Life expectancy in the United States declined at the most rapid rate since World War II in the past two years.
According to estimates from the Centers for Disease Control and Prevention, a June preprint study, and other research on the topic, the average life expectancy for Americans declined from 79 years in 2019 to about 76 in 2021.
It is wrong to assume the decline was caused by the COVID-19 pandemic, says Merrill Matthews, a resident scholar at the Institute for Policy Innovation.
“The pandemic certainly had an impact on life expectancy, but apparently not that much,” said Matthews. “Life expectancy was declining sharply before COVID-19 hit, and only declined slightly in 2020. Asian life expectancy even improved a bit. The real question is why life expectancy was declining before COVID.”
Causes other than COVID-19 are definitely part of the problem, says Gregg Girvan, a resident fellow at the Foundation for Research on Equal Opportunity (FREEOP).
“Clearly, the pandemic continued to take a toll on the U.S., so the decline in life expectancy is a reflection of that,” said Girvan. “But it certainly didn’t help that over the course of the pandemic, the United States has also seen increases in deaths due to drug overdose, homicides, traffic accidents, and chronic disease that has gone undetected and untreated.
“Many of these causes of death occur among younger age groups, which will have a disproportionate impact on overall life expectancy,” said Girvan.
Chronic diseases have historically contributed heavily to lagging life expectancy in the United States, says Girvan.
“Over the coming years, these rates will only continue and perhaps get worse, because more cases of such diseases have gone untreated or were not caught early enough,” said Girvan. “This is a negative consequence of lockdown policies and practices that did little to nothing to prevent COVID-19’s spread but will have lasting consequences on public health.”
The United States has a unique set of problems not found in other countries, including high rates of traffic accidents, drug overdoses, and homicide, says Girvan. The homicide rate “disproportionately affects younger ages and therefore has a greater effect on bringing down U.S. life expectancy,” said Girvan.
“To improve life expectancy, the United States has to address aspects of longevity that often have little to do with the health care system directly,” Girvan said. “America suffers from poor eating and lifestyle habits that contribute greatly to mortality.”
Substance abuse, homelessness, and crime are major factors in the life expectancy decline, says Matthews.
“One of the most notable changes in the past several years is the increase in homelessness and crime, both of which have a strong correlation with substance abuse,” Matthews said. “The government-imposed pandemic lockdowns exacerbated substance abuse.”
Another important factor is automobile use, says Girvan.
“The U.S. is more auto-centric culturally, as well as out of necessity because of the country’s suburban landscape,” said Girvan. “Again, many people of younger ages die from accidents, having a greater downward effect on life expectancy.”
Drug Abuse Problem
Drug overdose mortality disproportionately affects the young and thus has an outsized effect on life expectancy, says Girvan.
“Nearly half of [U.S.] overdose deaths in 2020 occurred among those ages 25 to 44,” said Girvan.
“While the number of overdose deaths of people older than 55 is growing, 72 percent of the opioid deaths occur in people between the ages of 25 and 54, with ages 25-34 experiencing the most deaths,” said Matthews.
Matthews says Americans should pay more attention to drug policy.
“Drug enforcement policies have been dramatically relaxed or ignored, especially in blue cities and states, even to the point of making it easy to access and use drugs openly,” Matthews said. “Drug-involved deaths nearly doubled from 2015 to 2020, to 91,799.”
A 2021 study by the National Institute on Drug Abuse found a steady increase in drug overdose deaths in the years 1999 to 2020.
Preventable opioid deaths increased by 41 percent in 2020 over the previous year. More than 17,000 people in the 25 to 34 age group died, a 38 percent increase from the year before.
“Averaging in those growing numbers of younger deaths has a disproportionate impact on the decline in the average lifespan,” said Matthews.
As a broad metric that does not distinguish between different types of mortality, life expectancy may be the wrong way to measure a health care system, says Girvan.
“Much of the improvement to life expectancy in the U.S. will come about with societal improvements that are not ameliorated by the health care system,” said Girvan.
FREOPP publishes a yearly country-by-country comparison of health care systems, the World Index of Healthcare Innovation. The index provides additional evidence the increasing U.S. mortality rate is not being caused by poor health care.
“The U.S. has access to the best treatments and methods to extend lifespan,” said Girvan. “We have room for improvement for greater health insurance coverage and certainly on affordability. But overall, the quality of available care suggests other interventions outside the health care system would deliver greater gains in longevity and quality of life.”
Harry Painter (firstname.lastname@example.org) writes from Oklahoma.
“Provisional Life Expectancy Estimates for 2021,” NCHS National Vital Statistics System, August 22, 2022: https://www.cdc.gov/nchs/data/vsrr/vsrr023.pdf
“Changes in Life Expectancy Between 2019 and 2021 in the United States and 21 Peer Countries,” MedRxiv, June 1, 2022: https://www.medrxiv.org/content/10.1101/2022.04.05.22273393v4.full.pdf
“Overdose Death Rates,” Advancing Addiction Science, National Institute on Drug Abuse, January 20, 2022:https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates