A Historical Drop In Life Expectancy

While many would like to forget this dark chapter of Covid-19 in our history and move on, we will likely be experiencing Covid-19 itself and the aftershocks for generations to come. Not just because of the impact of Long Covid but also because of a dramatic drop in life expectancy. New data from the CDC shows that U.S. life expectancy dropped by a total of 2.7 years between 2019 and 2021 to 76.1 years, the lowest number since 1996. Not only is this very distressing, but certain races and ethnic groups continue to be disproportionally affected by a decrease in life expectancy.

Despite being the richest country in the world, the U.S. has one of the lowest life expectancies of any developed country. The US has also seen one of the largest declines in life expectancy among such countries during the pandemic, according to World Bank data. By contrast, Japan has 36.73 Covid deaths per 100,000 people compared to the US’s 324.25 deaths per 100,000 people.

However, the US is not the only country to experience a drop in life expectancy. Globally, research from Nature shows that only four countries, Belgium, France, Sweden, and Switzerland, have returned to pre-pandemic levels of life expectancy.

The researchers calculated life expectancy using a technique called a period life table. The technique requires researchers to imagine a group of 100,000 hypothetical infants and apply the death rates observed for the real population in 2021 for each year of those infants’ lives. The data produced is not the life expectancy for actual babies born in 2021 but rather how life expectancy rates would apply to various age groups at a specific point in time

Life expectancy in the U.S. was on a gradual upward trajectory in the past century, with a few notable exceptions, including the 1918 influenza pandemic, World War II, and the HIV crisis. The Covid-19 pandemic has eroded much of that progress, with over 50 percent of the total causes of death contributing to the change in life expectancy in the United States in 2020 and 2021 directly related to Covid-19 infection. Unintentional injuries driven largely by drug overdoses also contributed to 15 percent of causes of death contributing to the change in life expectancy. Increases in deaths from heart disease, chronic liver disease, and suicide also contributed.

All of these conditions are part of what I refer to as inter-related Covid syndemics. The impact of Covid-related Post Traumatic Stress can not be underestimated. There were 91,799 drug overdose deaths in the U.S. in 2020, a 30% increase from 2019, which began accelerating in March 2020, and rates of mental health disorders have also surged during the pandemic. Americans have reported rates of depression and anxiety six times higher than in 2019. Creating integrated healthcare systems that treat the physical, mental and social health of patients will be critical in fighting the syndemics such as PTSD and addiction that accompany the Covid-19 pandemic.

The drop in life expectancy would have been greater if it had not been partially offset by declines in influenza and pneumonia deaths, which were likely reduced by pandemic-related precautions such as masking and social distancing. However, with few protective measures left in place against respiratory illnesses and a severe influenza season expected based on data from Australia’s season, these numbers are likely to rise.

What is particularly disturbing is how we continue to see certain races and ethnic groups continue to be disproportionally affected by Covid-19. Non-Hispanic Native American and Alaska Native peoples saw the biggest decline in life expectancy of 6.6 years. Life expectancy decreased by 4.2 years for the Hispanic population, by four years in the non-Hispanic Black population, by 2.4 years in the non-Hispanic white population, and by 2.1 years in the non-Hispanic Asian population. In 2021, the Native American and Alaska Native populations had the lowest life expectancy of any race or ethnicity: 65.2 years. This is equivalent to the life expectancy of the total U.S. population in 1944.

Many Native American and Alaska Native individuals, along with Hispanic and Black people, suffered disproportionately high death rates during the pandemic’s first year because many worked in essential jobs with a high COVID exposure risk. The researchers from the CDC study suggested that Indigenous peoples were disproportionately affected because of high rates of chronic disease and poor healthcare access before the pandemic. We need far greater public awareness, community relations, and accountability in our health systems to ensure that these disparities do not continue to widen.