An elderly man walks with a cane in Queens

Credit: Chris Goldberg

A Decline In Life Expectancy Is Connected To A "Public Health Crisis"

December 13, 2016

Life expectancies in the U.S. declined last year, according to a report released by the National Center for Health Statistics.

Medical ethicist Art Caplan joined BPR to explain how the decline is related to a “public health crisis in rural white middle-class America.”

He said the opioid crisis, among other persistent public health issues, are affecting rural America in a variety of ways.

“It is really taking a terrible toll on these places where there are no jobs, and people are abusing drugs, and their kids are getting addicted and dying earlier, and you’ve got also issues about obesity that may be due to... stress of being unemployed or underemployed,” said Caplan.

He stressed that Obamacare, despite widening coverage, doesn’t give people in rural areas access to more doctors.  Caplan said sometimes, people live in areas without specialists like psychiatrists, and the Affordable Care Act hasn’t done enough to encourage doctors to broaden their reach.

“There’s no doubling of the number of primary care doctors, there’s no nurses added, there’s no pharmacists or physicians’ assistants who have more medical authority,” he said.  “In fact, one way to do something about unemployment is probably to start to train a cadre of healthcare workers.”
 
Caplan said this lack of government intervention in places of poor access to doctors might be connected to Trump’s popularity in these places.

“You can’t blame the stress of the election on some kind of life expectancy decline, but I think you might, in part, in a tiny way, be able to attribute the victory of Donald Trump to this phenomena,” he said.  “I do think there’s actually a weak connection between Trump’s victory and this public health problem among a lot of working-class and unemployed whites.”

Art Caplan is the Drs. William F and Virginia Connolly Mitty Chair, and director of the Division of Medical Ethics at NYU Langone Medical Center. He’s also the co-host of the Everyday Ethics Podcast. To hear his interview on BPR in its entirety, click on the audio link above.


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