A decline in U.S. Life Expectancy.

Which, we would note, the government, which addressed this oddly enough on Twitter, terms catastrophic.

Dr. Robert M. Califf @DrCaliff_FDA

We are facing extraordinary headwinds in our public health with a major decline in life expectancy. The major decline in the U.S. is not just a trend. I’d describe it as catastrophic.

JAMA Internal Medicine published earlier this month that our overall life expectancy has dropped to 76 years, and remarkably, that male life expectancy in the U.S. has dropped to 73 years.

Since then, CDC released a report showing a slight rebound from lower life expectancy caused by the COVID-19 pandemic. Even with this encouraging report, we still have a lot of work to do before we see pre-pandemic life expectancy again. https://cdc.gov/nchs/data/vsrr/vsrr031.pdf

As we all know, life expectancy is far from uniformly distributed. Disparities as a function of race, ethnicity, wealth, education and geospatial location are profound and widening.

A college degree is associated with an 8.5 year longer life and differences of more than a decade in life expectancy are common when we go from urban areas and university towns to rural areas.

We expect to lose over 450K Americans due to tobacco related illness this year – we need to change that. We have a very important and ambitious agenda to tackle in our work on tobacco. We’ve made some important advances in that area recently, but there is still much to be done.

Each year, more than a million Americans die from diet-related diseases, including cardiovascular disease, diabetes, and certain forms of cancers.

While we’ve seen enormous progress in terms of controlling or developing treatments for many of these diseases, alarmingly, we’re in the midst of a significant backsliding relating to many of these and other chronic illnesses.

Our work in this area also supports the food industry in their efforts to reformulate in healthier ways and provide additional knowledge/choices for American consumers. Working with industry is an important part of the equation, since govt most assuredly can’t do this alone.

An important aspect of this life expectancy dynamic is the challenge of drug shortages, particularly low-cost generics. With over 90% of our prescriptions now generic, these low cost, effective medications are an essential part of an effective public health strategy.

But these medications are not effective if they are not available! Shortages are very frustrating, consume an enormous share of talented pharmacist and clinician time to find alternatives and explanations to patients.

Shortages also undermine the underlying goal of increased accessibility of these often life-saving products. Simply put, shortages put patients at risk.

I believe that we need to seriously examine our level of accountability and changes that we can make to help what needs to be an “all hands on deck” effort to continue and amplify the improvement in life expectancy discussed in CDCs latest report.

Earlier this month, I spoke to a group of professors of medicine about declining life expectancy, and in that speech, I talked about my short list of changes that they might lead to help reverse the negative trend.

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Every other sector in the health care ecosystem could develop its own list of improvements, and together, we could accelerate last year’s progress.

The government, industry, and the public all have a role to play in improving life expectancy. Let’s get to it.