One of the fundamental ways scientists measure the well-being of a nation is tracking the rate at which its citizens die and how long they can be expected to live.
So the news out of the federal government Thursday is disturbing: The overall U.S. death rate has increased for the first time in a decade, according to an analysis of the latest data. And that led to a drop in overall life expectancy for the first time since 1993, particularly among people younger than 65.
"This is a big deal," says Philip Morgan, a demographer at the University of North Carolina, Chapel Hill who was not involved in the new analysis.
"There's not a better indicator of well-being than life expectancy," he says. "The fact that it's leveling off in the U.S. is a striking finding."
Now, there's a chance that the latest data, from 2015, could be just a one-time blip. In fact, a preliminary analysis from the first two quarters of 2016 suggests that may be the case, says Robert Anderson, chief of the mortality statistics branch at the National Center for Health Statistics, which released the new report.
Anderson says government analysts are awaiting more data before reaching any definitive conclusions.
"We'll have to see what happens in the second half of 2016," he says.
Still, he believes the data from 2015 are worth paying attention to. Over that year, the overall death rate increased from 724.6 per 100,000 people to 733.1 per 100,000.
While that's not a lot, it was enough to cause the overall life expectancy to fall slightly. That's only happened a few times in the past 50 years. The dip in 1993, for example, was due to high death rates from AIDS, flu, homicide and accidental deaths that year.
On average, the overall life expectancy, for someone born in 2015, fell from 78.9 years to 78.8 years. The life expectancy for the average American man fell two-tenths of a year — from 76.5 to 76.3. For women, it dropped one-tenth — from 81.3 to 81.2 years.
"It's remarkable," Morgan says. "There are lots of things about this that are unexpected."
Most notably, the overall death rate for Americans increased because mortality from heart disease and stroke increased after declining for years. Deaths were also up from Alzheimer's disease, respiratory disease, kidney disease and diabetes. More Americans also died from unintentional injuries and suicide. In all, the decline was driven by increases in deaths from eight of the top 10 leading causes of death in the U.S.
"When you see increases in so many of the leading causes of death, it's difficult to pinpoint one particular cause as the culprit," Anderson says.
The obesity epidemic could be playing a role in the increase in deaths from heart disease, strokes, diabetes and possibly Alzheimer's. It could also be that doctors have reached the limit of what they can do to fight heart disease with current treatments.
The epidemic of prescription opioid painkillers and heroin abuse is probably fueling the increase in unintentional injuries, Arun Hendi, a demographer at Duke University, wrote in an email. The rise in drug abuse and suicide could be due to economic factors causing despair.
"Clearly, that could be related to the economic circumstances that many Americans have experienced in the last eight years, or so, since the recession," says Irma Elo, a sociologist at the University of Pennsylvania.
Whatever the cause, the trend is concerning, especially when the death rate is continuing to drop and life expectancy is still on the rise in most other industrialized countries.
"It's pretty grim," says Anne Case, an economist at Princeton University studying the relationship between economics and health.
RACHEL MARTIN, HOST:
We have sobering news this morning about the nation's health. For the first time in years, life expectancy has decreased. Here's NPR health correspondent Rob Stein.
ROB STEIN, BYLINE: One of the most fundamental ways to measure the well-being of a nation is to track the rate at which its citizens are dying and how long they tend to live. And Robert Anderson of the National Center for Health Statistics says the trend in the United States has been pretty consistent.
ROBERT ANDERSON: Over the last hundred years that we've been tracking these things, the death rate's declined pretty steadily with, you know, minor upticks here and there. But the trend long-term has been a decline.
STEIN: Leading to a fairly steady rise in how long people can expect to live. So Anderson was taken aback when he analyzed the government's latest data.
ANDERSON: What we're seeing is a slight increase in the overall rate for mortality.
STEIN: It ticked up just slightly between 2014 and 2015. That's the first time that's happened in a decade. And it was enough to cause the overall life expectancy to dip slightly for the first time since 1993.
ANDERSON: What we're seeing is a slight decline in overall life expectancy at birth, about a tenth of a year.
STEIN: It fell from 78.9 to 78.8 years in 2015. And even more disturbing in some ways, the drop occurred in the younger part of the population, not the oldest. Now, it's not clear why this is happening and it could just be a fluke. But the drop was driven by increases in deaths from 8 of the top 10 causes of death. Most notably, deaths from heart disease and strokes were up after declining for years. And more Americans are dying from unintentional injuries and committing suicide.
ANDERSON: When you see increases in so many of the leading causes of death, it's difficult to pinpoint one particular cause as the culprit.
STEIN: But it's probably a combination of factors. The obesity epidemic may be one, the epidemic of prescription painkiller and heroin overdoses may be another. But whatever the cause, experts say it's worrisome.
PHILIP MORGAN: This is a big deal.
STEIN: Philip Morgan is a demographer at the University of North Carolina.
MORGAN: There's not a better indicator of well-being than life expectancy. And most people expected it to go up several more years and in the next half-century. And for the effect that it's leveling off in the U.S., it's a striking finding.
STEIN: Especially when the death rate is continuing to drop and life expectancy is still on the rise in most other industrialized countries. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.