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The average length of an American life continues to decrease. And if you have been paying attention to the opioid crisis, you won't be surprised to learn that drug overdoses and suicides and accidents are playing a major role. Now, these numbers reported today by federal health officials come after decades of substantial improvement, improvement driven largely by declining heart disease rates. NPR's Richard Harris looks at what it would take to turn this trend around.
RICHARD HARRIS, BYLINE: The annual report from the Centers for Disease Control and Prevention breaks down deaths by categories. Cancer is down. Alzheimer's and strokes are up. But Kate McHugh, a psychologist at Harvard and McLean Hospital, says two of the most concerning categories - drug overdose deaths and suicides - aren't entirely separate.
KATE MCHUGH: It's much more of a continuum where someone might have significant suicidal thoughts prior to an overdose. They might have moderate suicidal thoughts. You know, at times it might be more ambivalence. I know I might die, but I don't care. I just want to feel better. So there's a tremendous amount of overlap between the two.
HARRIS: She would also include another big category in that continuum. Deaths listed as accidents, also on the rise, may in some cases be among people who are on the edge of despair and will leave it to fate whether they live or die. Framing the problem in this way helps determine what needs to be done about it. Many deaths beyond the overdose category are driven by the opioid epidemic. And McHugh says the trend tells us that national efforts to address the drug abuse problem are still falling far short of what's needed. And what's needed isn't a mystery.
MCHUGH: In the states that have engaged more people with medication-assisted treatment and have increased access to treatment, the overdose rates are lower. And they're dropping faster.
HARRIS: And McHugh says we're not doing nearly enough to approach this problem from the other direction, that of despair.
MCHUGH: There's not nearly enough happening in terms of mental health and psychiatric care, which speaks to this suicide issue. I don't think we're doing nearly enough in terms of increasing access to psychiatric treatment for things like depression, anxiety, trauma-related disorders, all of which are risk factors for developing opioid-related problems.
HARRIS: The challenges aren't simply to provide medical care, she says. We need to change the social conditions that are driving people to drug dependence and despair. Bill Dietz, a public health expert at the George Washington University, thinks a lot about these factors, the social determinants of health.
BILL DIETZ: Which include things like employment or good housing or access to good food and recreational facilities. We need to connect people back together the way this country was connected 30 years ago.
HARRIS: That's a tall order.
DIETZ: (Laughter) Yeah, but the health of the country depends on it. And I think these data tell us that there's a fundamental problem in the United States that we have to come to terms with.
HARRIS: This isn't just about drugs and hopelessness, Dietz notes. The nation also has an obesity epidemic affecting 40 percent of adults. And that will ultimately lead to more deaths from heart disease, stroke, certain cancers, kidney disease and diabetes. That's a looming health disaster confronting the United States in the years to come. Richard Harris, NPR News.
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