As life expectancy falls across US, Mass. bucks trend
A baby born in Massachusetts in 2016 can expect to live 80 years and eight months, three months longer than one born the previous year, according to a new report showing that Massachusetts is bucking the national trend toward shorter life spans.
State health officials attributed the increase in average life expectancy to years of health promotion efforts, such as antismoking campaigns, and near-universal health insurance. But they noted that life expectancy would be even higher were it not for deaths from opioid overdoses, which reached a record 2,154 in 2016.
“Massachusetts has for a long time invested in a number of conditions that create health,” such as access to healthy food, places to exercise, and protections from gun violence, said Dr. Sandro Galea, dean of the Boston University School of Public Health.
The annual report from the state’s Department of Public Health also reveals stark differences in the health of blacks and Hispanics, who have longer life expectancies than whites, but die at younger ages from heart disease and cancer. The reasons for the differences are not fully understood.
Nationwide, life expectancy averaged 78 years and eight months in 2016, the same as in 2015 and two months shorter than in 2014. It declined an additional month in 2017, a phenomenon blamed on overdoses and suicides. (Massachusetts data for last year are not yet available.) The Massachusetts suicide rate has been increasing but remains among the lowest in the nation.
The average life expectancy in Massachusetts has changed little since 2006, hovering around 80 years, with small fluctuations. It peaked at 80 years and 11 months in 2012 and 2013.
Overall there were 832 fewer deaths in 2016 than in 2015. But among blacks, deaths increased. Cancer was the leading cause of death, and lung cancer the leading cancer killer. Cancer death rates were highest among whites, but blacks and Hispanics died of cancer at earlier ages.
On an average day in 2016 in Massachusetts, 156 people died, including 35 from cancer, 33 from heart disease, 14 from respiratory conditions, and 13 from injuries. Of the injuries, an average of seven deaths were from poisoning — nearly all opioid overdoses — and two were suicides.
“We would likely see higher rates of life expectancy if we were not losing so many young people due to the opioid epidemic,” said Abigail R. Averbach, assistant commissioner and director of the Office of Population Health.
“Massachusetts is rated among the healthiest states in the nation. We’re always in the top two or three,” Averbach said. “We have consistently seen decreases in chronic health conditions such as heart disease and cancer.”
The state’s efforts to reduce smoking down to 14 percent of adults was a “key driver” of the reduction in chronic illness, she said.
Having near-universal health insurance also plays a role, Averbach said.
But Galea, the BU dean, doesn’t see health insurance as a big factor. “At the end of the day, health care is a small part of what produces healthy, long lives,” he said.
Instead, good health emerges from the cumulative effects of various advantages, from early childhood education to nutrient-rich foods to safe, walkable neighborhoods. Low rates of firearm injuries and obesity in Massachusetts have contributed to the increased life expectancy, Galea said.
Similarly, the poorer health of black people in Massachusetts “tracks back to the same conditions — reduced life opportunities, lower education, worse neighborhoods,” Galea said.
The infant mortality rate — almost three times higher for blacks than whites in Massachusetts — is a good illustration. “It’s not a health system issue. It’s an issue of social and economic opportunity,” Galea said.
A pregnant black woman is more likely than a white one to live in substandard housing, have limited access to nutritious food, work multiple jobs, and face daily stress, he said. Any of those factors can contribute to premature birth or low birth weight, the leading causes of infant death.
Dr. Monica Bharel, state public health commissioner, said in a statement that closing the gap in health between whites and other groups was “a major focus” of her office. “This annual report plays a key role in helping us to shape our prevention efforts so they are targeted where they are most needed to reduce those disparities,” she said.
Other findings in the report:
■ Hispanic women had the highest life expectancy in Massachusetts, living on average to age 89. Averbach said that this probably results from a phenomenon seen elsewhere in the country called the “salmon effect”: “Elderly Hispanics who are unwell will have a tendency to migrate toward their country of origin at the end of life,” leaving behind healthier people destined to live longer, she said.
■ Across the board, whites had lower life expectancy than blacks and Hispanics. Health officials attributed this seeming paradox to the toll of the opioid epidemic. Deaths among young people drive down the average life expectancy, and the highest death rates from opioid overdoses are among whites.
■ Blacks and Hispanics died from cancer at younger ages than whites and Asians.
■ Blacks, Hispanics, and Asians died from heart disease at younger ages than whites.
■ The rate of suicide deaths among whites was almost double the rates for blacks, Hispanics, and Asians.