US life expectancy forecasted to stall by 2050

The United States is expected to make only minor gains in life expectancy over the next few decades, and this minimal improvement highlights an “alarming trajectory of health challenges” facing the country, researchers say.

Life expectancy in the US is expected to increase from 78.3 years in 2022 to 80.4 years in 2050, according to forecasting models from the University of Washington’s Institute for Health Metrics and Evaluation.

For the analysis, published Thursday in The Lancet, researchers assessed the impacts of hundreds of diseases and other health risks on the US and individual states and compared them to a set of more than 200 other countries.

They found that the US would lag in life expectancy gains, putting the country behind most other high-income nations and some middle-income nations; In terms of overall life expectancy, the US is expected to fall to 66 out of 204 countries assessed in 2050, down from 49th in 2022.

Life expectancy among women in the US is predicted to improve less than men’s, shrinking the gap in life expectancy by gender. The US would drop from 51st to 74th in life expectancy for women in 2050 and from 51st to 65th for males, according to the IHME forecasts.

The slight increase in US life expectancy that’s forecasted for 2050 is driven by a predicted decline in mortality due to a few leading causes of death, including heart disease, stroke and diabetes, according to IHME.

But addressing a few key risk factors could make even more significant improvements to US life expectancy, the forecasting models suggest. Lower rates of obesity, smoking and drug use disorders could each lead to about a half a year increase in life expectancy by 2050, for example.

“In spite of modest increases in life expectancy overall, our models forecast health improvements slowing down due to rising rates of obesity, which is a serious risk factor to many chronic diseases and forecasted to leap to levels never before seen,” Christopher Murray, director of IHME and co-senior author of the new research, said in a news release. “The rise in obesity and overweight rates in the U.S., with IHME forecasting over 260 million people affected by 2050, signals a public health crisis of unimaginable scale.”

GLP-1 medications are booming in popularity in the US with promising outcomes, but the future of uptake remains uncertain and IHME did not include a scenario that included these treatments as a factor.

Recent data from the US Centers for Disease Control and Prevention also suggest that drug overdose deaths have started to decline after reaching record levels, but IHME notes that the levels of drug overdose remain high and will likely increase over the next few decades. IHME estimates that the rate of age-standardized mortality due to drug use disorders in the US will be the highest in the world, and more than twice as high as in Canada at second highest.

“The stark contrast that’s forecasted in the next 30 years comes after a concerted effort by federal, state, and local government agencies and health systems launched after the opioid crisis was declared a public health emergency in 2017. The opioid epidemic is far from over, and greater effectiveness and continued expansion of programs to prevent and treat drug use are still needed,” Ali Mokdad, IHME professor and lead author of the report, said in the news release.

Overall, if the US eliminated risk in three key areas – environment, behavioral and metabolic risks, and childhood nutrition and vaccination – there would be about 550,000 fewer deaths in 2050 alone – bringing life expectancy up by nearly four years, in line with current projections for Canada, according to the IHME forecasts.

“The rapid decline of the U.S. in global rankings from 2022 to 2050 rings the alarm for immediate action. The U.S. must change course and find new and better health strategies and policies that slow down the decline in future health outcomes,” Dr. Stein Emil Vollset, co-senior author and affiliate professor with IHME, said in the news release.