Map of life expectancy at birth from Global Education Project.

Tuesday, June 07, 2016

Not Stayin' Alive

You probably noticed the recent announcement by CDC that the U.S. death rate increased last year for the first time since 2005, and even that was just a blip. This may not mean anything -- sometimes numbers bounce around a bit seemingly at random -- but researchers have actually been predicting it.

First, a couple of clarifications. This is the age adjusted death rate, so it's not a function of the aging population. Second, this is not principally explained by the recently observed bump in deaths among middle aged white women, widely attributed to addiction other social problems. That's too small a group to move the whole population numbers like this.

I'm not sure if this is available to the un-academic rabble, but as David Ludwig explains, what we appear to be seeing is the long-predicted decrease in life expectancy due to obesity. The culprits are heart disease, diabetes, liver disease, stroke and Alzheimer. These are all associated with obesity. (Not so clear why the Alzheimer number went up but it is often associated with stroke and cerebral ischemia so obesity may be at least a partial explanation.) 

Of course we've been Fat Nation for a long time but  Ludwig's argument is that improvements in medical prevention and treatment -- e.g. statins and blood pressure meds, heart surgery, dialysis, etc. -- have masked the deadly effects of fatness, but now medical intervention can't keep up.

All this is so far somewhat speculative but it certainly wouldn't come as a surprise. We'll need to see what happens next year, and as people take a deeper dive into this data, but let this be a wake up call as if we needed one.

And yes, there are culprits and there are important political issues here. Food marketing, walkable neighborhoods, city planning, lots of questions that president Trump could address. We'll keep talking about it.

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