Suicides and drug overdoses pushed up U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live.
Overall, there were more than 2.8 million U.S. deaths in 2017, or nearly 70,000 more than the previous year, the Centers for Disease Control and Prevention said Thursday. It was the highest number of deaths in a single year since the government began counting more than a century ago.
The increase partly reflects the nation's growing and aging population. But it is deaths in younger age groups — particularly middle-aged people — that have had the largest impact on calculations of life expectancy, experts said.
The opioid epidemic has spawned a growing number of drug overdoses and when those deaths are calculated along with an escalating number of suicides, they together have a powerful impact on the nation's mortality statistics. More people are dying at younger ages, the CDC found.
“I think the optimist in me was hoping for a turnaround, but these trends have been going on for a while, especially with opioid overdoses and suicides,” said Dr. Alison Gemmill, an assistant professor in the department of family, population, and preventive medicine at Stony Brook University’s Renaissance School of Medicine.
She added that “the realist in me acknowledges that these trends may continue.”
Her own research has shown an escalation in deaths among pregnant opioid abusers.
"Pregnancy-associated mortality has gone up by huge numbers and more than doubled from 2007 to 2016," Gemmill said.
Other experts also found the trend unsettling.
"It is disappointing that we have allowed this to continue in a fairly wealthy society," said Dr. Yuri Jadotte, assistant director of Stony Brook's preventive medicine residency program. "The problem with the opioid epidemic is that it didn't begin last year.
"It is a manifestation of what's been happening on a broader level for decades," Jadotte said.
The suicide death rate last year was the highest it has been in at least 50 years, according to U.S. government records. There were more than 47,000 suicides, up from a little under 45,000 the year before.
"These sobering statistics are a wake-up call that we are losing too many Americans, too early and too often, to conditions that are preventable," Dr. Robert Redfield, the CDC's director, said in a statement.
For decades, U.S. life expectancy was on the upswing, rising a few months nearly every year. Now it's trending the other way: It fell in 2015, stayed level in 2016, and declined again last year, the CDC found.
The nation is in the longest period of a generally declining life expectancy since the late 1910s, when World War I and the worst flu pandemic in modern history combined to kill nearly 1 million Americans. Life expectancy in 1918 was 39.
Aside from that, "We've never really seen anything like this," said Robert Anderson, who oversees CDC death statistics.
In the nation's 10 leading causes of death, only the cancer death rate fell in 2017. Meanwhile, there were increases in seven others — suicide, stroke, diabetes, Alzheimer's, flu/pneumonia, chronic lower respiratory diseases and unintentional injuries.
An underlying factor is that the death rate for heart disease — the nation's No. 1 killer — has stopped falling. In years past, declines in heart disease deaths were enough to offset increases in some other kinds of death, but no longer, Anderson said.
CDC officials did not speculate about what's behind declining life expectancy, but Dr. William Dietz, a disease prevention expert at George Washington University, sees a sense of hopelessness.
Financial struggles, a widening income gap and divisive politics are all casting a pall over many Americans, he suggested. "I really do believe that people are increasingly hopeless, and that leads to drug use, it leads potentially to suicide," he said.
Drug overdose deaths also continued to climb, surpassing 70,000 last year, in the midst of the deadliest drug overdose epidemic in U.S. history. The death rate rose 10 percent from the previous year, smaller than the 21 percent jump seen between 2016 and 2017.
That's not quite cause for celebration, said Dr. John Rowe, a professor of health policy and aging at Columbia University.
"Maybe it's starting to slow down, but it hasn't turned around yet," Rowe said. "I think it will take several years."
Accidental drug overdoses account for more than a third of the unintentional injury deaths, and intentional drug overdoses account for about a tenth of the suicides, said Dr. Holly Hedegaard, a CDC injury researcher.
The CDC figures are based mainly on a review of 2017 death certificates. The life expectancy figure is based on current death trends and other factors.
The agency also said:
- A baby born last year in the U.S. is expected to live about 78 years and 7 months, on average. An American born in 2015 or 2016 was expected to live about a month longer, and one born in 2014 about two months longer than that.
- The suicide rate was 14 deaths per 100,000 people. That's the highest since at least 1975.
- The percentage of suicides due to drug overdose has been inching downward.
- Deaths from flu and pneumonia rose by about 6 percent. The 2017-18 flu season was one of the worst in more than a decade, and some of the deaths from early in that season appeared in the new death dates.
- West Virginia was once again the state with the highest rate of drug overdose deaths. The CDC did not release state rates for suicides.
- Death rates for heroin, methadone and prescription opioid painkillers were flat. But deaths from the powerful painkiller fentanyl and its close opioid cousins continued to soar in 2017.
The CDC did not discuss 2017 gun deaths in the reports released Thursday. But earlier CDC reports noted increased rates of suicide by gun and by suffocation or hanging.