“Americans are dying younger, as drug overdoses and suicide kill an increasing number of people, according to a grim new set of government statistics” The Guardian
Life expectancy declined in 2017, falling to 78.6 years, according to the new report from the Centers for Disease Control. It is the third straight year life expectancy in the US has declined or stayed flat, reversing course after decades of improvement.
Adverse Childhood Experiences (ACEs), including child sexual abuse, neglect, and witnessing domestic violence, leave survivors up to 40 times more likely to self medicate through injecting illegal drugs, and hundreds of times more likely to attempt suicide.
Will the #METOO movement reverse American’s trend of dying younger than our parents generation?
Part one of a two part series.
Tolerance for abuse is nothing new in the United States or the world. There is a long, sad and frightening history of tolerating cruel behavior now considered domestic violence and child abuse. Despite some improvement, particularly in understanding the enormous harm abuse causes, in recent years this country has seen open and deliberate support for practices and actions that promote domestic violence and sexual assault.
A third straight year of decline in life expectancy directly related to tolerance of abuse, and other ACEs.
The success of countries is often measured by the gross national product, an economic measure. Life expectancy goes to the heart and lungs of society’s well-being. It provides a measure of the quality of our lives. Our tolerance of abuse substantially reduces life expectancy.
Life expectancy has steadily risen as technological, medical and scientific discoveries help people live longer. Improved nutrition, safety features and medical treatment increase lifespans. The last time the United States experienced a three-year decline in life expectancy was from the large number of soldiers dying during World War I. Prevention, such as societal measures to discourage smoking, have also contributed to the success in helping people live longer.
The trend of reduced life expectancy should be viewed as an abject failure because the strong factors promoting longer lives can only be overcome by unusual catastrophes or incredibly short-sighted practices. Certainly the failure to take more effective steps to prevent climate warming or sensible steps to keep guns out of the hands of dangerous criminals contributes to higher death rates. The easiest way to restore a yearly increase in life expectancy and improve the quantity and quality of lives is to implement proven practices to prevent domestic violence and sexual assault.
Profound Health Risks from Abuse
In 1964, the Surgeon General issued a groundbreaking report linking smoking with cancer. Society used this knowledge to develop public policy, education and programs to help smokers quit. This response has significantly reduced smoking and therefore saved lives and money. Reducing smoking has had a significant impact promoting the increase in life expectancy.
In 1998, the Centers for Disease Control and Prevention released the first ACE (Adverse Childhood Experiences) Study. As medical research, ACE was initially used to diagnose and treat patients. Dr. Vincent Felitti, lead author of the first ACE Study now believes prevention is the best use for his research.
ACE has established that exposure to domestic violence, child abuse and other trauma causes far more harm than previously understood. Children exposed to ACEs will live shorter lives and face a lifetime of health and social problems. Contrary to popular assumptions, most of the harm from domestic violence and child abuse occurs not from the immediate physical injuries, but from living with the fear that leads to stress. This stress contributes to many common diseases including heart disease and cancer.
The significance of fear and stress is important both for treatment and prevention. Children exposed to domestic violence and/or child abuse can be saved from the full consequences if they are provided effective treatment and saved from further exposure to abuse. In other words shielding children who have been exposed to ACEs from fear and stress can increase their life expectancy. Unfortunately, standard family court practices minimize the significance of exposure to domestic violence and child abuse and are titled in favor of keeping abusers in children’s lives. Courts often fail to protect children because they rely on professionals unable to recognize abuse.
Children are more vulnerable because of their age and incomplete development, but adults are also impacted by exposure to domestic violence and sexual assault. These are also among the most underreported crimes because society often fails to believe victims and does not treat gendered crimes with the priority they deserve.
Reports about reduced life expectancy have focused on the increase in deaths from opioid use and suicide. Significantly, children exposed to ACEs and adults exposed to domestic violence and sexual assault are at substantially greater risk for substance abuse and suicide. In other words, practices that would reduce abuse and sexual assault would also reduce suicide and opioid use.
Domestic Violence and Sexual Assaults Are Preventable
Domestic violence and sexual assault are the most underreported crimes. The myth that women and children frequently make false accusations discourages reports and encourages professionals to disbelieve victims. Abusers and the professionals who help them promote this misinformation. As a result only six percent of rapes result in jail time for the rapist. Domestic violence offenders enjoy even better odds.
We know domestic violence can be prevented because communities that have implemented best practices enjoyed dramatic reductions in domestic violence crime. Practices that included strict enforcement of criminal laws, orders of protection and probation rules; a coordinated community response and practices that make it easier for victims to leave were implemented successfully in communities like Quincy, Nashville and San Diego. In Quincy, a county that averaged 5-6 DV homicides enjoyed several years in a row with no murders.
Most domestic violence and sexual assault is committed by someone the victim knows, but society treats these crimes seriously only when the criminal is a stranger. The experience from successful programs is that these crimes are reduced when the community takes domestic violence and sexual assault seriously. Today these horrific crimes that cause so much harm and reduce life expectancy are routinely minimized and disbelieved.
I am saddened by the sudden reversal in the long march towards longer lives. At the same time I am glad this reversal has encouraged a discussion of the causes. There is an important policy component in this debate because ultimately the purpose is to make the changes needed to resume increasing our lifespan.
There is now a specialized body of knowledge about domestic violence and sexual assault. Policy makers often fail to use the research and this perpetuates the widespread failed response. Those in charge of larger issues like health, crime and the economy do not treat abuse issues as a priority. Perhaps this is because most of the victims are women and children.
Most public officials are unaware of the connection between domestic violence and sexual assault with the larger health issues and the enormous obstacle the tolerance for abuse places on economic growth. I am hoping that the interest in life expectancy might encourage officials to understand how abuse impacts health and thus provides a new perspective on the need to take domestic violence and sexual assault more seriously.
Our long tolerance for gendered crimes continues to destroy lives and undermine the quality of lives for survivors. We should have taken these crimes more seriously long ago. This country should have implemented practices to prevent abuse because it is the moral response. If the needed changes can only be won because of the impact on health and life expectancy, I will take it.
Every day I hear these horrific stories. They are made worse by the fact we know how to prevent them. I just want the abuse to stop.
Domestic Violence Writer, Speaker, and Advocate
Barry Goldstein is one of the leading domestic violence authors, speakers, advocates, and a frequent expert witness.