EDITORIAL

A Sign of Several Scary Trends

Death Rate Rises for First Time in Decade
Health Officials Aren’t Sure Why
Increase Has Nothing to Do with the Aging Population

T

he U.S. death rate rose last year, the first increase in a decade, health officials reported on June 1, 2016. This means that the year after year decline in American death rates has reversed course, as reported based on preliminary 2015 numbers for all causes of mortality as compiled by the CDC.1

The CDC examined changes in death rates per 100,000 people between 2014 and 2015, adjusting the findings to reflect an aging population as baby boomers head into their retirement years.

Only certain groups showed the increase in deaths. The leading reversals are deaths from drug overdoses (mostly prescription painkillers), suicide, and Alzheimer disease (AD). AD increases with age. Also this particular increase may have to do with deeper readings of the death certificates for more accurate causes (see “Alzheimer’s Deaths Rival Cancer’s” in the May 2014 issue).

However, how to account for the other increases, drug ODs, and suicide?

The death rate rose to 729.5 deaths per 100,000 people in 2015, up from 723.2 in 2014, according to the National Center for Health Statistics.1 It was one of the few times in the past 25 years that the rate has increased. A bad flu season pushed it up in 2005, AIDS and the flu contributed to a sharp increase in 1993. In 1999, there was a tiny increase. The age-adjusted death rate remained higher in 2015 than in 2014 (729.5 and 723.2, respectively).

Why the increase in drug ODs and suicide? Lethal drug overdoses rose from 14.0 per 100,000 people in early 2014 to 15.2 by mid-2015.

What are the possible explanations for the latest increases in deaths?

Because no clear explanations are available, experts said the current rise was surprising. Was the uptick in the death rate a statistical fluke? While the CDC will have final numbers at the end of this year, a single year does not create a trend. But according to some “experts,” the report may suggest that the American way of life is too often leading to an early death. But drug ODs and suicides?

From a demographic point of view, this probably reflects psychosocial turmoil of the economy. Moreover, it compares with the collapse of the Russian economy following the breakup of the Soviet Union in the 1990s. Then, Russia underwent drastic and economic changes. Numerous factories were closed, a large number of people became unemployed, and the government was no longer able to pay salaries to civil servants and pensions to retirees on time. Lots of cirrhosis, alcohol ODs, and suicides made the 1990s look like a civil war was happening, with 7 to 9 million or even as many as 12 million (the statistics are murky) extra deaths

In the U.S., death rates — measured as the number of deaths per 100,000 people — have been declining for years, an effect of improvements in health, disease management and medical technology.


The leading reversals are deaths from
drug overdoses, suicide, and
Alzheimer disease (AD).


While recent research has documented sharp rises in death rates recently among certain groups — in particular less educated whites, which have been hardest hit by the prescription drug epidemic—increases for the entire population are relatively rare.

What’s the significance of an uptick?

According to Robert Anderson, the chief of mortality statistics at the National Center for Health Statistics, part of the CDC, “It’s an uptick in mortality and that doesn’t usually happen, so it’s significant.”2 But what it means is the real question. If the data for 2016 shows another rise, there will be a lot more concern.

“We are not accustomed to seeing death rates increase on a national scale.” This quote was from Andrew Fenelon, a researcher at the CDC. “We’ve seen increases in mortality for some groups, but it is quite rare to see it for the whole population.”2

Fenelon added that the United States would fall further behind its European peers: “Many countries in Europe are witnessing declines in mortality, so the gap between the U.S. and other countries is growing.”2

Other researchers thought the finding seemed to fit the broader pattern of rising mortality among working-class whites,3 for which a trend has drawn significant attention recently. (See “Lithium Helps Prevent Suicide” in the May issue of this publication.) This trend is even more apparent in those with no more than a high school education. Other research has found rising rates among younger whites.

Narrowing the Case

“This is probably heavily influenced by whites,” said Sam Harper, an epidemiologist at McGill University in Montreal who told the New York Times,2 “It does sort of fit together.” Bingo, Dr. Harper!

Who wants to talk about disadvantaged whites killing their pain with prescription drugs and taking their lives.

The rate for Alzheimer’s disease (AD) was also up, rising to 29.2 in 2015, compared with 25.4 in 2014, although as pointed out this may have been compounded by more accurate reporting. However, maybe it really is rising.

Perhaps the public is increasingly aware that the growing AD problem is a reflection of the “zombie apocalypse” It is interesting to note that people with late-stage dementia uncannily resemble the mindless and often violent zombies of modern horror movies. This mentality among the young could be another reason they are ODing on prescription painkillers.

References

  1. Vital Statistics Rapid Release. http://www.cdc.gov/nchs/index.htm. June 1, 2016. Accessed: June 1, 2016.
  2. Travernise S. First U.S. death rate in years surprises experts. The New York Times. June` 1, 2016. http://www.nytimes.com/2016/06/01/health/american-death-rate-rises-for-first-time-in-a-decade.html. Accessed June 2, 2016.
  3. Case A, Deaton A. Reply to Schmid, Snyder, and Gelman and Auerbach: Correlates of the increase in white non-Hispanic midlife mortality in the 21st century. Proc Natl Acad Sci U S A. 2016 Feb 16;113(7):E818-9.

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