A new study estimates that life expectancy in the U.S. decreased by nearly two years between 2018 and 2020, largely due to the COVID-19 pandemic. And the declines were most pronounced among minority groups, including Black and Hispanic people.
In 2018, average life expectancy in the U.S. was about 79 years (78.7). It declined to about 77 years (76.9) by the end of 2020, according to a new study published in the British Medical Journal.
"We have not seen a decrease like this since World War II. It's a horrific decrease in life expectancy," said Steven Woolf of the Virginia Commonwealth University School of Medicine and an author of the study released on Wednesday. (The study is based on data from the National Center for Health Statistics and includes simulated estimates for 2020.)
Beyond the more than 600,000 deaths in the U.S. directly from the coronavirus, other factors play into the decreased longevity, including "disruptions in health care, disruptions in chronic disease management, and behavioral health crisis, where people struggling with addiction disorders or depression might not have gotten the help that they needed," Woolf said.
The lack of access to care and other pandemic-related disruptions hit some Americans much harder than others. And it's been well documented that the death rate for Black Americans was twice as high compared with white Americans.
The disparity is reflected in the new longevity estimates. "African Americans saw their life expectancy decrease by 3.3 years and Hispanic Americans saw their life expectancy decrease by 3.9 years," Woolf noted.
"These are massive numbers," Woolf said, that reflect the systemic inequalities that long predate the pandemic.
"It is impossible to look at these findings and not see a reflection of the systemic racism in the U.S.," Lesley Curtis, chair of the Department of Population Health Sciences at Duke University School of Medicine, told NPR.
"This study further destroys the myth that the United States is the healthiest place in the world to live," Dr. Richard Besser, president of the Robert Wood Johnson Foundation (an NPR funder), said in an email.
He said wide differences in life expectancy rates were evident before COVID-19. "For example, life expectancy in Princeton, NJ—a predominantly White community—is 14 years higher than Trenton, NJ, a predominantly Black and Latino city only 14 miles away," Besser said.
Life expectancy in the U.S. had already been declining — albeit slowly — in the years leading up to the pandemic. And the U.S. has been losing ground compared with other wealthy countries, said Magali Barbieri of the University of California, Berkeley, in an editorial published alongside the new study.
The study estimates that the decline in life expectancy was .22 years (or about one-fifth of a year) in a group of 16 peer countries (including Austria, Finland, France, Israel, the Netherlands and the United Kingdom) compared with the nearly two-year decline in the United States.
"The U.S. disadvantage in mortality compared with other high income democracies in 2020 is neither new nor sudden," Barbieri wrote. It appears the pandemic has magnified existing vulnerabilities in U.S. society, she added.
"The range of factors that play into this include income inequality, the social safety net, as well as racial inequality and access to health care," Duke's Curtis said.
So, what's the prognosis going forward in the United States? "I think life expectancy will rebound," Woolf of Virginia Commonwealth said.
But it's unlikely that the U.S. is on course to reverse the trend entirely.
"The U.S. has some of the best hospitals and some of the greatest scientists. But other countries do far better in getting quality medical care to their population," Woolf said. "We have big gaps in getting care to people who need it most, when they need it most."
STEVE INSKEEP, HOST:
So many Americans have died during the pandemic that it altered the life expectancy of the entire country. A study finds a decline by almost two years. For people who identify as Black or Latino, life expectancy declined even more. NPR's Allison Aubrey reports.
ALLISON AUBREY, BYLINE: In 2018, people in the U.S. could expect to live, on average, about 79 years. But the pandemic changed this. Dr. Steve Woolf of Virginia Commonwealth University estimates life expectancy at the end of 2020 dropped to about 77 years.
STEVEN WOOLF: We have not seen a decrease like this since World War II. So this is - it's a horrific decrease in life expectancy. And this dramatic fall is clearly due to the pandemic.
AUBREY: In addition to the roughly 600,000 people who died from COVID-19, Woolf says many other factors play into the decreased longevity - for instance, disruptions in health care.
WOOLF: Disruptions in chronic disease management, like problems with controlling diabetes, and behavioral health crises, where people struggling with addiction disorders or depression might not have gotten the help that they needed.
AUBREY: The lack of access to care and other disruptions hit some Americans much harder than others. It's been documented that the COVID death rate for Black Americans was twice as high compared to white Americans. And the new study finds steeper declines in life expectancy.
WOOLF: African Americans saw their life expectancy decrease by 3.3 years, and Hispanic Americans saw their life expectancy decrease by 3.9 years. These are massive numbers.
AUBREY: Life expectancy in the U.S. had already been slowly declining in the years leading up to the pandemic. And compared to people in other countries, the U.S. fares pretty poorly, ranking 41st among wealthy nations. People in the U.S. live shorter lives on average than people in Canada, Australia, Japan, Korea and many European countries. Lesley Curtis is chair of the department of population health sciences at Duke University School of Medicine.
LESLEY CURTIS: I wasn't surprised that the life expectancy actually decreased between 2018 and 2020.
AUBREY: But she was surprised to see that the decline in life expectancy in a group of 16 other wealthy nations was only a couple of months, compared to the nearly two-year decline in the U.S. And she says the even larger declines in longevity among Blacks and Hispanics in the U.S. are very telling.
CURTIS: I think it is impossible to look at these findings and not see a reflection of the systemic racism.
AUBREY: As well as income inequality and a lack of access to health care and healthy food that all predate the pandemic. Dr. Steve Woolf says life expectancy in the U.S. will likely rebound post-pandemic, but a complete reversal of the trend is unlikely.
INSKEEP: The U.S. has some of the best hospitals and some of the greatest scientists, but we have big gaps in getting care to people who need it most when they need it most.
AUBREY: And that will continue, he says, until systemic problems are addressed.
Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.