February 19, 2021

Charted: America's worst decline in life expectancy 'in decades'

Daily Briefing

    The average life expectancy for Americans dropped precipitously in the first half of 2020, according to preliminary data from CDC's National Center for Health Statistics (NCHS), marking the largest drop in life expectancy since World War II—and the lowest life expectancy projection since 2006.

    When will the Covid-19 epidemic end? Here are the good, bad, and ugly scenarios.

    Life expectancy drops a full year

    Overall, according to the report, the average life expectancy for the U.S. population dropped a full year in the first half of 2020, from 78.8 years in 2019 to 77.8 years for January through June 2020.

    When broken down by gender, life expectancy for men dropped from 76.3 years to 75.1 years, while life expectancy for women dropped from 81.4 years to 80.5 years. As a result, the life expectancy gap between men and women increased from 5.1 years in 2019 to 5.4 years in 2020.

    The report also found that minorities were hit especially hard by life expectancy declines.

    Overall, the non-Hispanic Black population saw life expectancy drop from 74.7 years to 72 years. And non-Hispanic Black men experienced the sharpest decline among all populations in the report, with their life expectancy declining an average of three years. Non-Hispanic Black women, meanwhile, experienced a life expectancy decline of 2.3 years.

    Meanwhile, the Hispanic population saw life expectancy drop from 81.8 years to 79.9 years. The non-Hispanic white population saw life expectancy drop from 78.8 years to 78 years.

    Overall, the declines in life expectancy among non-Hispanic white people narrowed the life expectancy gap between Hispanic and white non-Hispanic populations from three years in 2019 to 1.9 years in the first half of 2020. However, the gap between non-Hispanic white and Black populations increased from 4.1 years in 2019 to six years in the first half of 2020, the largest gap between those two groups since 1998.

    Key caveats

    According to the Associated Press, the latest findings mark the first time CDC has reported life expectancy averages based on early, provisional death certificate data rather than final counts—data which, because of its limited nature, does not capture the full impact of Covid-19. It also means the data doesn't include the death count for the winter months, when fatality rates generally increase, NPR reports.

    Another limitation was that coronavirus pandemic hit different areas at different times, with urban areas hardest hit in the first half of the year and rural areas struggling in the second half. As a result, "life expectancy at birth for the first half of 2020 may be underestimated since the populations more severely affected, Hispanic and non-Hispanic black populations, are more likely to live in urban areas," the researchers wrote.

    According to Elizabeth Arias, a health scientist at the Mortality Statistics Branch of NCHS and lead author on the report, the full year's data will be available in May or June, and the agency expects to release its finalized 2020 data on mortality and life expectancy at the end of 2021 or the start of 2022.

    Discussion

    Arias said the magnitude of the drops in life expectancy was a surprise to her. "I knew it was going to be large but when I saw those numbers, I was like, 'Oh my God,'" she said, adding that the United States hasn't experienced a full year drop in overall life expectancy "in decades."

    Arias added that while the Covid-19 epidemic likely is directly responsible for "the majority of the decline" in life expectancy, a further portion may be indirectly related to the epidemic, such as the rise in drug overdose deaths.

    In 2018, drug overdose deaths dropped for the first time in almost 30 years, but they rose again in 2019 and even more in the first half of 2020, the New York Times reports.

    Separately, Kirsten Bibbins-Domingo, a health equity researcher and dean at the University of California, San Francisco, said because the findings represent only the first half of 2020, she expects that when the full year's worth of data is available, "these numbers [will] only get worse."

    She also pointed out that the findings demonstrate how "Black and Hispanic communities throughout the United States have borne the brunt of this [epidemic]." According to Bibbins-Domingo, Black and Hispanic people are more likely to work in frontline, low-wage jobs and live in crowded areas where the new coronavirus can spread more easily. They also have "stark, pre-existing health disparities in other conditions" that increase their risk of death from Covid-19, she added.

    Dominic Mack, a professor of family medicine in Atlanta, said he doesn't expect the life expectancy gap between Black and non-Hispanic white populations to shrink once the epidemic is over, in part because Black Americans are disproportionately affected by chronic conditions such as diabetes and hypertension, and because they likely stopped receiving routine medical care during the epidemic.

    "The issue you have is not just the Covid, but the medical system fallout from [Covid-19]," Mack said. "Once that's corrected, the population still has chronic diseases that probably festered during this time, went untreated" (Sohn, STAT News, 2/18; Tavernise/Goodnough, New York Times, 2/18; Marchione, Associated Press, 2/17; Wamsley, NPR, 2/18).

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