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ife expectancy in the U.S. has fallen for the second year in a row, the first time it’s dropped for two consecutive years in more than half a century.

People born in the U.S. in 2016 could expect to live 78.6 years on average, down from 78.7 the year before, according to a new report released Thursday by the Centers for Disease Control and Prevention. The most common cause of death: heart disease.

The report also found death rates — calculated from the number of deaths per 100,000 people — actually rose among young adults between 2015 and 2016. And while the authors didn’t draw a direct link, another report also released Thursday by the CDC found an estimated 63,600 people died of drug overdoses in 2016. Two-thirds of those deaths were caused by opioids. Adults between the ages of 25 and 54 had the highest rate of drug overdose death.

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Here’s a look at the findings:

Most common causes of death

Heart disease was the leading cause of death, followed by cancer, unintentional injuries, chronic lower respiratory diseases, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease, and suicide.

One key point: Unintentional injuries climbed to the third leading cause of death in 2016, swapping spots with chronic lower respiratory diseases. It’s worth noting that most drug overdose deaths are classified as unintentional injuries.

Megan Thielking / STAT. Source: Mortality in the United States, 2016. National Center for Health Statistics.

Black men are dying at alarmingly high rates

Life expectancy isn’t falling for women — just for men. Life expectancy for women at birth is 81.1 years, compared to 76.1 years for men.

The death rate for the general population actually declined slightly in 2016, but that drop wasn’t seen across all racial and ethnic groups. Death rates among black men climbed 1 percent in 2016, while death rates among white women actually fell 1 percent. There weren’t any big changes in death rates among black women, white men, or Hispanic men or women.

Megan Thielking / STAT. Source: Mortality in the United States, 2016. National Center for Health Statistics.

Drug overdose deaths continue to climb

Drug death rates are increasing much faster than they have in recent years. Overdose death rates climbed roughly 10 percent per year between 1999 and 2006. Then there was a relative lull: Between 2006 and 2014, they increased roughly 3 percent each year.

But from 2014 to 2016, death rates tied to drug overdoses jumped 18 percent each year.

Megan Thielking / STAT. Source: Drug Overdose Deaths in the United States, 1999–2016. National Center for Health Statistics.

Deaths due to synthetic opioids are rising

The rate of overdose deaths involving synthetic opioids other than methadone — a category that includes fentanyl, fentanyl analogs, and tramadol — doubled between 2015 and 2016. The rate of drug overdose deaths involving natural and semisynthetic opioids, such as oxycodone and hydrocodone, also rose, while overdoses involving methadone declined.

Megan Thielking / STAT. Source: Drug Overdose Deaths in the United States, 1999–2016. National Center for Health Statistics.

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  • I wanted to keep this comment separate from my other one, below.

    We are throwing around a lot of statistics, but looking for comparison produces a picture of apples and oranges.

    So let’s sort the drug overdose deaths out of the “unintentional injuries” list, and see where those two separate figures lead us. I suspect they will both be significantly lower on the chart.

  • I take prescription Hydromorphone to help me live with chronic pain. I wasn’t concerned about it; I realized that (in some ways) taking opioids is like handling a loaded gun.

    Now, the government has scared me.

    Or at least it did for a moment.

    I understand what I and my doctor are doing. I understand the risks involved. I have no reason to fear I’ll have any problems. But the government is still worried about me. And that is unnerving.

  • It is unfortunate that there is no national standard for autopsies in the US. This surely impedes valid interpretation of morbidity and mortality data due to unreliability. I and others have speculated that suicide is substantially under-reported as cause of death.

    For example, if the decedent was being treated for a cancer or some other painful medical symptoms, and a blood tox was positive for opioids, it is unlikely that many MEs would even consider intentional overdose given that they were on painkillers. In addition, there is also the problem of religious taboos regarding suicide that some MEs surely respect, and place an “accidental” or “unintentional” adjective on the cause of death. Finally, there is the fentanyl risk. A tox screen that detects fentanyl likely leads many MEs to speculate that the overdose was unintentional, yet it is hardly a secret among addicts that street opioids contain the drug which can trigger immediate respiratory arrest. Even as far back as 1963, David Wilkerson referred to opioid abuse as “death on the installment plan.”

    The reason that accurate cause of death is important has to do with where to focus limited resources to improve the public health. Currently, policy focuses attention almost exclusively on access-related factors: first-responder naloxone intervention in the case of overdose, increasing access to addiction treatment, and intensified law enforcement. Many of us are beginning to shift attention to “hopelessness” rather than opioid access, as the trigger for increased opioid deaths. The US economy is experiencing an abrupt shift in the US economy away from manufacture towards a service economy. This places certain groups at elevated risk of opioid abuse and suicide, especially Black males and white men in their middle age who find themselves unemployed with few prospects to return to a prosperous future. As politicians of old have chided – “It’s the economy, stupid.” We need to accept that, and focus more resources on the US human obsolescence problem. That goal will be advanced by ensuring that MEs across the US assume opioid deaths are suicide unless there is valid and clear evidence to the contrary.

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