Covid plus overdose deaths drove down life expectancy in 2020

Life expectancy in the U.S. plunged last year in the largest one-year drop since World War II, the Centers for Disease Control and Prevention reported Wednesday, further widening the longevity gap between the U.S. and comparable countries.

Deaths from Covid-19 and drug overdoses fueled the decline — wiping out any improvements the country made in decreasing deaths from cancer and chronic lower respiratory diseases — leading to a 1.5-year drop and bringing the life expectancy at birth down to 77.3 years. (Life expectancy at birth refers to how long a person born in the year being studied — in this case, 2020 — is expected to live.)

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The decline, which was reported by provisional models last month, spotlights the country’s system of poor health, experts said.

“What happened in the U.S. did not occur in other comparable countries despite Covid-19 being a global pandemic,” said Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University.

Deaths from Covid-19 caused almost 75 percent of the reduction in life expectancy on average. But the disease was responsible for 90 percent of the drop in life expectancy among Hispanic Americans, compared to 68 percent in white Americans and almost 60 percent in Black Americans.

The life expectancy advantage among Hispanic Americans compared to white Americans more than halved — from 3 years in 2019 to 1.2 years in 2020, bringing Hispanic Americans’ current life expectancy to 78.8 years. Life expectancy for Black Americans declined by almost 3 years, to 71.8 years, the youngest age for the population since 2000; the decline was nearly 2.5 times the decline among white Americans, whose life expectancy fell to 77.6 years. Data were unavailable for other races and ethnicities.

The particular impact the pandemic had on Hispanic and Black Americans “reflects the inequalities that were present before the pandemic that have to do with unequal access to health care and racial and ethnic disparities in health more generally, which largely have to do with socioeconomic disadvantages,” said Irma Elo, chair of the sociology department and a research associate at the Population Aging Research Center at the University of Pennsylvania.

“The people who have disproportionately suffered from this pandemic were the same people who were put in positions where they were more likely to be exposed because of their employment,” Elo said.

The report also highlighted an increase in homicides and diabetes, which together accounted for about 5.5 percent of the decrease in life expectancy. Chronic liver disease and cirrhosis — which hint at an increase in alcohol abuse, Woolf said — accounted for nearly 2.5 percent of the decrease.

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It also emphasized the impact of the opioid epidemic.

The researchers estimated that an increase in deaths from accidents or unintentional injuries — one-third of which were drug overdoses — was responsible for 11 percent of the decline in life expectancy. Last week, the CDC reported an all-time high of over 93,000 overdose deaths in 2020, an increase of nearly 30 percent from 2019. Overdoses increased by about 4 percent from 2018 to 2019.

“We were already seeing a worrying trend before the pandemic and were predicting that the stress and depression brought on by job loss, housing insecurity and the pandemic itself would exacerbate issues with drug addiction. This report shows that it did,” Woolf said, adding that the pandemic also disrupted access to addiction treatment, psychological help and lifesaving resources, such as naloxone distributors.

However, he emphasized that a system of poor health is the underlying force driving down life expectancy in the U.S. while it increases in comparable countries.

“People may think that with Covid-19 and opioids off the table, we’d be in good shape, but the reality is quite different,” Woolf said.

Still, controlling Covid-19, which is responsible for the lion’s share of the decrease in life expectancy, is necessary for the U.S. to close racial disparities in longevity.

“We are going to see this continue if people don’t get vaccinated,” Elo said. “Not being vaccinated puts everyone in danger, not just the unvaccinated individual, and provides opportunities for the virus to mutate, which may make the vaccines we have less effective.”

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