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‘There’s something terribly wrong’: Americans are dying young at alarming rates

“問(wèn)題嚴(yán)重”，美國(guó)人正以驚人的速度英年早逝

By Joel Achenbach November 27, 2019 at 12:00 a.m. GMT+8

Brian Benson unloads the body of a 44-year-old woman at the Kern County coroner’s office in Bakersfield, Calif. Prescxtion narcotics were among the medications found in the woman’s apartment. (Bonnie Jo Mount/The Washington Post)

布萊恩·本森在加州貝克斯菲爾德克恩縣驗(yàn)尸官辦公室中搬運(yùn)一名44歲婦女的尸體。在這名女子的公寓里發(fā)現(xiàn)的藥物中包括處方麻醉劑。

Death rates from suicide, drug overdoses, liver disease and dozens of other causes have been rising over the past decade for young and middle-aged adults, driving down overall life expectancy in the United States for three consecutive years, according to a strikingly bleak study published Tuesday that looked at the past six decades of mortality data.

美國(guó)的年輕人和中年人，在過(guò)去的十年里因自殺、服藥過(guò)量、肝臟疾病和許多其他原因?qū)е滤劳雎室恢痹谏仙?導(dǎo)致美國(guó)整體預(yù)期壽命連續(xù)三年下降。根據(jù)周二（注：11月26日）發(fā)表的一項(xiàng)研究，《過(guò)去60年的死亡率數(shù)據(jù)令人觸目驚心》。

“It’s supposed to be going down, as it is in other countries,” said the lead author of the report, Steven H. Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “The fact that that number is climbing, there’s something terribly wrong.”
He said many factors are at play. The opioid epidemic is a major driver of the worrisome numbers, but far from the sole cause. The study found that improvements in life expectancy, largely because of lower rates of infant mortality, began to slow in the 1980s, long before the opioid epidemic became a national tragedy.

該報(bào)告主要作者、弗吉尼亞聯(lián)邦大學(xué)社會(huì)與健康中心名譽(yù)主任史蒂文·h·伍爾夫(Steven H. Woolf)說(shuō)，“死亡率應(yīng)該會(huì)像其他國(guó)家一樣下降?！薄笆聦?shí)上，這個(gè)數(shù)字還在繼續(xù)攀升，這說(shuō)明問(wèn)題相當(dāng)嚴(yán)重?！?br/>他說(shuō)，問(wèn)題涉及很多因素。**類藥物的流行是這些憂心數(shù)字的主要原因，但遠(yuǎn)非唯一原因。研究發(fā)現(xiàn)，在**類藥物泛濫成為全國(guó)性悲劇之前，距今久遠(yuǎn)的上世紀(jì)80年代，預(yù)期壽命的增加(主要是嬰兒死亡率降低)即開(kāi)始減緩。

“Some of it may be due to obesity, some of it may be due to drug addiction, some of it may be due to distracted driving from cellphones,” Woolf said. Given the breadth and pervasiveness of the trend, “it suggests that the cause has to be systemic, that there’s some root cause that’s causing adverse health across many different dimensions for working-age adults.”

伍爾夫說(shuō)道"部分原因可能是肥胖，吸毒成癮，或因開(kāi)車分心。"鑒于這一趨勢(shì)的廣度和普遍性，“這說(shuō)明，造成健康問(wèn)題的原因一定是系統(tǒng)性的，在許多不同層面上，適齡工作的成年人都存在一些導(dǎo)致健康問(wèn)題的根本原因?！?br/>

The report reveals a broad erosion in health, with no single “smoking gun,” said Ellen Meara, a professor at the Dartmouth Institute for Health Policy and Clinical Practice.
“There’s something more fundamental about how people are feeling at some level — whether it’s economic, whether it’s stress, whether it’s deterioration of family,” she said. “People are feeling worse about themselves and their futures, and that’s leading them to do things that are self-destructive and not promoting health.”

達(dá)特茅斯衛(wèi)生政策與臨床實(shí)踐研究所教授艾倫·米拉認(rèn)為，這份報(bào)告雖揭示出健康普遍惡化狀況，但沒(méi)有一個(gè)“確鑿證據(jù)”。
她說(shuō):“在某種程度上，人們更在意的是與切身相關(guān)的東西，如經(jīng)濟(jì)，精神壓力，或是家庭關(guān)系不和方面。“人們對(duì)自己和自己的未來(lái)感到擔(dān)憂，這導(dǎo)致他們做出一些自殘行為，而不是去做有利于身心健康的事情?！?br/>
The JAMA report looked at life expectancy and mortality across the country from 1959 through 2017. Final life expectancy numbers for 2018 will soon be released by the U.S. Centers for Disease Control and Prevention. The general trend: Life expectancy improved a great deal for several decades, particularly in the 1970s, then slowed down, leveled off, and finally reversed course after 2014, decreasing three years in a row.

《美國(guó)醫(yī)學(xué)會(huì)雜志》對(duì)1959年至2017年期間全國(guó)的預(yù)期壽命和死亡率進(jìn)行了調(diào)查。美國(guó)疾病控制與預(yù)防中心(U.S. Centers for Disease Control and Prevention，簡(jiǎn)稱cdc)很快在2018年公布最終預(yù)期壽命數(shù)據(jù)?？偟内厔?shì)是，在這幾十年期間里，預(yù)期壽命在70年代大幅提高，然后下降，逐漸趨穩(wěn)，最終在2014年之后開(kāi)出現(xiàn)轉(zhuǎn)折，進(jìn)而出現(xiàn)連續(xù)三年下滑的情況。

“These kids are acquiring obesity in their early teen years, sometimes under the age of 10,” said S. Jay Olshansky, a professor of public health at the University of Illinois at Chicago. “When they get up into their 20s, 30s and 40s, they’re carrying the risk factors of obesity that were acquired when they were children. We didn’t see that in previous generations.”
“This isn’t a one-time phenomenon,” he added. “It’s going to echo through time.”

這些孩子在十幾歲的時(shí)候就得上了肥胖病，有些還不到10歲，”伊利諾伊大學(xué)芝加哥分校的公共衛(wèi)生教授s·杰伊·奧爾山斯基(S. Jay Olshansky)說(shuō)道?！爱?dāng)他們到了20多歲、30多歲或40多歲的時(shí)候，他們?cè)趦和瘯r(shí)代埋下的肥胖基因?qū)脮r(shí)就會(huì)顯現(xiàn)出來(lái)。而我們?cè)谇皫状松砩峡床坏竭@一點(diǎn)?！?br/>“這不會(huì)只有一次，”他補(bǔ)充道?！八鼘⑹冀K將會(huì)在時(shí)光中回蕩?！?/p>