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There’s no good precedent for this very American crisis

Why one problem stands out ahead of Biden's 2023 State of the Union.
Photo Illustration: A collage of Chris Hayes and Joe Biden with multi-colored dots
There is a story here about the dark side of American exceptionalism. MSNBC / Getty Images

The State of the Union address is an opportunity to identify the problems a president wants to solve. And as we survey American life in 2023, I think there is one problem that really stands out, an issue that embodies a lot about the level of acute crisis in our society.

The declining life expectancy for Americans.

Countries that are growing, rich and healthy generally do not see sharp drops in life expectancy, unless something huge and terrible happens.

Countries that are growing, rich and healthy generally do not see sharp drops in life expectancy, unless something huge and terrible happens. Like the 2021 study that showed “life expectancy plummeted in the successor states of the former Soviet Union in the early 1990s” immediately after the fall of the USSR. Or in Syria, where there was a six-year drop in life expectancy during the early years of that country’s brutal civil war.

Clearly, neither of those things is happening here. But something is happening, and there’s no good precedent for it.

President Joe Biden will deliver his second State of the Union address on Tuesday at 9 p.m. ET. Follow msnbc.com/sotu for live updates and analysis from experts and insiders.

For more than a century, life expectancy in this country rose steadily. Every new generation could expect to live longer than its parents. And that is something you typically see as a country attains more wealth; one of the benefits is a longer lifespan. Then something happened.

Life expectancy in the U.S. peaked in 2014, at just shy of 79 years, plateauing there until the pandemic. Then, it began to drop. The graph line just falls away, to a level we have not seen since 1996.

And of course, the pandemic is a big part of this decline over the last few years in places beyond the U.S.

Other wealthy, developed peer countries experienced drops in life expectancy during the pandemic. But on average, those countries suffered smaller drops and have recovered nearly all of the lost years. The U.S., meanwhile, remains in an apparent free fall.

There is a story here about the dark side of American exceptionalism.

As an example, World Bank data shows France has a gross domestic product just shy of $3 trillion. That’s roughly where the U.S. was in 1980, meaning France is about 40 years behind us in terms of economic growth. But a Kaiser Family Foundation analysis found that people in France can expect to live about 6½ years longer than Americans. In fact, our current life expectancy is comparable to the French life expectancy in 1987.

Now, this is clearly not a story of money. America cannot use its economic muscle to just buy its way out of this problem. We already spend more on average than anyone else in the world on health care, and we still live shorter lives than people in our peer countries.

This is clearly not a story of money. America cannot use its economic muscle to just buy its way out of this problem.

The U.S. is an extreme outlier, showing that something is deeply wrong. And there are several factors we can point to as sources of this problem. The most obvious is our handling of the pandemic. It continues to be deadlier here than almost any other OECD nation, and a bloc of eastern European countries in the early waves. That is likely because, in large part, we were already suffering through worse health outcomes than many other countries going into the pandemic. On top of that, only about 16% of the eligible U.S. population have received their bivalent booster shots, despite widespread availability.

But this life expectancy issue is one that existed long before the pandemic supercharged it. We have far more gun violence cutting lives short than any other peer country, with our homicide rate climbing in recent years. Suicides, which are the leading cause of gun deaths, are also rising again after a brief decline. After years of decline, traffic deaths are rising to levels not seen since the early 2000s. Preliminary numbers show that 2021 was a particularly deadly year on the roads. And overdose deaths are shockingly high. More than 107,000 people died of drug overdoses in 2021 alone. Overdose numbers have been trending in the wrong direction for years now, hitting certain sections of the country particularly hard.

So if we put all this together, we find that one of the richest countries in the world is losing ground in the most precious, irreplaceable resource that exists: the lives we have on this planet. It bears repeating: Something is profoundly wrong. It is the job of leaders in our government to identify those problems and fix them.

So if I were advising President Joe Biden on his State of the Union address on Tuesday, I would tell him to talk about extending life in America. I would tell him he should announce a government task force, a blue-ribbon committee dedicated to the issue. He should pledge a whole-of-government approach devoted to identifying the causes of the declining American life expectancy and reversing that trend before the end of his first term.

Because the declines are, as with all things in American life, unequally distributed. Life expectancy for Black Americans dropped by nearly four years. The first year of the pandemic alone took three years off Black Americans’ projected lifespans. And for Indigenous people, life expectancy dropped by almost seven years. It is a devastating cut to the life expectancy of a group already projected to live shorter lives than other Americans.

We live in one of the richest societies that humans on the planet have ever produced. We should be living long, healthy lives in America. Too many of us are not, and it is long past time for our government to act.

CORRECTION (Feb. 7, 2023, 2:00 p.m. ET): A previous version of this article misstated the number of Americans who died of drug overdoses in 2021. Over 107,000 people died from overdoses, not more than 142,000.