Smoking is a leading cause of preventable death.Jianan Yu / Reuters

Three reports released by the Centers for Disease Control and Prevention on Thursday paint a bleak picture of a country in which people are growing sick, using drugs, and dying young—many of them by their own hand.

American life expectancy is continuing its recent decline, according to the CDC’s latest statistical release. Americans are dying at an average age of 78.6. Though that is roughly the same life expectancy the CDC reported last year, the agency called it a decline of a tenth of a year. The drop has been driven significantly by 70,237 deaths from drug overdoses. For comparison, that number’s nearly equal to the entire population of Bismarck, North Dakota’s capital. In 2016, a fifth of all deaths among Americans aged 24 to 35 were due to opioids.

Health experts typically expect longevity to increase as the economy grows and more health advancements are made, so the fact that life expectancy has been flat or trending downward for years now is concerning.

This data point, says Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, “confirms that there’s a profound change in the trajectory of mortality. This should really be getting everyone’s attention in a major way.” By comparison, life expectancy in Europe in 2016 was 81, but Murray says other high-income countries are also seeing a flattening out of life expectancy, thanks in part to the obesity epidemic.

The report found that Americans are also dying at a faster rate: Deaths are up 0.4 percent in the past year. The age-adjusted death rate rose for black men, white men, and white women.

Age-adjusted death rates, by race, ethnicity, and sex, in 2016 and 2017 (CDC)

“Sadly, this result confirms what many suspected based on data coming out earlier this year: that we continue to lose ground due in large part to preventable causes of death like overdose, suicide, and for deaths due to chronic lower-respiratory diseases, many of which are attributable to tobacco use,” said Ellen Meara, a professor of health economics at Dartmouth College.

Young people are being hit especially hard. Death rates increased by nearly 3 percent for people aged 25 to 34, and by 1.6 percent for Americans aged 35 to 44.

The uptick in overall deaths was driven by the usual suspects: the prevalence and lethality of Alzheimer’s disease, diabetes, and the flu, which was more severe than usual last year. But there were also large increases in deaths from unintentional injuries, a category that includes drug overdoses. The rate of drug overdoses rose by nearly 10 percent from 2016 to 2017, largely due to the use of fentanyl and its analogues.

There’s also been a major rise in suicides, up 3.7 percent in the past year alone. Since 1999, the suicide rate among women has gone up 53 percent, while for men it’s increased by 26 percent. Experts have attributed this rise to economic woes, physical-health problems, deteriorating relationships, and mental-health issues.

Suicide, which has always been more prevalent in rural areas, has become even more common in rural counties compared with urban areas. The suicide rate in the most rural counties has risen by 53 percent since 1999, according to the CDC. Rural areas tend to have less access to mental-health services. One study attributed the difference to the fact that people in rural areas were more likely to attempt suicide with guns, which are more lethal than other means. When firearms are controlled for, the study found, suicide rates in rural and urban areas were similar.

The only bright spots? Deaths from heart disease have slightly declined, and the rate of growth in drug-overdose deaths has slowed a bit. “I think the overall message is that whatever we are doing in the U.S. to improve health and survival in our population,” Meara said, “we need to do more.”

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