New Report Details Steps to Reverse Decline in U.S. Life Expectancy

Expert faculty in the Bloomberg American Health Initiative provide 10 specific ideas, based in evidence, to save lives and change trends

BALTIMORE & PHILADELPHIA – December 6, 2022 – The Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health released a report today setting out 10 practical steps to address major causes of declining life expectancy in the U.S. Those causes include COVID-19, overdose, gun-related homicide and suicide, teen suicide, motor vehicle crashes, and heart disease, stroke, and diabetes. The actions proposed by   expert faculty across the School are addressed to Congress, hospitals and clinics, as well as state governments, and schools, so they can help reverse the deepest reduction of U.S. life expectancy in more than a century, since World War I and the Great Influenza. “Reversing the Decline: 10 Ideas to Improve Life Expectancy” is available here.

The report was released at the 5th annual Bloomberg American Health Summit in Philadelphia, Pennsylvania where the Bloomberg American Health Initiative’s leaders, faculty, fellows, and partners are meeting with elected leaders, key health officials, and leaders of nonprofit organizations from around the country. The Summit will highlight the impact of local public health initiatives, explore implications for national policy, and uncover opportunities to continue to improve equitable access to quality healthcare. 

The Centers for Disease Control and Prevention (CDC) recently reported that in 2021, life expectancy at birth was 76.1 years – down 2.8 years from its peak, erasing all life expectancy gains since 1996. Life expectancy at birth in the U.S., a core measure of the health of a population, had previously increased steadily to a peak of 78.9 years in 2014 before hitting a plateau. Bringing together ideas and input from 19 expert faculty members in public health, this report sets out policies and programs that can help the nation turn the corner to improve health.  

“The decline in U.S. life expectancy is a devastating trend that we refuse to accept,” said Michael R. Bloomberg, founder of Bloomberg Philanthropies and WHO Global Ambassador for Noncommunicable Diseases and Injuries. “The good news is that while the challenges we face are serious and stubborn, they are not insurmountable, and the history of American public health is filled with extraordinary successes. To help guide policymakers, this new report offers 10 urgent yet practical steps for reversing the decline – and putting more Americans on a path toward longer, healthier lives.”

“Declining health in the United States is not inevitable,” said Dr. Joshua M. Sharfstein, director of the Bloomberg American Health Initiative. “This report illustrates that there are opportunities to save lives and address inequity all around us.”

The ideas presented for reversing the decline in life expectancy are aimed at saving lives from an array of both recent and prior public health challenges including COVID-19, overdose, guns, teen suicide, motor vehicle crashes, heart disease/stroke/diabetes, and heat or other weather-related emergencies. The report outlines concrete steps, including:

• Congress should support the Biden Administration's request for additional funding for public health outreach, COVID-19 vaccination, treatments and research
• Hospitals and clinics, as well as jails and prisons, should all provide access to medications that treat opioid use disorder 
• Funding agencies should support harm reduction services
• States should be implementing extreme risk protection orders, require permits for gun purchase, and support community violence intervention programs
• Schools should offer easily accessible, confidential, and comprehensive adolescent health care in schools
• The U.S. Food and Drug Administration should release long-term, mandatory, industry targets for sodium reduction in the U.S. processed food supply while developing local and regional food infrastructures
• Cities should promote and protect biking and walking and reduce sprawl to reduce motor vehicle crashes, and implement heat action plans

“The roots of declining life expectancy in the U.S. are many and deep. Long-standing inequality and structural racism drive many threats to health,” said Dr. Kelly Henning, who leads Public Health programs at Bloomberg Philanthropies. “This report demonstrates that reversing the decline is within the nation’s grasp.”

The report’s contributors, all from the Johns Hopkins Bloomberg School of Public Health, include:

• Sean Travis Allen, DrPH, Bloomberg Assistant Professor in American Health, Department of Health, Behavior and Society
• Kiara Alvarez, PhD Bloomberg Assistant Professor of American Health, Department of Health, Behavior and Society
• Sonia Angell, MD, MPH Professor of the Practice, Department of Epidemiology
• Alison Gemmill, PhD, Assistant Professor, Department of Population, Family and Reproductive Health
• Javier Cepeda, PhD, Bloomberg Assistant Professor in American Health, Department of Epidemiology
• Cassandra Crifasi, PhD, Associate Professor, Department of Health Policy and Management
• Aisha Dickerson, PhD, Bloomberg Assistant Professor of American Health, Department of Epidemiology
• Johnathon P. Ehsani, PhD, Associate Professor, Department of Health Policy and Management
• Shannon Frattaroli, PhD, Professor, Department of Health Policy and Management
• Shima Hamidi, PhD, Bloomberg Assistant Professor of American Health, Department of Environmental Health and Engineering
• Joshua Horwitz, PhD, Professor, Department of Health Policy and Management
• Jaime Madrigano, ScD, Visiting Associate Professor, Department of Environmental Health and Engineering
• Yeeli Mui, Bloomberg Assistant Professor of American Health, Department of International Health
• Brendan Saloner, PhD, Bloomberg Associate Professor of American Health, Department of Health Policy and  Management
• Joshua M. Sharfstein, MD, Bloomberg Professor of the Practice in American Health, Department of Health Policy and Management 
• Maria Trent, MD, MPH, Bloomberg Professor of American Health, Department of Population, Family and Reproductive Health
• Melissa Walls, PhD, Bloomberg Associate Professor of American Health, Center for Indigenous Health, Department of International Health
• Daniel Webster, ScD, Bloomberg Professor of American Health, Department of Health Policy and Management
• Tiara Willie, PhD, Bloomberg Assistant Professor of American Health, Department of Mental Health

Read the full report here.

Watch the livestream of the Bloomberg American Health Summit here.

About the Bloomberg American Health Initiative

The Bloomberg American Health Initiative was developed at the Johns Hopkins Bloomberg School of Public Health to tackle five core issues that deeply challenge the nation’s health: addiction and overdose; adolescent health; environmental challenges; obesity and the food system; and violence. The Initiative’s work with faculty, fellows, and collaborating organizations is building a dynamic nationwide network committed to harnessing data and developing new approaches to public health that will ensure a healthier future for all Americans. Learn more here: Bloomberg American Health Initiative.

About Bloomberg Philanthropies

Bloomberg Philanthropies invests in 941 cities and 173 countries around the world to ensure better, longer lives for the greatest number of people. The organization focuses on five key areas for creating lasting change: the Arts, Education, Environment, Government Innovation, and Public Health. Bloomberg Philanthropies encompasses all of Michael R. Bloomberg's giving, including his foundation, corporate, and personal philanthropy as well as Bloomberg Associates, a pro bono consultancy that works in cities around the world. In 2021, Bloomberg Philanthropies distributed $1.66 billion. For more information, please visit bloomberg.org or follow us on Facebook, Instagram, YouTube, and Twitter.

Media contacts

• Gina Davis, Bloomberg American Health Initiative, +1 443-789-0620 or gdavis71 [at] jhu.edu (gdavis71[at]jhu[dot]edu)
• Stacy Montejo, Powell Tate, +1 202-585-2025 or SMontejo [at] powelltate.com (SMontejo[at]powelltate[dot]com)