A new report from the American Association of Medical Colleges (AAMC) Research and Action Institute, co-authored by Dr. Megan L. Ranney, dean of the Yale School of Public Health, examines how alcohol, drug, and firearm deaths have lowered life expectancy in the United States and contributed to a widening gap in life expectancy between the U.S. and other high-income countries.
If these preventable deaths were eliminated (and other causes of death remained the same), U.S. life expectancy at birth would increase by 1.6 years, narrowing the current life expectancy gap by about half, the report says. Targeted public health interventions and investments in mental health and social services—as opposed to making changes in clinical care—would help minimize alcohol, drug, and firearm deaths, and potentially other preventable causes of death, across the country.
The comprehensive Data Snapshot: "Narrowing the Gap: The Burden of Alcohol, Drugs, and Firearms on U.S. Life Expectancy,” can be found on the AAMC’s website.
Background
- Despite an enormous investment in health care, life expectancy in the United States in 2022 (77.6 years) was significantly lower than that of similar high-income countries (80.6 years on average).
- In 2022, the United States experienced more than 48,000 firearm-related deaths, nearly 108,000 drug-related deaths, and over 51,000 alcohol-induced deaths.
- These preventable deaths disproportionately affected children and younger adults, contributing to a reduced life expectancy at birth.
- Life expectancy has been strongly correlated with demographics, locations, and social and economic factors. Southern states generally experience lower life expectancies than other regions of the country; people with lower incomes tend to have lower life expectancies than those with higher incomes; other factors such as education, lifestyle, genetics, and environment can also impact life expectancy.
Key Findings
- Drug-related deaths accounted for the greatest number of potential years of life expectancy lost. If these deaths did not occur, the average American could expect to live nearly one year longer (0.9 years).
- The United States would add an average of 0.4 years and 0.3 years of life expectancy if deaths due to firearms and alcohol, respectively, were eliminated.
- Ten states would see a more than 2-year jump in life expectancy if deaths due to alcohol, drugs, and firearms did not occur, ranging from 2.0 years in South Carolina to 3.0 years in New Mexico.
- Some subgroups of race/ethnicity would see dramatic increases in life expectancy if deaths due to alcohol, drugs, or firearms did not occur.
Why It Matters
The findings highlight the critical role of non-clinical interventions in improving longevity in the U.S. Addressing preventable causes of death through targeted public health interventions, mental health and substance use disorder treatments, and enhanced social services could substantively reduce the life expectancy gap.
What The Authors Say
Dr. Megan L. Ranney, MD, MPH, Dean of Yale School of Public Health:
"So much of our health and life expectancy is determined by factors outside of the health care system. Although fully eliminating deaths from substance use, alcohol, or firearms is unlikely, this report highlights the impact of these causes of death on U.S. life expectancy - and provides a path forward for us to do better."
Dr. Atul Grover, MD, PhD, Executive Director, AAMC Research and Action Institute:
“Instead of focusing solely on clinical spending, we must also acknowledge other non-clinical factors that shorten our life expectancy average, especially those that affect children and young adults. If we really want to improve life expectancy, we need to think about interventions outside of the doctor’s office that affect the health and welfare of our communities.”
Policy Recommendations
- The three causes of death that are impacting life expectancy in the U.S. are amenable to policy interventions at both the national and state level.
- Public health interventions have proven to be effective in reducing preventable death. Instituting seatbelt laws, drunk driving awareness campaigns, and changes in car engineering, for example, successfully reduced car crash deaths beginning in the 1970s.
- If researchers and policymakers believe that life expectancy is a primary measure of a nation’s health, immediate gains are likely to be achieved through investments in targeted public health efforts such as access to treatment for mental health and substance use disorders, firearm safe storage laws, limitations on hours of alcohol sale, and enhancement of community programs.