COVID causes largest decline in U.S. life expectancy since World War II

COVID-19. (NIAID-RML/Zuma Press/TNS)

In the wake of more than 377,000 COVID-19 deaths last year, the average life expectancy in the U.S. fell by 1.5 years, new federal data shows.

Life expectancy at birth for the total population declined from 78.8 years in 2019 to 77.3 years in 2020. That is the lowest level since 2003, according to provisional data released Wednesday by the National Center for Health Statistics.

The decline was even greater among minorities. The average life expectancy of Hispanics in the U.S. plummeted by three years to 78.8 years, the report shows.

The average life expectancy of Black people fell by 2.9 years to 71.8 years, ending a trend that saw that demographic’s average lifespan inch closer to those of white Americans. The average life expectancy of that group fell 1.2 years to 77.6, its lowest since 2002.

Public health experts expected the coronavirus pandemic would significantly alter life expectancy, but they were surprised at the impact on a metric that normally shifts in small increments over many years. The sudden 1.5 year drop is the largest since World War II, when life expectancy fell 2.9 years as U.S. military personnel fought in World War II between 1942 and 1943.

COVID-19 deaths contributed to 74 percent of the 2020 decline, the report states. The numbers are a sobering reminder of the devastating effect of the pandemic, said Cindy Prins, an associate professor of epidemiology at the University of Florida’s College of Public Health and Health Professions.

“We think of World War II as a catastrophic event; now we’ve got a comparison with COVID-19,” she said. “This is a catastrophic loss of life.”

The report is seen by some public health experts as another sign of how the U.S. has mismanaged the pandemic.

The coronavirus was the third leading cause of death in the U. S. in 2020 behind heart disease and cancer, according to data from the Centers for Disease Control and Prevention. The current U.S. COVID-19 death toll of more than 609,000 represents the the fifth worst per capita fatality rate in the world, behind South American nations Peru, Brazil, Columbia and Argentina, according to data from Johns Hopkins University and Medicine.

Other wealthy nations have also reported declines in average life expectancy, but not as great as in the United States. One study in the British Medical Journal found that the 2020 decline in life expectancy in the United States was 8.5 times more than the average of 16 high-income peer countries that included Denmark, France, New Zealand and the United Kingdom.

It means the average life expectancy in the U.S. is now almost five years shorter than in its peer countries.

“It’s a wake up call for all of us,” said Ali Mokdad, a professor and chief strategy officer of population health at the University of Washington’s Institute for Health Metrics and Evaluation. “We had a pandemic that we didn’t control. We have people who are attacking science and people who refuse to shutdown the country.”

Since the 1.5 year fall in life expectancy is a national average, the true impact of the pandemic will be much greater in poorer and minority communities. That is already reflected in the greater slump in average life expectancy for Black and Hispanic residents, Makdad said.

Factors such as a poor diet, food deserts and higher stress can lead to chronic health conditions that put people at higher risk from severe coronavirus symptoms. Those same neighborhoods also tend to have more blue collar, “essential” and service industry workers who could not work from home during the pandemic, Mokdad said, therefore they were exposed more often to the coronavirus.

At the same time, he said, those communities have higher rates of uninsured and underinsured people and less access to health care while also having a greater chance of receiving poorer quality of care.

“We need to address to the gaps in health care system,” Mokdad said. “We need to do it right.”

The “alarming” drop in life expectancy will also mean a corresponding loss of spending and productivity that could hinder the economic future of many families and the overall economy, said John Sinnott, chairman of internal medicine at the University of South Florida and an epidemiologist at Tampa General Hospital. More families may struggle economically because of the loss of wage earners.

There is also uncertainty about how the long term health of so-called “long-haul” coronavirus patients, who make up roughly 10 percent of those infected.

“If someone can’t work because their lungs or heart or kidneys are damaged, that’s a huge drain on society and the medical profession and their families,” Sinnott said.

He is also concerned that there may be long-term effects from COVID-19 that have yet to be discovered. Von Economo encephalitis and chronic lung disease emerged as side effects from the 1918 influenza pandemic, Sinnott said.

The pandemic may have indirectly also contributed to other factors that led to the fall in average life expectancy.

The National Center for Health Statistics attributed an estimated 11 percent of the decline to increases in deaths from accidents and unintentional injuries. Roughly one third of the latter category were drug overdose deaths.

Last week the agency reported a record high of more than 93,000 overdose deaths in 2020 that experts believe was driven by isolation, mental health issues and unemployment all caused by the pandemic.


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