Node Smith, ND

For the better part of a century, life expectancy in industrialized countries like the United States steadily improved. But during the past three decades, and particularly since 2010, the trend has slowed or, in some places, reversed for non-Hispanic white populations in the U.S. It’s been especially stark for 25- to 44-year-olds and for women, as well as in rural communities.

Life expectancy trend has slowed or, in some places, reversed for non-Hispanic white populations in the U.S.

Those are the key findings of research from University of Pennsylvania demographers Irma Elo and Samuel Preston and colleagues, which they published in the journal Population and Development Review.

The trends vary by region

Large central metropolitan areas have done extremely well, particularly compared to the non-metropolitan areas that have done poorly. To varying degrees, that pattern is evident across the country,” said Irma Elo, a professor of sociology and part of Penn’s Population Studies Center (PSC).

The mortality trajectory of non-Hispanic whites in the U.S. has worsened

In the past 10 or so years, the mortality trajectory of non-Hispanic whites in the U.S. has worsened, diverging from progress seen for Hispanic and non-Hispanic black populations. This prompted Elo and colleagues to take a closer look at what was happening with this population and why. They also broadened their focus to include adults as young as 25 and as old as 64.

National Center for Vital Health Statistics data compiled into four locality categories

To draw their conclusions, they analyzed age, sex, race/ethnicity, and cause-of-death data compiled by the National Center for Vital Health Statistics, then estimated death rates by age, year, and geographic region. Finally, they distilled the data into four locality categories: large central metropolitan areas, large metro suburbs, small/medium metros, and non-metros.

The biggest contrast

“The biggest contrast we saw was between large metropolitan areas and their suburbs and non-metropolitan areas, which have moved in different directions,” says Preston, a Penn professor of sociology and member of the PSC. “Between 1990 and 2016, non-metropolitan areas had rising mortality, which is extremely unusual in the context of life expectancy that has gotten better nearly every year for nearly every group for more than a century.”

Women in general and younger adults

Women in general and younger adults also didn’t fare well, the former perhaps because of educational disparities, the latter largely due to drug overdoses. Though the opioid epidemic initially seemed gravest in Appalachia and other non-metropolitan areas, it has since proven much more widespread.

One plausible cause for the bleak mortality trends

It’s one plausible cause for the bleak mortality trends for non-Hispanic whites as a whole. Elo and Preston also point to increases in mortality from mental and nervous-system disorders and respiratory disease, likely a lingering result of the smoking epidemic.

“Compared to other countries in 1990, the U.S. started out doing very poorly, and we are now in a much worse situation,” says Preston. “But there are two pieces of good news: The decline in HIV/AIDS mortality has been important in all central metros, but particularly in the mid-Atlantic, south Atlantic, and some of the Pacific region. And there have been declines in cardiovascular diseases pretty much everywhere.”

Screenable cancers

Plus, he adds, deaths from screenable cancers like prostate, breast, cervical, and colon cancer are down in all areas, too.

More in-progress research from this team

Other in-progress research from this team looks at non-Hispanic black populations and the U.S. population as a whole. But Elo says the work this paper highlights is an important step toward grasping and potentially reversing the negative trend. “There’s a lot to be done to try to understand what’s driving these patterns and, most importantly, what could be done to change them,” she says. “I don’t think anyone has the crystal ball yet for how to do it.”

Source:

1. Elo, I.T. et al. (2019) Trends in Non‐Hispanic White Mortality in the United States by Metropolitan‐Nonmetropolitan Status and Region, 1990–2016. Population and Development Review. doi.org/10.1111/padr.12249.

Node Smith, ND, is a naturopathic physician in Humboldt, Saskatchewan and associate editor and continuing education director for NDNR. His mission is serving relationships that support the process of transformation, and that ultimately lead to healthier people, businesses and communities. His primary therapeutic tools include counselling, homeopathy, diet and the use of cold water combined with exercise. Node considers health to be a reflection of the relationships a person or a business has with themselves, with God and with those around them. In order to cure disease and to heal, these relationships must be specifically considered. Node has worked intimately with many groups and organizations within the naturopathic profession, and helped found the non-profit, Association for Naturopathic Revitalization (ANR), which works to promote and facilitate experiential education in vitalism.

Node Smith graduated from the National University of Natural Medicine (NUNM) in 2017, and is currently licensed as a naturopathic physician in Oregon and working towards becoming licensed in Saskatchewan, Canada as well.