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What's Behind Decreased Life Expectancy In The U.S.

LULU GARCIA-NAVARRO, HOST:

There's been alarming data about the quality of life in the United States. First, a new study published last week in the Journal of the American Medical Association found that life expectancy in the U.S. has decreased and that working-age Americans are less likely to live to retirement age than previous generations.

And then there's also this - at a time of low unemployment, most of the jobs now created are in the service industry and are low-paying. That information comes from the Job Quality Index, which says jobs are plentiful, but good jobs are not.

Ohio is one of the states that's seen a dramatic decline in life expectancy, as it's continued to struggle with the loss of manufacturing jobs and the opioid crisis. And so we wanted to talk about how these two reports intersect. Amy Bush Stevens is the vice president at the Health Policy Institute of Ohio. And she joins us now. Welcome.

AMY BUSH STEVENS: Thank you for inviting me.

GARCIA-NAVARRO: So what is the average life expectancy in your state?

BUSH STEVENS: The average life expectancy at birth in Ohio in 2017 was about 77 years. And that is a drop of about one year in a seven-year span, which is really striking, given that for several decades, we saw this trend going in the other direction. We saw our lives getting longer. And now we've seen this pretty dramatic reversal.

GARCIA-NAVARRO: How does that break down among racial and ethnic lines?

BUSH STEVENS: We see large disparities by race in our state. We also see large disparities by geography. We found that there is a more than 29-year gap in life expectancy...

GARCIA-NAVARRO: Wow.

BUSH STEVENS: ...Depending on where a person lives in Ohio - really incredible. And if you think about gaps like that - 29 years. You know, that's 29 years that someone is not able to spend with their grandchildren, to volunteer in their community, to be with family at holidays.

GARCIA-NAVARRO: And what do those geographic gaps look like? I mean, what are we talking about - rural, urban or not even that?

BUSH STEVENS: Well, the areas of the state that have the longest life expectancy tend to be in our suburban communities, which are doing better economically. The shorter life spans are happening in some of our urban communities, certainly, shorter lifespans for African Americans and then in, also, some of our rural and Appalachian counties.

GARCIA-NAVARRO: We know the so-called diseases of despair - drug addiction, suicide, alcoholism - are driving down these stats. But what are some of the other health issues affecting people in Ohio?

BUSH STEVENS: Chronic disease. Cancer and heart disease are the second- and third-leading causes of premature deaths. Diabetes and respiratory diseases are also trending up.

GARCIA-NAVARRO: When you looked at these statistics and you saw the reversal, I mean, how worried as a health professional are you?

BUSH STEVENS: We were very concerned. Certainly, the overdose death numbers are really driving this. But we think that it's important that we continue to focus on tobacco. Ohio has much higher rates of smoking among adults with low incomes and lower educational levels and for people with mental illness and disabilities. We also know that people who have experienced trauma are much more likely to smoke. You know, imagine, for example, a woman who has lost her son to an overdose death and is now raising her grandchildren with special needs. Quitting smoking is probably not her top priority. In fact, she might see smoking as a way to cope with the stress. So all of these issues are really connected. And we need to be doing more to help people quit and help people struggling with addictions.

GARCIA-NAVARRO: When you look at these statistics and you see that, you know - that there is trouble for families to get nutritious food, to get access to the health care that they may need - even though your state expanded Medicaid - what does that tell you about the intersection between how long we live and how much money we make?

BUSH STEVENS: Ohio is an interesting example here because we have a fairly low uninsured rate compared to other states. But we know that access to care is necessary but not sufficient for good health. If you think about what shapes your own health in your day-to-day life, it's really things like, how much stress do you have on a daily basis? And that's why it's really important for our approach to take into account all of these different factors and bring different partners together - so bringing housing partners to the table, transportation partners, focusing on education outcomes. That's really going to give us the biggest bang for the buck in terms of improving health.

GARCIA-NAVARRO: Amy Bush Stevens is the vice president at the Health Policy Institute of Ohio. Thank you very much.

BUSH STEVENS: Thank you so much. Transcript provided by NPR, Copyright NPR.