Legal Interventions to Address US Reductions in Life Expectancy

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In a 2019 report by Woolf and Schoomaker, average life expectancy in the U.S. was revealed to be in decline from 2014-2017, a trend which the COVID-19 pandemic is anticipated to exacerbate in 2020. As we assess in this commentary, concerted actions to address these declines are highly warranted. Among many potential solutions, “legal determinants of health,” namely how law can address underlying causes of premature mortality, provide clear options for policymakers seeking to reverse these trends for the next decade. Cost-effective, evidence-based laws can safeguard the public’s health, reduce disparities, and extend life expectancy across socio-economic groups, especially in disproportionately impacted U.S. regions. These benefits are often achievable without substantial public sector funding increases.

Yet, public health laws are underutilized. Variations in legal innovations lead to uneven applications of evidence-based laws and geographic disparities in key health indicators. Federal inaction lends to legal inconsistencies in socially controversial spheres, including firearms, reproductive health, and commercial taxation and regulation. Federal and state authorities increasingly preempt lower level public health laws, impeding grassroots initiatives in food and nutrition, environment, or consumer litigation.

Declinations in U.S. life expectancy requires a resetting of national health priorities especially against the backdrop of the greatest public health infectious disease threat of the 21st century. Evidence-based, cost-effective laws can reverse ongoing declines in health and longevity, and help improve social determinants.

Publication Citation

Journal of the American Medical Association (JAMA), published online first, August 24, 2020, at E1-E2.