As America declines, so does the life expectancy of Americans.

Do we need a "national strategy" or a national awakening?

In this post from last May, I cited the following facts, among others, to support my argument that America is in decline:

Homicides have skyrocketed in recent years. On average, adjusted for age, the annual U.S. suicide rate increased by 30 percent between 2000 and 2020.

There’s an epidemic of drug abuse, such that approximately one million Americans have died from overdoses of fentanyl since 1999. A provisional count from the CDC found that more than 105,000 Americans died due to drug overdoses in 2022.

According to Gallup, 29 percent of U.S. adults report having been diagnosed with depression at some point in their lifetime, nearly 10 percentage points higher than in 2015. The percentage of Americans who currently have, or are being treated for, depression has also increased, to 17.8 percent, up about seven points over the same period. . . .

The U.S. fertility rate is now 1,784 births per woman. In 2007, the rate was 2.052.

I should have tied this grim statistical package together with the following fact: Life expectancy in the U.S. has fallen to 76.4 years and the slide has left us trailing Canada, nearly every major European nation, and China.

Today’s Washington Post features a long article about the situation. It’s called “America has a life expectancy crisis. But it’s not a political priority.”

The Post assumes that increasing life expectancy should be a political priority. And it finds support for this position from Sens. Bernie Sanders and Elizabeth Warren who want to parlay the issue into a vast expansion of federal power over the lives of Americans.

But before calling for such an expansion, we must ask what’s causing the decline in life expectancy. The Post doesn’t spend much time on this question, but does mention some contributing factors.

Among them are two that I included in my discussion of American decline: drug overdoses and suicides. The Post also points to gun violence and auto accidents, along with “chronic disease, poor nutrition, and insufficient access to care.”

I think we can dismiss “insufficient access to care” as a factor in the decline. Access to health care may be “insufficient,” but I doubt there is less of it now than there was before Obamacare expanded free and partially subsidized health care. Yet, life expectancy has been declining.

As to the other contributors, they can be encapsulated in this statement: Americans aren’t taking care of themselves as much and as well as we used to.

Americans are using deadly drugs more than before. They are joining gangs and criminal enterprises more than before, and therefore shooting more people than before.

They are probably less attentive to their mental health and that of their children than before. They are probably driving more recklessly than before.

Americans are eating more, and less wisely, than before. Hence, the epidemic of obesity — something the Post doesn’t mention, but that definitely is shortening the lives of Americans.

I don’t know whether Americans are getting as much medical care as before, but if they aren’t, at a time when the government is subsidizing more medical access than ever, it’s very likely because Americans aren’t seeking as much care as before.

All of these contributing factors are symptoms of our national decline. As Sen. Chris Murphy told the Post, “Americans are just much less physically and spiritually healthy than they have been for a long time.”

If my diagnosis is correct, what conclusions follow about how to improve life expectancy?

The Post describes two approaches. One focuses on improving discrete factors linked to life expectancy. For example, it’s possible that better enforcement at the border and more treatment centers would reduce deaths from drug overdoses. More proactive policing, increased prosecutions, and longer criminal sentences would likely reduce the number of homicides. (It has happened before.) If there are gun control measures that would reduce gun violence and pass constitutional muster (I’m not persuaded that there are), they could be implemented.

The other approach is a grand national project. Sen. Warren offered a glimpse of its magnitude, but not its content when she said:

We’re no longer an America that talks about building a national highway system or sending a man to the moon, and yet it’s that kind of reach and ambition that we need to have to tackle the declining longevity problem.

(Emphasis added)

When leftists say “reach,” I hear “overreach.” When they talk about “sending a man to the moon,” I think of the non sequitur, popular half a century ago, that if we can accomplish this, then surely we can end poverty.

We couldn’t. All we could do was declare war on it, and proceed to establish a lot of government programs, many of which were failures and some of which may have been counterproductive.

Sen. Sanders wants more health care reform, by which, I assume, he means socialized medicine. Would this improve health care outcomes?

I don’t know. But based on the Post’s report, it doesn’t seem that the expanded access to subsidized health care provided by Obamacare has improved outcomes. Moreover, according to the Post, “life expectancy in the United States was once a source of national pride.“ At that time, our health care system was less socialized than it is now.

Sanders says:

Sometimes, we may, in the midst of our work, lose sight of the big picture … to create a nation in which the people in the United States can live long, healthy, happy and productive lives.

Put aside the overreach implicit in the phrase “create a nation” and note the question-begging nature of Sanders’ statement. The Senator is assuming that America is not a nation in which its people can live long, healthy lives. But that’s actually the question that needs to be answered at the threshold.

What if, as I have claimed, we are a nation whose people can live long and healthy lives, and the reason why people aren’t living them is their own choices and behavior? If that’s the case, the solution to the decline in longevity is better choices and behavior. And if this becomes a government-imposed solution, it will entail a huge amount of government coercion.

The Sanders/Warren approach will make us less free. It’s unlikely to make us healthier.

Addressing the discrete contributors to declining longevity one-by-one (where feasible) will mean less loss of freedom. But the increase in longevity will likely be quite marginal.

Only arresting our national decline through a national awakening is likely to make life expectancy in the U.S. a source of national pride, as the Post says it once was. But I see no sign of such an awakening in a nation that’s sleepwalking towards a Biden-Trump rematch.