Many major news media outlets covered an important story about the decline in life expectancy in the United States. This is based on research released by the National Center for Health Statistics that found life expectancy dropped from 78.9 to 78.8 years in 2015. This information is significant because there has been a steady increase in American life expectancy and many people, including experts hoped and expected that this trend would continue. The last clear reduction occurred in 1993 and was influenced by the AIDS epidemic and other temporary circumstances.
The new research led to significant concern because the death rate increased for eight of the ten leading causes of death. The experts interviewed by reporters for the stories all took the news seriously. They were concerned that the decline in life expectancy was more than a statistical blip and may indicate that the long time increases in life expectancy may be in the process of reversing.
One of the experts interviewed was Philip Morgan, a demographer at the University of North Carolina. He said the findings were “a big deal,” because “There’s not a better indicator of well-being than life-expectancy.” Many of the causes of death had previously been declining. Some of the stories suggested the findings might mark a turning point with declines in life expectancy becoming the new norm. Perhaps we had reached the limit for new technologies and medical breakthroughs to keep increasing our lifespan.
I am not an expert in health or demographics and would not be someone the reporters would consider interviewing for a life expectancy story. My expertise concerns domestic violence and child abuse. In my field there is tremendous excitement about research that demonstrates how exposure to domestic violence and child abuse increases health risks and shortens lives. I knew immediately when I started reading the life expectancy stories that the research I was relying on can be used to overcome the concerns discussed in these stories.
Using Current Scientific Research to Increase Life Expectancy
In 1964, important research from the Surgeon General linking cancer with smoking gave us a wonderful opportunity to increase life expectancy by reducing smoking. Society responded with laws and programs that included prohibitions against smoking in many public places; higher taxes particularly directed at discouraging children from starting to smoke; educational campaigns; media coverage about the harm of smoking and second hand smoke; organizations like the Cancer Society and Heart Association made prevention of smoking part of their work; doctors worked to discourage patients from smoking; and products and smoking cessation programs were created to help smokers quit. The present life expectancy would be far shorter without this important response.
Exciting medical research from the Centers for Disease Control and Prevention called the ACE (Adverse Childhood Experiences) Studies offer an even better opportunity to increase life expectancy by preventing adverse childhood experiences. The fundamental finding is that children exposed to domestic violence, child abuse and other traumas will live shorter lives and face more health and safety problems throughout their lives.
Domestic violence is at the heart of adverse childhood experiences. It is one of the ten ACEs and directly implicated in emotional abuse of children. Fathers who abuse mothers are 40-60% more likely to also abuse the children physically or sexually. And domestic violence makes all of the other ACEs more likely. Children receive a score of one for each type of adverse experience they suffer. A score of six reduces life expectancy by 20 years.
The essence of domestic violence is that abusers engage in a variety of tactics to control and coerce their intimate partners to do what the abusers want. This causes direct victims and their children to live in fear which causes the worst kind of stress. The women and children never know when the father will abuse them and there is nothing they can do to change his behavior. Although domestic violence advocates have long understood that most domestic violence is neither physical nor illegal most courts, government agencies and outside organizations tend to limit their focus to physical assaults. Until recently researchers believed the United States was spending $5-8 billion annually on health costs related to domestic violence. The investigations, however, were limited to treating her immediate wounds. Based on the ACE Research, the full health costs caused by our tolerance of domestic violence is actually $750 billion. In other words, society has been focusing on only one percent of the problem.
The stress caused by exposure to ACEs harms children in many ways. Much of the harm is not revealed until many years or decades later which makes it harder to respond to the ACEs. The stress leads to the release of pro-inflammatories. It also undermines the immune system and encourages sleeping and eating disorders. Stress has been shown to cause or exacerbate many medical problems including heart disease. Society’s tolerance of domestic violence, child abuse and other traumas is associated with many health and social problems that contribute to reductions in life expectancy. A partial list would include cancer, heart disease, diabetes, mental illness, substance abuse, crime, dropping out of school and suicide. Exposure to domestic violence and child abuse cause children to make poor decisions which leads to many of the social problems we face.
The recent spate of criminal behavior by NFL players illustrates how our history of tolerating what we now call domestic violence and child abuse continues to influence behavior today even though the laws have changed. The ACE Studies demonstrate that our level of many common diseases and our life expectancy is significantly influenced by our tolerance of domestic violence and child abuse. It can be depressing to consider the enormous pain and suffering our society is inflicting on our children, but the ACE and other research demonstrates it is also an opportunity to increase life expectancy and improve the quality of life by using proven practices to prevent domestic violence and child abuse.
When the Surgeon General’s Report came out linking cancer and smoking, many people said it would not matter because smoking was inevitable. We sometimes hear the same claims about domestic violence and child abuse because it has such a long history. The reality is that communities like San Diego, Nashville and Quincy, Massachusetts enjoyed a substantial reduction in domestic violence and child abuse by implementing best practices to stop domestic violence.
In a future article I will discuss the research about how any community, state or nation can implement practices that will prevent domestic violence and child abuse; increase life expectancy and save our children from exposure to adverse childhood experiences. And many people will be surprised at the price tag, not for preventing these traumas, but for allowing them to continue.