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“For years, many assumed that drug overdoses in midlife explained stalled U.S. life expectancy. But our findings show that the problem is much broader,” says Leah Abrams.<br>Image: Shutterstock
Public Health
Why Aren’t Americans Living Longer?
Some generations—especially late Gen X and early Millennials—are already experiencing worse mortality than those before them, according to new analysis
by
Genevieve Rajewski
March 9, 2026
Public Health
Aging
Health
School of Arts and Sciences
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Despite major advances in medicine, U.S. life expectancy barely budged in the 2010s, and it still lags that of other wealthy nations. Researchers have pointed to rising “deaths of despair”—drug overdoses, suicides, and alcohol-related deaths—and stalled progress against heart disease as potential causes, but no single explanation seemed to account for this troubling trend.<br>In a new study published in the journal Proceedings of the National Academy of Sciences, Leah Abrams, an assistant professor of community health at Tufts University, and her collaborators from The University of Texas Medical Branch and several research European institutions examined death certificate data for U.S. residents born between the 1890s and 1980s. The team analyzed changes in mortality from 1979 through 2023 across age groups and over time.<br>The researchers analyzed deaths from all causes and from three of the most common ones in the United States: cardiovascular disease, cancer, and so-called external causes, which include drug overdoses, suicides, homicides, and accidents. This allowed the researchers to see whether shortened life expectancy has a single driver or if multiple, overlapping crises are unfolding across generations.<br>The research reveals that some birth cohorts, particularly late Gen Xers and early Millennials, are already experiencing worse outcomes than their predecessors, including dying from diseases once rare in the young.<br>Abrams recently spoke about what the findings reveal about what we can learn from past decades of U.S. mortality—and what they may signal for the country’s future.<br>Why was it important to conduct this research?<br>U.S. life expectancy has been stalled or declining for over a decade now, putting the country further behind its peer nations. These trends can reflect events that affect everyone at once, like COVID-19, or they can reflect differences between generations—when people born in certain years experience worse health than those born before or after them.<br>We plotted 40 years of data on mortality increases or decreases across multiple ages and major causes of death to understand how these forces are shaping U.S. mortality.<br>Did you see any trends that applied broadly across the U.S. population?<br>For years, many assumed that drug overdoses in midlife explained stalled U.S. life expectancy. But our findings show that the problem is much broader.<br>The 2010s was a bad decade for mortality across ages. There’s a clear period pattern, but it’s not just due to deaths from drug overdoses. It’s also due to suicides, homicides, traffic accidents, and...