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‘There’s something terribly wrong’: Americans are dying young at alarming rates


By Joel Achenbach November 27, 2019 at 12:00 a.m. GMT+8

Brian Benson unloads the body of a 44-year-old woman at the Kern County coroner’s office in Bakersfield, Calif. Prescxtion narcotics were among the medications found in the woman’s apartment. (Bonnie Jo Mount/The Washington Post)


Death rates from suicide, drug overdoses, liver disease and dozens of other causes have been rising over the past decade for young and middle-aged adults, driving down overall life expectancy in the United States for three consecutive years, according to a strikingly bleak study published Tuesday that looked at the past six decades of mortality data.


“It’s supposed to be going down, as it is in other countries,” said the lead author of the report, Steven H. Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “The fact that that number is climbing, there’s something terribly wrong.”
He said many factors are at play. The opioid epidemic is a major driver of the worrisome numbers, but far from the sole cause. The study found that improvements in life expectancy, largely because of lower rates of infant mortality, began to slow in the 1980s, long before the opioid epidemic became a national tragedy.

该报告主要作者、弗吉尼亚联邦大学社会与健康中心名誉主任史蒂文·h·伍尔夫(Steven H. Woolf)说,“死亡率应该会像其他国家一样下降。”“事实上,这个数字还在继续攀升,这说明问题相当严重。”

“Some of it may be due to obesity, some of it may be due to drug addiction, some of it may be due to distracted driving from cellphones,” Woolf said. Given the breadth and pervasiveness of the trend, “it suggests that the cause has to be systemic, that there’s some root cause that’s causing adverse health across many different dimensions for working-age adults.”


The report reveals a broad erosion in health, with no single “smoking gun,” said Ellen Meara, a professor at the Dartmouth Institute for Health Policy and Clinical Practice.
“There’s something more fundamental about how people are feeling at some level — whether it’s economic, whether it’s stress, whether it’s deterioration of family,” she said. “People are feeling worse about themselves and their futures, and that’s leading them to do things that are self-destructive and not promoting health.”


The JAMA report looked at life expectancy and mortality across the country from 1959 through 2017. Final life expectancy numbers for 2018 will soon be released by the U.S. Centers for Disease Control and Prevention. The general trend: Life expectancy improved a great deal for several decades, particularly in the 1970s, then slowed down, leveled off, and finally reversed course after 2014, decreasing three years in a row.

《美国医学会杂志》对1959年至2017年期间全国的预期寿命和死亡率进行了调查。美国疾病控制与预防中心(U.S. Centers for Disease Control and Prevention,简称cdc)很快在2018年公布最终预期寿命数据。总的趋势是,在这几十年期间里,预期寿命在70年代大幅提高,然后下降,逐渐趋稳,最终在2014年之后开出现转折,进而出现连续三年下滑的情况。

“These kids are acquiring obesity in their early teen years, sometimes under the age of 10,” said S. Jay Olshansky, a professor of public health at the University of Illinois at Chicago. “When they get up into their 20s, 30s and 40s, they’re carrying the risk factors of obesity that were acquired when they were children. We didn’t see that in previous generations.”
“This isn’t a one-time phenomenon,” he added. “It’s going to echo through time.”

这些孩子在十几岁的时候就得上了肥胖病,有些还不到10岁,”伊利诺伊大学芝加哥分校的公共卫生教授s·杰伊·奥尔山斯基(S. Jay Olshansky)说道。“当他们到了20多岁、30多岁或40多岁的时候,他们在儿童时代埋下的肥胖基因届时就会显现出来。而我们在前几代人身上看不到这一点。”