Population Health in Peril: Needed U.S. Science and Public Policy Action.

With unprecedented increases, mortality trends in the US have received significant attention in recent years. To date, research on this topic has emphasized specific causes of death and proximal behavioral or physiological determinants. In this commentary, I consider novel contributions of Zheng & Echave (Am J Epidemiol. XX:XX-XX) in examining trends in mental health, health behaviors, and physiologic dysregulation. I then discuss broader developments in related research and make a case for: (1) not allowing recent health trends among Whites to overshadow the urgent work that needs to be done to mitigate persistent racial inequities, (2) further investigation of what accounts for increases in income inequality and its life span health consequences; and (3) broadening the scope of mechanisms considered to include under-discussed topics such as the role of increases in social media usage or environmental toxicant exposures. Underlying several potential explanations for observed trends in health and mortality is the fact that substantial change has occurred on multiple fronts in US society and that policy responses to these changes have been insufficient. An enhanced emphasis on innovative population health research will be essential to provide the evidence base needed for policy makers to rise to these urgent challenges.