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August 24, 2020

Legal Interventions to Address US Reductions in Life Expectancy

Author Affiliations
  • 1O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC
  • 2Sandra Day O’Connor College of Law, Arizona State University, Phoenix
  • 3Network for Public Health Law, Edina, Minnesota
JAMA. 2020;324(11):1037-1038. doi:10.1001/jama.2020.7715

According to a 2019 report by Woolf and Schoomaker,1 average life expectancy in the US began to level off in 2010 and then declined from 2014 to 2017. Although life expectancy increased slightly in 2018, concerted actions to address the “cumulative insults to the nation’s health” are warranted,2 especially considering the increase in mortality in 2020 due to the coronavirus disease 2019 (COVID-19) pandemic. Among many potential solutions, “legal determinants of health,” namely how law can address underlying causes of premature mortality,3 merit examination and consideration. Cost-effective evidence-based laws can safeguard the public’s health, reduce disparities, and extend life expectancy across socioeconomic groups, especially in disproportionately affected regions of the US. Despite their promise, public health laws are underutilized.

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    2 Comments for this article
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    Post Hoc Ergo Propter Hoc
    Michael Plunkett, MD MBA | Practice/ teaching
    Surprise. The authors, all lawyers, think more laws will reverse the decline in longevity. But their illogical examples of how ever more restrictive laws will save lives flies in the face of simple well known facts. The opioid epidemic wasn’t caused by lack of laws but a combination of the Sackler brothers, the government pushing “the fifth vital sign”, and physicians following the two.

    The answer is not more laws. (How did Prohibition work for us?) It’s education, modeling, and measuring.

    And if you really want to get rid of the societal adverse effects
    of narcotics how about fewer laws like in the Netherlands and Portugal. Get rid of the War on Drugs and replace it with a medical/social approach.
    CONFLICT OF INTEREST: None Reported
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    Who Dares Wins (Qui Audet Adipiscitur), Even Against COVID-19
    Michael McAleer, PhD (Econometrics), Queen's | Asia University, Taiwan
    Legal professionals use laws to govern behaviour, economists rely on the price mechanism, and medical and healthcare practitioners use clinical and empirical evidence.

    Interventions are essential to modify and change behaviour, as in the case of the declining life expectancy in the USA and elsewhere.

    The situation may well be magnified in a world that is presently being exacerbated by the COVID-19 pandemic.

    The War on Drugs is being won by drugs, with similar sad outcomes for the War on Anything, including Sickness, Poverty, Ignorance, Human Trafficking, Domestic Violence, Child Abuse, and Reduced Life Expectancy, among many sad
    maladies that do not reflect well on society.

    The War on COVID-19 will eventually be won by the combined global efforts of innovative medical researchers.

    Lawyers will then determine regulations about discovery, ownership, patents, and legal liability, while economists will prognosticate about the prices of vaccines, and medical and health insurance premiums.
    CONFLICT OF INTEREST: None Reported
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