Life expectancy in the United States fell the most in more than seven decades last year, when Covid-19 sent hundreds of thousands of Americans to early death.
The disproportionate burden on color communities from the pandemic has also widened existing gaps in life expectancy between white and black Americans, the Centers for Disease Control and Prevention estimates.
The record is an extraordinarily grim record of an ongoing catastrophe. The first year of the pandemic dealt a bigger blow to American life expectancy than any year of the Vietnam War, AIDS crisis, or “deaths of desperation” that hit life expectancy in the mid-2010s pressed.
“It’s breathtaking and depressing,” said Noreen Goldman, a professor of demographics and public affairs at Princeton University. “The US is lagging behind virtually every high-income country in life expectancy, and now it is lagging even further.”
The pace of Covid-19 deaths dropped sharply as vaccinations spread in the first half of 2021. However, it is unclear how long it will take for life expectancy to recover. The U.S. has recorded a total of 609,000 Covid deaths since the pandemic began. More than 43% occurred in 2021, almost half the year is still ahead.
The first year of the pandemic reduced American life expectancy at birth by 1.5 years to 77.3 years. That wiped out the country’s profits since 2003. It was the largest annual decline since 1943, in the middle of World War II. Goldman said it was the second largest drop since the 1918 influenza pandemic, which killed around 50 million people worldwide.
The decline in the pandemic in 2020 has widened the distance between the US and other wealthy democracies like France, Israel, South Korea and the UK, according to a study recently published in the BMJ-Journal.
“This is not a decline like other high-income countries, so something went terribly wrong in the US, where the number of Americans who died far exceeded what was required,” said Steven Woolf, Center on Society director emeritus and Health at Virginia Commonwealth University and one of the authors of the BMJ study.
Life expectancy is a statistical construct that reflects death rates in a specific place and time. The CDC report describes life expectancy at birth as “the average number of years a group of infants would live if throughout life they experienced the age-specific mortality rates that prevail over a given period of time”. It is not intended to predict the actual life expectancy of people born during this time. Rather, it is a way of comparing death rates across regions and years.
Three quarters of the decrease in 2020 were due to Covid. Accidental injuries, a category that includes record-high fatal drug overdoses for 2020, also dragged the measure down, as did homicides, diabetes and liver disease. The decline would have been steeper had it not been offset by fewer deaths from other factors such as cancer, chronic lower respiratory diseases, heart disease, and suicide.
All demographic groups saw a decrease in life expectancy in 2020. However, the decline was not evenly distributed. Men lost more ground than women. Hispanic Americans, who have longer life expectancies than white or black Americans, recorded the greatest losses during Covid, with life expectancy falling by three full years, twice as much as the country as a whole.
Black Americans also experienced a 2.9 year loss of life expectancy. This decline widened the gap between blacks and whites in the United States, a difference in life expectancy that had shrunk since the 1990s. The life expectancy of white Americans decreased by 1.2 years in 2020.
“There is no biological reason for people of any skin color to die more often from a virus,” said Woolf, noting that the different effects reflect structural inequalities.
Distorted representation in frontline jobs like retail, meat packaging, transportation and healthcare, combined with higher chronic disease rates, puts both an increased risk of Covid exposure and an increased risk of dying from it, Goldman said.
Unequal access to health care, language barriers, and overcrowded or multigenerational housing also contributed to the disproportionate burden of the virus on Hispanic and black populations, she said.
The estimates published by the CDC’s National Center for Health Statistics reflect death certificate data reported by states and cities. The report did not include data on the populations of Asian Americans, American Indians, Native Americans, Hawaiians, and other Pacific islanders.
As alarming as the one year decline in life expectancy in 2020 is, Woolf said more attention should be paid to the decade-long life expectancy gap that has cut more American lives than Covid.
In the 20th century, life expectancy generally increased in affluent countries as science and hygiene helped defeat infectious diseases. In the US, worrying signs surfaced in the 1990s that the country could not match the profits of other nations. This divergence has come to be known as a U.S. health disadvantage.
“The more important issue than the acute event we’re currently seeing in life expectancy is the long-term trend,” said Woolf. “This is actually much more frightening for the US than what we are reporting for 2020, as strange as that may sound.”