Between 2019 and 2021, life expectancy among all Americans experienced the steepest decline since the early 1920s, according to new findings from CDC and a preprint study.

Cheat sheet series: Population health

What's contributing to this 'historic' decline in life expectancy?

In 2019, the average life expectancy for all Americans was 78.86. Since then, life expectancy in the United States has dropped to 76.44—a decline of nearly three years. Among white and Black Americans, life expectancy fell to the lowest level seen in more than 25 years.

According to data from CDC's National Center for Health Statistics (NCHS), life expectancy among Indigenous groups was shortened by more than four years from 2019 to 2020—and it fell even further in 2021. Since the pandemic began, life expectancy for indigenous groups has declined by six and a half years on average, bringing the average life expectancy to 65. 

While the pandemic was responsible for some of the decline in life expectancy, several other factors contributed to the decline, including an increase in accidental deaths and drug overdoses, heart disease, chronic liver disease, and cirrhosis.

In addition, health problems related to poverty, discrimination, and poor access to health care left indigenous populations vulnerable to the coronavirus, said Ann Bullock, former director of diabetes treatment and prevention at the federal Indian Health Service agency and a member of the Minnesota Chippewa Tribe.

"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," Bullock said.

Noreen Goldman, professor of demography and public affairs at the Princeton School of Public and International Affairs noted that the average life expectancy in indigenous populations is now "lower than that of every country in the Americas except Haiti, which is astounding."

In 2021, white Americans experienced the second-largest decline in average life expectancy, followed by Black and Hispanic Americans.

However, the average life expectancy for Hispanic Americans declined by four years during the first year of the pandemic. During the same period, the average life expectancy for Black Americans declined by over three years. While white Americans saw the smallest drop during the first year of the pandemic, life expectancy for white and Black Americans is currently at its lowest level since 1995.

According to Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, the decline in life expectancy in the United States can be characterized as "historic."

US life expectancy falls far below peer countries

According to the preprint study, other wealthy nations have started to recover from the decline in life expectancy that occurred during the pandemic while the average American's life expectancy has continued to fall.

For instance, from 2019 to 2020, the United States' average life expectancy fell from 78.86 to 76.98. In 2021, the decline in life expectancy continued, falling to 76.44. However, among the United States' peers, life expectancy fell from 82.22 in 2019 to 81.67 in 2020 before rising back up to 81.93 in 2021.

"None of them experienced a continuing fall in life expectancy like the U.S. did, and a good number of them saw life expectancy start inching back to normal," Woolf said.

According to Woolf, the United States' peer countries deployed more successful vaccination campaigns and had populations that were more willing to take steps to lower transmission, including masking and isolation guidelines. "The U.S. is clearly an outlier," he noted. (McDonough, Vox, 9/7; Rabin, New York Times, 8/31; Masters et al., medRxiv, 6/1)