Mortality Rising: Trump and the Death of the “American Dream”

Photograph Source: Michael Galpert – CC BY 2.0

Donald Trump’s 2016 electoral slogan was “Make America Great Again” and it was supposed to foreshadow his promise — if elected – to recapture the promise that the post-WW-II recovery inspired.  Well, after being elected and three years in office, Trump is ending the promise that long was the “American Dream.”  And this end is coming in a deeply troubling manner – the U.S. mortality rate is increasing, reversing a half-century increase in life expectancy.

A recent study published in the JAMA (Journal of the American Medical Association), “Life Expectancy and Mortality Rates in the United States, 1959-2017,” is disturbing.  It warns, “life expectancy at birth, a common measure of a population’s health, has decreased in the United States for 3 consecutive years.”  It adds:

The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. … By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases.

The study’s data came from the National Center for Health Statistics and the U.S. Mortality Database for 1959 to 2017.Americans are dying at an ever-growing rate and this many Trump’s ultimate legacy.


During the half-century between 1959 and 2016, Americans’ life expectancies increased by nearly 10 years. Sadly, since then, the average lifespan slowly declined. Between 2010 and 2017, the death rate increased from 328.5 to 348.2 per 100,000 people.

“There has been an increase in death rates among working age Americans,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, and co-author of study. “This is an emergent crisis. And it is a uniquely American problem since it is not seen in other countries. Something about life in America is responsible.”

Woolf notes, “while it’s a little difficult to place the blame on despair directly, the living conditions causing despair are leading to other problems.”  He adds, “for example if you live in an economically distressed community where income is flat and it’s hard to find jobs, that can lead to chronic stress, which is harmful to health.”

The report is disturbing, especially concerning the death rate among middle-aged white people.  Two age cohorts witnessed the greatest increase in the death rate – young adults aged between 25 and 44 years and people over 85 years; the only good news in the report seems to be that the death rates decreased among people aged 45 to 54 years.

Broken down by gender, men could expect to live an average of 76.1 years, down from 76.2 in 2016, while women could anticipate living until 81.1, the same age projected in 2016.

The principle causes for this increase are drug overdoses, suicides, alcohol abuse and a “diverse list of organ system disease” – these are popularly known as diseases of despair. Key factors include:

+ Between 1999 and 2017, fatal overdoses increased by 386.5 percent; in 2017, more than 70,000 deaths occurred because of drug overdoses and opioids accounted for more than 47,000 of those.

+ During the same period, deaths due to alcohol abuse conditions – e.g., chronic liver disease and cirrhosis of the liver — rose by 40.6 percent

+ Since 1999, the national suicide rate has increased by 33 percent; in 2017 alone, that rate went up by 3.7%.

+ Between 2000 and 2016, death rates among three additional leading causes of death – unintentional injuries, Alzheimer’s disease and septicemia – increased.

The study reports that the largest relative increases in midlife mortality rates occurred in New Hampshire, 23.3 percent; West Virginia, 23.0%; Ohio, 21.6%; Maine, 20.7%; Vermont, 19.9%; Indiana, 14.8%; and Kentucky, 14.7%.

The study notes: “The increase in midlife mortality during 2010-2017 was associated with an estimated 33,307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.”


“The current problems we are seeing are decades in the making,” Woolf said. “We used to have the highest life expectancy in the world. The pace at which life expectancy was increasing in the U.S. started to fall off relative to other countries in the 80s.”

The report points out:

Despite excessive spending on health care, vastly exceeding that of other countries, the United States has a long-standing health disadvantage relative to other high-income countries that extends beyond life expectancy to include higher rates of disease and cause-specific mortality rates.

Most disturbing, the findings from the JAMA study of the rise in the death rate over the last three years represent the longest consecutive decline in the American lifespan at birth since the period between 1915 and 1918. And this was a period that included World War I and the Spanish Flu pandemic, events that killed many millions in the U.S. and worldwide.

The rise in mortality rate may be Trump’s ultimate legacy.

David Rosen is the author of Sex, Sin & Subversion:  The Transformation of 1950s New York’s Forbidden into America’s New Normal (Skyhorse, 2015).  He can be reached at; check out