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."
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