美国人预期寿命为何降至25年来最低？(下)

The CDC lays blame for this principally on COVID and on drug overdoses, principally linked to fentanyl.

美国疾病控制与预防中心将预期寿命减少主要归咎于新冠肺炎与止痛剂使用过量。

But there's other citations in there as well, including alcohol and alcoholism. Can you talk a little bit about that?

不过，也有其他的原因，包括饮酒和酗酒。你能谈一下吗?

That's not something we often talk about, about its impact on public health.

我们不常谈论它对公众健康的影响。

Well, again, even before the pandemic, in the years preceding it, we were very much aware of the opioid epidemic and rising death rates from drug overdoses, and alcoholism, suicides, and heart disease.

嗯，强调一下，即使在疫情之前的几年，我们非常清楚阿片类药物的盛行，以及因药物过量、酗酒、自杀和心脏病造成的死亡率上升。

All of those problems continued right into the pandemic.

所有这些问题一直持续到了疫情。

Layered upon that, though, of course, was the tremendous stresses that people experienced during the pandemic.

在此基础上，人们在疫情期间自然承受了巨大的压力。

So, individuals struggling with addiction disorders, either to drugs or alcohol, were more vulnerable to those conditions, and had reduced access to substance abuse and counseling services to address those problems.

那些苦苦挣扎于成瘾症的人，无论是药物成瘾者还是酒精成瘾者，都更容易受到这些情况的影响，而且减少药物滥用的机会更少，获得解决这些问题的咨询服务的机会也更少。

So, unfortunately, we have seen a disturbing rise in deaths from alcohol and drugs, but also our health care system was disrupted overall.

不幸的是，我们看到死于酒精和药物的人数出现了令人不安的上升，而且我们的医疗保健系统整体上也受到了破坏。

And so people with chronic diseases have more limited access to primary care and specialty services.

慢性病患者获得初级保健和专业服务的机会也变得更有限。

And we saw increases in death rates from heart disease and diabetes and other chronic illnesses.

我们还发现心脏病、糖尿病和其他慢性疾病的死亡率的上升。

It's just so striking to see this standard benchmark metric going down in a country as wealthy and prosperous as we are.

看到这个基准指标(预期寿命)在我们这样一个富裕繁荣的国家里下降，真是太令人震惊了。

And, as you're saying, we are unique compared to other similar nations. Why is that?

正如你所说，与其他类似的国家相比，我们的情况很特殊。为什么呢?

Well, it's not because we don't spend enough on health care.

嗯， 这并不是因为我们在医疗保健上花的钱不够。

We are unique from other countries also in the massive amount of money we spend on health care, much higher than other countries and much higher than countries in which people live longer lives and are healthier.

与其他国家不同，我们在医疗保健上花费了巨额资金，远远高于其他国家，也远远高于人们寿命更长、身体更健康的国家。

So this is a lesson for us that health care is only a partial answer.

这对我们来说是个教训，医疗保健并非所有的答案。

It's -- studies suggest it only accounts for about 10 to 20 percent of health outcomes.

研究表明，医疗保健只占健康结果的10%到20%。

Our health is really shaped by our living conditions, jobs, the wages we earn, our wealth accumulation, the education that enables us to get those jobs. And we're struggling in those areas.

我们的健康实际上是由我们的生活环境、工作条件、工资收入、财富积累以及让我们得到这些工作的教育所决定的。我们正在这些领域苦苦挣扎。

And it's because of that struggle that we're seeing our health suffer as a result.

正是由于这种挣扎，我们的健康受到了损害。

You're describing, then, potential remedies to arrest this decline are fundamental structural changes to American society.

你所描述的遏制寿命减损的潜在补救措施是对美国社会进行根本性的结构改革。

It's not just vaccines to avoid COVID deaths or naloxone to avoid overdose deaths.

不仅仅是可以避免新冠死亡的疫苗，也不仅仅是可以避免药物服用过量死亡的纳洛酮。

You're talking about something much more systemic.

你谈论的是更系统性的东西。

If this had only happened during the pandemic, we could blame it on a virus.

如果这种情况只发生在疫情期间，我们可以将其归咎于病毒。

But the fact that it's been going on for so many years tells us that we, as a society, have to make a decision.

但事实是，这种情况已经持续了这么多年，这告诉我们，作为一个社会，我们必须做出决定。

We have to shift our priorities if we want to be healthier and we want our children to not die prematurely.

如果我们想要身体更健康，不想让我们的孩子过早死亡，我们必须改变我们的优先事项。

The country that we live in is the richest in the world, but we have the highest level of income inequality.

我们生活的国家是世界上最富有的国家，但我们的收入不平等程度最高。

So, much of the resources that we need for a healthy population are not available to most of the population.

所以，维持人口健康所需的很多资源，大多数人都无法获得。

All right, Dr. Steven Woolf, director emeritus at the Center on Society and Health at Virginia Commonwealth University, always good to see you.

好，史蒂文·伍尔夫博士，弗吉尼亚联邦大学社会与健康中心名誉主任，很高兴见到你。

Thank you.

谢谢你！

Likewise, and thanks for giving attention to this important issue.

同样，感谢您对这一重要问题的关注。