America is suddenly getting healthier. No one knows why.
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“Americans are unusually likely to die young compared with citizens of other developed countries. The U.S. has more fatalities from gun violence, drug overdoses, and auto accidents than just about any other similarly rich nation, and its obesity rate is about 50 percent higher than the European average. Put this all together and the U.S. is rightly considered a “rich death trap” for its young and middle-aged citizens, whose premature death is the leading reason for America’s unusually short lifespans.
But without much media fanfare, the U.S. has recently experienced a boomlet in good health news. In May 2024, the U.S. government reported that drug-overdose deaths fell 3 percent from 2022 to 2023, a rare bright spot in a century of escalating drug deaths. In June, the National Highway Traffic Safety Administration reported that traffic fatalities continued to decline after a huge rise in 2020 and 2021—and that this happened despite a rise in total vehicle miles traveled. In September, the U.S. government announced that the adult-obesity rate had declined in its most recent count, which ended in August 2023. Also in September, FBI analysis confirmed a double-digit decline in the national murder rate.
How rare is this inside straight of good news? Some government estimates—such as rates of obesity and overdose deaths—have reporting lags of one to two years, meaning that these causes of mortality are not necessarily all currently declining. Still, by my count, this year marks the first time in the 21st century that obesity, overdose deaths, traffic fatalities, and murders all declined in the official data analysis. The level of premature death in the U.S. is still unacceptably high. But progress isn’t just about where you are; it’s also about what direction you’re going in. And by the latter definition, 2024 was arguably the best year for American health reports in decades.
It would be convenient—for both efficient punditry and public-policy clarity—if a small number of factors explained all of these trends. After all, if we could isolate a handful of lessons, we could carry them forward and unleash a golden age of American health. Unfortunately, reality is messy and does not always comport with our preference for simple explanations.
Take, for example, the decrease in overdose deaths, which might be the most surprising news of the bunch. “This is the largest decline we’ve seen in recent data, going back at least back to 1999, which is remarkable because overdoses have been going up so steadily,” Charles Fain Lehman, a fellow at the Manhattan Institute, told me. But the exact cause of the decline is mysterious. “I could tell you a policy story,” he said, “such as the fact that we’ve made it easier for people to access drug-addiction treatment and we’ve significantly expanded the availability of Narcan”—an opioid antagonist that rapidly reverses the effects of overdose.“
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