Pandemic, healthcare system blamed for historic decline in U.S. life expectancy

In what experts said is an indictment of the U.S. healthcare system and persistent economic and racial inequality, federal health researchers on Wednesday released data showing the U.S. saw the largest decline in life expectancy in nearly a century during the first two years of the coronavirus pandemic, with Americans now expected to live nearly three fewer years than they were in 2019.

While life expectancy changes have historically been measured in months instead of years, the National Center for Health Statistics (NCHS) reported that average life expectancy fell to 76.4 in 2021, dropping a whole year from 2020. That decline comes after life expectancy fell from nearly 79 to 77.4 between 2019 and 2020.

The pandemic drove half of the statistical decline, said the NCHS, but an increase in mortality also grew in cases of unintentional injuries—particularly drug overdoses—by nearly 16%, heart disease by more than 4%, chronic liver disease by 3%, and suicide by more than 2%.

“There is no doubt Covid was a contributor to the increase in mortality during the last couple of years, but it didn’t start these problems—it made everything that much worse,” Dr. Stephen Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, told the New York Times.

Chronic inequality helped drive an especially sharp decline in life expectancy among Indigenous people. Since the pandemic began, the average life expectancy of Native Americans and Alaska Natives has plummeted by more than six and a half years, dropping to age 65. Life expectancy for all Americans was 65 years nearly 80 years ago.

Indigenous people have the highest rate of diabetes among any racial or ethnic group in the U.S., and are more likely to live in multigenerational households—both risk factors for severe Covid-19 infections.

The two-year decline in life expectancy in Indigenous communities was so severe, Robert Anderson, chief of mortality statistics at the NCHS, had researchers “re-run the numbers to make sure.”

“It’s a ridiculous decline,” Anderson told Stat News. “When I saw a 6.6 year decline over two years, my jaw dropped.”

Among both Black and white Americans, average life expectancy is now the lowest it’s been since 1995.

Researchers noted that while life expectancy fell in other wealthy nations in the first year of the pandemic, several countries in the Global North have begun to recover from the decline.

Dr. Joshua Sharfstein, vice dean for public health practice at the Bloomberg School of Public Health at Johns Hopkins University, suggested the continued drop in life expectancy in the U.S.—despite the wide availability of Covid-19 vaccines—was tied to rampant misinformation about vaccination, the refusal of policymakers to abandon the profit-driven healthcare system and replace it with universal care, and other failures to protect public health.

“Did the politicized rejection of reasonable public health measures put many people in harm’s way? Yes,” said Sharfstein. “Has our failure to provide universal healthcare access contributed to many unnecessary deaths? Yes… Is it finally time to build an effective public health system? Yes.”

Woolf pointed to what public health experts call “the U.S. health disadvantage,” with Americans relying on a healthcare system driven by profit motives instead of public health, widespread access to guns, high levels of pollution, and economic inequality as risk factors contributing to the drop in life expectancy and overall poor health outcomes compared to other high-income countries.

“The U.S. is clearly an outlier,” Woolf told the Times regarding the country’s pandemic response and its falling average life expectancy.