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The United States is forecasted to experience stagnation in life expectancy gains by 2050, as health progress fails to keep pace with peer nations, according to a new analysis published in The Lancet. Conducted by the Institute for Health Metrics and Evaluation (IHME), the study examined life expectancy (LE), mortality, and morbidity trends across all 50 states and Washington, D.C., from 1990 to 2050.
Declining Global Ranking
The study revealed that U.S. life expectancy is expected to rise modestly, from 78.3 years in 2022 to 80.4 years in 2050, but this increase will not be enough to maintain the nation’s global ranking. The U.S. is projected to fall from 49th in life expectancy in 2022 to 66th in 2050 among 204 countries and territories included in the Global Burden of Disease (GBD) study.
Healthy life expectancy (HALE), which measures the average years lived in good health, is also set to decline in global standing, from 80th in 2022 to 108th by 2050. Women in particular face a sharper decline, with female life expectancy ranking projected to plummet from 19th globally in 1990 to 74th in 2050.
Key Drivers of Health Stagnation
While mortality rates for leading causes of death like ischemic heart disease, stroke, and cancer have decreased significantly since 1990, these gains are overshadowed by rising rates of chronic diseases linked to lifestyle factors.
Obesity is highlighted as a critical concern, with over 260 million Americans projected to be affected by 2050. This dramatic rise in obesity rates poses a severe risk for conditions such as diabetes, cardiovascular diseases, and hypertension.
Drug-related mortality rates also present a grim outlook. Deaths from drug use disorders, including opioids and amphetamines, have surged by 878% since 1990 and are expected to climb an additional 34% by 2050. This will solidify the U.S.’s position as the country with the highest drug-related death rate globally.
Health Disparities Across States
Significant disparities persist across states. For instance, while New York is forecasted to have the highest life expectancy in the U.S. by 2050, it will rank only 41st globally, a decline from its 33rd place in 1990. Hawaii, once a global leader in life expectancy, is expected to drop to 43rd by mid-century.
Women in certain states, including Ohio, Tennessee, and Indiana, are particularly vulnerable, with HALE predicted to decline by 2050. In contrast, states like Arizona, Idaho, and North Dakota are expected to maintain stable female HALE levels.
Call for Action
Experts stress the urgency of addressing key risk factors like obesity, high blood sugar, and smoking to mitigate the decline in health outcomes. IHME forecasts indicate that eliminating these risks could prevent millions of deaths by 2050, though it may not be enough to close the gap with other high-income countries.
Dr. Christopher J.L. Murray, IHME’s director, called obesity a “public health crisis of unimaginable scale,” urging immediate action to address its root causes. Co-senior author Dr. Stein Emil Vollset emphasized the importance of systemic changes, including expanding access to preventive care and universal health coverage.
Economic and Global Implications
The stagnation in U.S. health progress has broader implications for the economy and global influence. Poor health outcomes reduce workforce productivity and increase healthcare costs, potentially undermining the nation’s economic competitiveness and geopolitical standing.
IHME’s findings underscore the critical need for policymakers, health professionals, and community leaders to collaborate on transformative health policies. As Dr. Ali Mokdad of IHME put it, “The rapid decline in U.S. global health rankings rings the alarm for immediate action to reverse these troubling trends.”
Looking Ahead
The comprehensive study highlights the pressing need for the U.S. to revamp its approach to health, with a focus on prevention, education, and equitable access to care. As the nation grapples with these challenges, the path forward requires bold leadership and innovative solutions to safeguard the future of American health.
For more details, the full study is available in The Lancet.
