ABSTRACT
The Center for Disease Control and Prevention (CDC)'s National Center for Health Statistics (NCHS) published a startling report in July 2021 documenting a decrease in the life expectancy of Americans to the lowest level since 2003.1,2 This was the largest one-year drop since World War II. The leading causes of death for 2020 were heart disease, cancer, and COVID.3 Seventy-four percent of the decline in life expectancy was attributed to COVID while accidental and unintentional injuries contributed to 11% of the decline, homicide contributed 3.1%, diabetes contributed 2.5%, and chronic liver disease and cirrhosis contributed 2.3%.1,2 The overall decline of 1.5 years would have been greater if there had not been offsetting effects of declining mortality due to cancer, chronic lower respiratory diseases, heart disease, suicide, and certain perinatal conditions.2 Across racial groups, there were differences in the decline as well as the reasons for lower life expectancy. Excess mortality due to COVID contributed to 67.9% of the decrease followed by unintentional injuries, chronic liver disease and cirrhosis, diabetes, and homicide.2 Changes in the Missouri Life Expectancy Rates The Missouri Department of Health and Senior Services published a report in August 2021 providing details on the decrease in life expectancy for Missourians.4 The overall decline was 2.1 years with male life expectancy dropping 2.3 years to 72.3 and females dropping 1.9 years to 78.4 years. Accidental and Unintentional Injuries The Substance Abuse and Mental Health Services Administration (SAMHSA) defines harm reduction as a "proactive and evidence-based approach to reduce the negative personal and public health impacts of behavior associated with alcohol and other substance use at both the individual and community levels.