mericans’ life expectancy continued to slide in 2021. According to provisional data from the National Center for Health Statistics released on Aug. 31, life expectancy dropped by 0.9 years in 2021, leading to a total decrease of about 2.7 years between 2019 and 2021—the largest two-year decline in a century.
COVID-19, responsible for over half the American death rate, is again the leading cause of premature deaths. However, other causes of death—including drug overdoses, heart disease, and liver disease—also surged, hinting at the devastating ripple effects the pandemic has had on society.
In 2021, the life expectancy of someone who was born was 76.1 years. This is down from 77 in 2020. Men suffered more than women. The life expectancy of 2021-born males fell by 73.2 years compared to 2020. Females lost 0.8 years.
The drop in life expectancy wasn’t inevitable, especially after a highly effective COVID-19 vaccine became available, says Andrew Stokes, an assistant professor in the department of global health at Boston University School of Public Health. In fact, many wealthy countries—including much of western Europe—recovered in 2021 after experiencing declines in life expectancy in 2020—while some countries, like Australia, experienced no declines at all. “The U.S. is an outlier,” says Stokes. “In a highly functioning public health and health care system, one would expect rebounds due to widespread access to vaccines.”
The COVID-19 vaccine could have reduced life expectancy even more. According to estimates by the Commonwealth Fund, about 1.1 million Americans would have been more likely to die from COVID-19 in the period between December 12, 2020 and November 21, 2021. The virus also indirectly increased risk factors for other conditions, including by disrupting the health care system and people’s lives.
Researchers have also warned that people are at higher risk for dying due to the pandemic. COVID-19 has strained the U.S. health care system, leading to widespread understaffing, while patients delayed both routine doctors’ visits and trips to the hospital. More directly, SARS-CoV-2 infection can damage the heart, and is thought to have raised patients’ risk of dying.
Drugs and alcohol were also major threats to health during the pandemic. The number of drug overdoses rose sharply from 2020 to 2021. This was especially true for Black, American Indian and Alaska Native populations. An important contributing factor is the increasing use of illegal fentanyl. This highly addictive synthetic opioid was responsible for 66% of all overdose deaths. Researchers believe that the pandemic made substance use riskier by adding to isolation and worsening mental health, as well as disrupting patients’ access to treatment programs and health care. Among American Indians and Alaska Natives, chronic liver disease and cirrhosis—both of which can result from alcohol use—contributed to 18.6% of the decline in life expectancy.
Between 2019 and 2021, the largest declines in life expectancy were experienced by black people, Hispanics and Native Americans. American Indians, Alaska Natives saw the greatest decline between 2019 and 2021. They experienced a decrease of 1.9 years in their life expectancy from 2020 through 2021. That’s a drop total of 6.6 year since 2019.
White people saw an even greater drop in their life expectancy in 2021: 1 year. That’s compared to Black people (0.7 of a year) and Hispanics (0.1 of a year). This isn’t because conditions improved for Black and Hispanic communities, Stokes emphasizes; rather, it was because more white people died. COVID-19 accounted for 54.1% in decline in life expectancy among whites. For the most part, says Stokes, this is because the Delta wave killed younger people and affected more rural areas—places with weaker health care systems, lower vaccination rates, and more white people, although the average age at death shifted older among white people during the Omicron wave.
“I think it’s fair to say that at least part of the [U.S.’s] poor performance is due to the lackluster health care response and lack of uptake of vaccines,” says Stokes. “Things could have been different if we had had a more rigorous public health response.”
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