The Washington Post and others of that ilk have been sounding the alarm about declining life expectancy in the U.S., driven mostly by rising death rates due to opioid use and obesity among the young and middle-aged.
There’s something terribly wrong says the Post headline. Maybe. But the content of the article suggests that a better headline might have been There’s something to celebrate. Certainly the article offers no argument or evidence for the former interpretation.
There is something to celebrate if rising death rates result from voluntary, informed choices. The thing to celebrate, of course, is not the deaths themselves, but the fact that people have found something worth dying for — just as, when you buy a house, I’ll congratulate not for the expense, but for finding something that made the expense worthwhile.
You’d think (or at least I‘d think) this was entirely obvious, but apparently it’s not obvious to everyone, so maybe it’s worth offering an extreme example. Suppose we’re all tied to beds in hospital rooms, with doctors monitoring every blip in our health and attending to it immediately. As a result, we mostly live long and miserable lives. Now one day, we engineer a mass escape. Life expectancy goes down for reasons that call for a celebration.
Opioids offer escape from miserable lives. They also offer enhancement of non-miserable lives. The decision to be obese comes with a great many perks — you can spend a lot more time eating M&M’s and a lot less on the treadmill. (I myself spend much of my treadmill time wondering whether I’ve made the wrong choice.) Like all good things, these come with costs. In this case, the cost is in the form of increased mortality. Apparently, people think that’s a cost worth paying. We should be glad for them.
Now you can certainly tell a story in which mortality due to opioid use is up because the world has gotten so much worse that there’s more demand for escape. That would be a bad trend (though even then, we’d want to celebrate the ability of opioids to mitigate some of that misery). Or you can tell a story in which mortality due to opioid use is up because people have gotten so much richer they can afford to be opioid addicts, or because opioids have gotten better, or because they’ve become more readily available. That would be a good trend. The Washington Post article alludes to the former possibility, without a shred of a good reason to think it’s the right story, as opposed to one of many possible stories.
You know what else is way up over the past couple of decades? Expenditures on smartphones. That sounds really really bad if you choose to ignore the fact that the people who are spending all that money get to have smarthpones. Likewise, an upward trend in mortality from M&M consumption sounds really really bad if you choose to ignore the fact that the people who are shortening their life expectancies also get to eat a lot of M&Ms. There is more to life than life expectancy.