The economy is in robust good health, but our social fabric isn’t.
By two basic measures of social vitality, births and deaths, American society is faltering. Both the fertility rate and life expectancy are declining, in a sign that people feel less secure and, in some cases, have no hope at all.
We are attuned to headline-grabbing economic statistics — GDP growth, the unemployment rate, wages — as monthly and quarterly metrics of American well-being, but they aren’t as telling as these more fundamental indicators.
To put it bluntly, contemporary America is characterized by less pro-creation and more self-destruction. This suggests something is profoundly wrong with the state of the union, although it doesn’t receive the attention and the debate it deserves.
The fertility rate in 2018 dropped for the fourth straight year. It has hit a record low, and has fallen 15% since 2007. With the recovery after the Great Recession, the rate bumped up a little in 2014 before receding again.
Part of the story is a steep drop over the years in teenage pregnancy, a welcome and long-sought development. Women in their 20s have also been having fewer children, though. The trend is toward women delaying having children and having fewer of them.
As demographer Lyman Stone notes, the survey data tends to show that women still want kids, in fact perhaps more children than before. But later-in-life childbearing is inherently more difficult, and student debt, high housing costs and intense parental investment in children make having kids more burdensome (or at least feel that way).
While we now have fewer births, the death rate is increasing. A new study published in JAMA notes that after stalling out in 2010, life expectancy in the country has been declining since 2014, down from 78.9 years to 78.6 in 2017.
The U.S. has been losing ground to other countries in life expectancy since the 1980s. According to the Kaiser Family Foundation, it now has the lowest life expectancy among comparable advanced nations.
The decline isn’t hitting older Americans, who are still making improvements, but is cutting down people in the prime of their life, ages 25-64. “The odds,” Lyman Stone writes, “that a 32-year-old will die in a given year rose by almost 25% between 2012-14 and 2015-17. American adulthood has suddenly become more lethal than it has been in decades.”
Drug overdoses are a major driver (midlife mortality from drug overdoses has increased almost 400% over the past 20 years), with liver disease and suicide also contributing.
In 2017, an astonishing 150,000 Americans died from drug or alcohol abuse and suicide, more than U.S. combat deaths in World War I, the Korean War and the Vietnam War combined. Evidence suggests that the increased mortality is concentrated among persons with lower levels of educations and income.
If we can get a handle on the opioid crisis, it will make an enormous difference, but the trends in life expectancy and fertility ought to occasion soul-searching. How is it that a society as technologically advanced and affluent as ours can’t provide a more inviting environment for childbearing or the supports to keep people from doing themselves grievous harm?
Even if there are no ready policy answers, the question must be asked.