Life expectancy in the US had mostly been on an upward march in the 21st century. Then COVID hit.
From 2019 to 2020 life expectancy dropped for all 50 states and Washington, DC, by about 1.8 years, according to a new CDC report, which shows some regions were hit harder than others.
The biggest decrease in life expectancy was found among people in New York, who had a decline of three years. Meanwhile, Hawaii saw the smallest decline in life expectancy: 0.2 years. The changes were "mostly due to the COVID-19 pandemic and increases in unintentional injuries (mainly drug overdose deaths)," according to the report.
This doesn’t mean Americans are now destined to live shorter lives. The findings, which are based on 2020 mortality records and population estimates, are more of a reflection of the deaths that occurred in 2020 and less of a crystal ball forecast of the future.
An expert who studies population health statistics who wasn’t involved in the new report said the data are “historically unprecedented.”
“We haven't seen drops in life expectancy on this scale since World War II, and that's the important point because people sometimes don't think these numbers sound very big, especially when you're talking about fractional decreases in life expectancy,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. “But they’re actually representing large losses of life.”
It makes sense that New York’s life expectancy is the hardest hit because COVID had the deadliest impact on its residents at the start of the pandemic in 2020. Other states and regions, including DC, Louisiana, New Jersey, Arizona, and Mississippi, which also experienced massive COVID-related death tolls overall, saw the next largest drops in life expectancy.
“The biggest finding is that none of the states escaped these declines, even Hawaii and Alaska, which are somewhat isolated,” said Robert Anderson, chief of the Mortality Statistics Branch at the CDC’s National Center for Health Statistics, who supervised the study. “On a population scale, it’s actually quite large, and represents a lot of premature mortality.”
Yet, many places that saw a decline weren’t involved in COVID’s initial furious wave, Woolf pointed out. Instead, it was early decisions — or lack thereof — on infection prevention measures such as business closures and mask requirements that ultimately led to their states’ large number of deaths throughout the course of 2020, and thus their declines in life expectancy.
Generally, Southern states like Alabama, Kentucky, and South Carolina had the lowest life expectancies in 2020, while Western and Northeastern states like California, Oregon, Connecticut, and Vermont had the highest. It’s a trend that “goes back decades,” Woolf said, primarily because of state-specific public health policy decisions, such as the expansion of Medicaid.
Overall, life expectancy in the US in 2020 was 77 years (74.2 for men and 79.9 for women), which isn’t that impressive compared with other wealthy nations.
Woolf coauthored a study published in April in the journal JAMA Network Open that also found life expectancy in the US decreased by 1.87 years from 2019 to 2020. When compared to 21 other high-income countries, however, America’s decrease was unrivaled. The average decline in life expectancy of these countries was only 0.58 years.
The new data adds to the growing life expectancy gap between the US and other nations, which was flat or on a downward trend since about 2010 while that of other countries continued to increase. In fact, life expectancy in the US declined for three years straight from 2014 to 2017, “the longest sustained decline … since the influenza pandemic of 1918-1919,” according to a 2021 report from the National Academies of Sciences, Engineering, and Medicine.
Researchers say that the gap is a result of increasing premature deaths in young and middle-aged adults from drug overdoses, obesity, type 2 diabetes, and other chronic diseases. It’s a consequence of the little attention the US has paid to education, poverty, income inequality, public transportation, affordable housing, social well-being, and access to healthcare — among other life necessities — compared with peer countries, researchers say.
Studies also show that marginalized communities face “horrifically larger” declines in life expectancy, Woolf said.
His April study found that life expectancy dropped by more than three years among Hispanic and Black people in 2020 compared with white people (1.38 years), a finding that reflects the disproportionate losses and vulnerabilities people of color have and continue to face during the COVID pandemic.