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Friday, January 12, 2018

What If American Life Expectancy Declined Again and the Elite Cared More About Trump’s Tweets?

The news came and went so fast that you might have missed it. American life expectancy has declined. Again. In 2015 and 2016, in fact, the average American life span declined for two years in a row for the first time in more than 50 years.

The preliminary numbers for 2017 are looking grim as well. Multi-year declines are typically attributable to war or disease outbreaks. In America? Our decline is based largely on our capacity for self-harm, as the Washington Post explained: The 2016 data shows that just three major causes of death are responsible: unintentional injuries, Alzheimer’s disease and suicides, with the bulk of the difference attributable to the 63,632 people who died of overdoses. That total was an increase of more than 11,000 over the 52,404 who died of the same cause in 2015. 

 To put that overdose number in perspective, in one year more Americans died of overdoses than were killed during the entire course of the Vietnam War. The toll dwarfs the number of homicides. It’s almost double the number who were killed in car accidents. It’s a stunning number, and it’s supplemented by a terrifying surge in suicides. The rate hit a 30-year high in 2014 and just kept on climbing. Earlier this week — after the news of decreased life expectancy barely caused a media ripple — Vox’s German Lopez tweeted this:

It’s an excellent, thought-provoking point. Make no mistake, there has been a great deal of good reporting on the crisis. Lopez’s own work has been invaluable. Salena Zito has written powerfully about the existential crisis that grips so many residents of “flyover country.” The Washington Post and the New York Times have done important work. The list could go on. But Lopez is right — there’s no comparison between the amount of coverage of the decline in life expectancy versus the amount of coverage we’d see after two consecutive years of economic downturns. 

There’s one aspect I’d dispute, however. I don’t think it’s precisely true that the “money we make has come to mean more” than “basic well-being.” I think it’s more true that partisan gamesmanship (wherever it can be found) means more. There’s almost always a partisan hook to the economy — the public tends to hold presidents responsible for the health of the American market. There’s a partisan hook to foreign policy. There’s a partisan hook to Trump’s tweets. 

That’s what energizes our political and media elite. 

If there were a clear partisan hook to the opioid crisis, it would dominate public debate. Or perhaps I’m too ungracious. Perhaps the better answer is that media and lawmakers tend to focus their energies on problems they believe they can fix. The best media coverage of the opioid crisis tends to teach us that when it comes to drugs — especially opioids — hope is hard to find and there are no easy answers. It is hard to look on the staggering cultural toll and the long odds that confront each and every addict and not simply do what so many families do — give in to despair. If you’ve lived long enough, I’d guess you probably know an addict, and if you know an addict, you know that there are no simple answers — nor any government programs — that guarantee a positive result. “More resources” is perhaps the easiest request, and it’s a good request. We do need more drug-treatment centers. 

We need more access to quality rehabilitation facilities. But talk to wealthy families who’ve spent hundreds of thousands of dollars at the best rehabilitation centers in the land only to find brothers, husbands, and fathers unconscious under a bridge months, weeks, or sometimes only days later. No amount of money (and no amount of treatment) can guarantee an outcome when the thing that will kill an addict is the very thing he wants most in life. Moving beyond the government, not even “more love” works. How many families have expended every ounce of their emotional energy on the people they love the most, only to discover a body in the bedroom — sometimes on the very day when they had the most hope? Moreover, the challenge is compounded by the fact that the crisis is worst in the communities most disconnected from social and economic support.

 I wrote last October about some disturbing findings from Senator Mike Lee’s invaluable Social Capital Project. Less-educated individuals are more likely to overdose, but look at the statistics on marriage: Married and widowed Americans account for 68 percent of the population but only 28 percent of overdose deaths. “In contrast, never-married and divorced Americans made up about 32 percent of the population, but accounted for 71 percent of all opioid overdose deaths.”

 In that piece I wrote about the necessity of family repair as a means of confronting the crisis, but I fear that using those words doesn’t sufficiently convey the complexity of the task. Family repair is an immense cultural challenge, yet success in that immense challenge isn’t foolproof. The best of families can still face the scourge of addiction. The most loving wives lose their husbands. The best parents still lose their children.


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