June 29, 2021

Charted: The 'horrific' toll of Covid-19 on US life expectancy

Daily Briefing

    Overall life expectancy in the United States dropped by almost two years between 2018 and 2020, the largest drop since 1943, according to a new BMJ study. Notably, certain racial and ethnic groups saw even greater declines, largely driven by the economic fallout from Covid-19.

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    U.S. life expectancy drops

    For the study, researchers looked at data for the United States and 16 other high-income countries through the National Center for Health Statistics and the Human Mortality Database.

    The researchers found that the gap in average life expectancy between the United States and peer countries increased from 1.88 years to 3.05 years between 2010 and 2018. Overall life expectancy in the United States dropped by 1.87 years between 2018 and 2020—a decline 8.5 times the average decrease in 16 other high-income countries during the same time frame.

    Specifically, in the United States, the average life expectancy declined from 78.7 years in 2018 to just 76.9 by the end of 2020. By comparison, individuals living in the other nations included in the study can currently expect to live 4.7 years longer than Americans, Kaiser Health News reports.

    Moreover, the researchers found that while all U.S. population segments experienced a decline in life expectancy, minority populations were disproportionately affected, NPR reports. For instance, non-Hispanic white Americans saw their life expectancy drop by 1.36 years from 2018 through 2020. In contrast, non-Hispanic Black Americans saw their life expectancy drop by 3.25 years, and the life expectancy of Hispanic Americans dropped by 3.88 years.

    "We have not seen a decrease like this since World War II," Steven Woolf, from the Virginia Commonwealth University School of Medicine and an author on the study, said. "It's a horrific decrease in life expectancy."

    He added that since life expectancy usually varies by about a month or two year to year, declines of the size recorded in the latest study are "pretty catastrophic."

    Why life expectancy dropped in the U.S.

    The United States' drop in life expectancy can largely be attributed to the Covid-19 pandemic, directly or indirectly, KHN reports.

    Specifically, research has found that, in 2020, the mortality rate in the United States increased by almost 23%, with around 522,000 more deaths than typically expected. Many of these deaths were directly attributable to Covid-19, but others stemmed from heart attacks and strokes—both of which increased in 2020 in part because delayed treatment or poor access to medical care, Woolf said.

    'Aftershocks of Covid'

    The economic fallout from the pandemic is another large contributor to the drop in life expectancy, KHN reports. According to KHN, about 10.7% of Americans lived in poverty in January 2020, compared with about 11.3% currently.

    Because of increased poverty levels, many more Americans are suffering from food insecurity, which has been linked to a host of conditions such as, high cholesterol, hypertension, depression, anxiety, and more, KHN reports.

    And stress related to the pandemic has also led to increases in smoking, drinking, and weight gain, all of which increase the risk of chronic diseases, KHN reports. According to CDC data, the United States saw a 30% increase in fatal drug overdoses between October 2019 and October 2020.

    Further exacerbating the situation, a federal eviction moratorium is slated to expire on June 30, which experts say could endanger the health of many more people.

    For example, research has found that adults who are evicted are more likely to report poor mental health and be hospitalized for a mental health crisis, and pregnant women who are evicted are more likely to give birth prematurely. Meanwhile, children who are evicted are more likely to be at risk of lead poisoning from low-quality housing and to be hospitalized, according to Emily Benfer, a visiting professor at Wake Forest University School of Law.

    "Poverty causes a lot of cancer and chronic disease, and this pandemic has caused a lot more poverty," Otis Brawley, a professor at Johns Hopkins University, said. "The effect of this pandemic on chronic diseases, such as cardiovascular disease and diabetes, will be measured decades from now."

    Separately, Robert Califf, former FDA commissioner, in an April editorial in Circulation wrote, "Once the acute phase of this crisis has passed, we will face an enormous wave of death and disability. These will be the aftershocks of covid."

    However, it is possible to stem this crisis by addressing issues such as poverty, racial inequality, and affordable housing access, according to Richard Besser, president and CEO of the Robert Wood Johnson Foundation.

    "How the pandemic will affect people's future health depends on what we do coming out of this," he said. "It will take an intentional effort to make up for the losses that have occurred over the past year." (Szabo, Kaiser Health News, 6/24; Aubrey, NPR, 6/23)

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