Fewer deaths from cancer, more from alcohol

A pair of health-related headlines appearing the very same day last week recently prompt a further look.

First, the good news. The American Cancer Society reported that U.S. deaths from cancer dropped by 2.2% in 2018, for their largest single-year decline ever seen, and that cancer death rates have now declined steadily by about 30% from 1991 to 2018 (front page, Jan. 9).

Much of the decline came from reduced rates of lung cancer, since fewer Americans are now smoking. Experts said the overall improvement was driven by a combination of factors, including better diagnosis, more precision in radiation treatment and availability of new genetic testing that allows oncologists to better target specific therapies to individual patients. Patients with advanced cancers are now living longer, with some surviving years instead of months. And, finally, new immunotherapy treatments are coming in wider use, giving hope for continued improvement in the years ahead.

But the National Health Institute's arm on alcohol abuse and alcoholism reported that deaths from alcohol and related diseases such as cirrhosis of the liver have doubled over the period from 1999 through 2017, rising from about 36,000 to 73,000 (tinyurl.com/newstats-alcohol). While alcoholism still kills more men than women, the rate of increase among women has been greater. Much of the increase was seen among those who are middle-aged or older.

While much attention has been paid to the opioid epidemic, deaths from alcohol abuse now exceed deaths from overdoses of drugs, including opioids, with 73,000 dying from alcoholism in 2017 but 3,000 fewer (70,000) from drug abuse. (Opioids were involved in 47,600 overdose deaths in 2017.)

Since cancer still kills more than eight times as many as alcohol does (even at the changed rates of both), overall the benefits of declining cancer deaths greatly exceed the human costs of increased alcohol deaths. But this means more Americans will be living longer, putting further strains on Social Security and Medicare programs.

And in a wider perspective, these changing statistics suggest a fundamental paradox in America today: Progress is widening on many fronts at the same time hope is waning on others. In a society of plenty, an emptiness remains. Alcohol and opioids together are killing almost 10,000 Americans each month, or three times as many as die from gun violence. (This is not to minimize gun violence, but only to point out the relative magnitude of the alcohol-opioid issue.)

As my still-favorite economist, John Maynard Keynes, once remarked, "In the long run, we are all dead." Or as the ancient syllogism went, "All men are mortal. Socrates is a man. Therefore, Socrates is mortal."

Whether we acknowledge it or not, we all know none of us lives forever. The real question we face is not how we die, but how we live. The Pew Research organization reports that about 23% of those raised as Christians no longer identify with Christianity. Other faiths also face declines. The point is that these systems of belief that once gave both meaning and a moral compass to many have been abandoned. And many who have abandoned them have no philosophical or ideological system to replace their old beliefs.

To be clear, this is not a call like that recently made by the current U.S. attorney general saying we must go back. It is an admonition that we must go forward to develop new human meaning, a new raison d'être.

Is consumerism America's new religion? For many Americans, it appears to be. And advertisements from every company in every industry suggest their products will solve your problems, make you more attractive or make you happier, if you would only buy them please.

But for many others, more and more means less and less. More things, less meaning. More things, less happiness. More things, less to live for. In a society of plenty, an emptiness remains.

While the survival of capitalism requires continuing our consumption addiction, we can shift the mix of our consumption toward things, like more education, that can potentially give us more meaning than just more things — things that are often coming to us at the expense of our planet and its other inhabitants.

David Peterson is an author and economist. He lives in Duluth, Minn.