but AA can be kind of rigid. And any program depends entirely on the addicts wanting to recover.
Of possible interest: https://www.scientificamerican.com/article/does-alcoholics-anonymous-work/
Jack R. can probably speak to this better than me.