Briefing

America's declining life expectancy, explained

It's not just COVID

Americans aren't living as long as they once did. 

For the second straight year, life expectancy in America has dropped significantly. The Centers for Disease Control and Prevention on Wednesday announced that "life expectancy at birth dropped by nearly a year between 2020 and 2021 – and by more than two and a half years overall since the start of the COVID-19 pandemic," CNN reports. In 2019, the average American could expect to live to be 79 years old. Now that number is 76. 

Indigenous groups, which include American Indian and Alaska native people, have suffered the worst: Life expectancy in those communities has dropped a "startling 6.6 years since 2019 – more than twice as much as it did for the total U.S. population," says CNN. Life expectancy in those groups now stands at 65 years. Why is American health doing so poorly? Here's everything you need to know:

Why is life expectancy dropping?

COVID is obviously a big reason, but not the only one. In addition to the pandemic, "a rise in accidental deaths and drug overdoses also contributed, as did deaths from heart disease, chronic liver disease, and cirrhosis," reports The New York Times. Some of the heart disease deaths may actually be related to the coronavirus, Time reports — both because the pandemic overwhelmed understaffed hospitals, but also because a COVID infection "can damage the heart, and is thought to have raised patients' risk of dying."

America's opioid epidemic is particularly taking a toll. "Drug overdose deaths reached a record high in 2021, killing about 109,000 people," CNN points out. "And deaths from unintentional injuries — about half of which are due to drug overdose — was the second-leading cause of the decline in life expectancy."

Is the U.S. doing worse or better than other countries during the pandemic?

Worse, at least compared to our peer nations. "Many wealthy countries — including much of western Europe — recovered in 2021 after experiencing declines in life expectancy in 2020 — while some countries, like Australia, experienced no declines at all," Time reports. Some of the disparity is probably due to America's "don't tread on me" conservative political culture: "Those countries had more successful vaccination campaigns and populations that were more willing to take behavioral measures to prevent infections, such as wearing masks," notes The New York Times. 

Is this just a short-term thing? 

Unfortunately, no. "American life expectancy began to stagnate around 2010 — while other developed countries continued to see gains," STAT News observes. In 2018, two years before the pandemic began, The Washington Post pointed out that the U.S. was already experiencing the  "longest sustained decline in expected life span at birth in a century, an appalling performance not seen in the United States since 1915 through 1918."

Researchers have had a tough time finding a silver bullet explanation for why American health has declined so precipitously. Theories that stagnating life expectancy can be attributed to obesity rates and opioid drug use "fail to explain a problem that feels broader," The New York Times reported back in 2016. Instead, the Los Angeles Times reported the next year, the problem appears to be driven by a range of factors, including "diseases linked to social and economic privation, a healthcare system with glaring gaps and blind spots, and profound psychological distress."

Why are indigenous communities hit so hard by this trend?

It can't be overstated: COVID has hit native communities with particular viciousness. "American Indians are 2.2 times more likely to die from COVID-19 and 3.2 times more likely to be hospitalized for the virus," NPR reports.

The biggest factor: poverty. One in four Native Americans lives below the poverty line, The New York Times reports. That leads to "inadequate access to health care, poor infrastructure, and crowded housing, much of it the legacy of broken government promises and centuries of bigotry." What's more, the newspaper points out, discrimination has been linked to "the erosion of mental and physical health, as has exposure to polluted air and water."

Dr. Ann Bullock, a member of the Minnesota Chippewa tribe who formerly served at the Indian Health Services agency, summed it up for the newspaper: "This is simply what happens biologically to populations that are chronically and profoundly stressed and deprived of resources."

What can be done? 

First of all, there is some good news in the numbers. "Mortality's been a little better in 2022 than it was in 2020, so I think it's likely that we would see maybe a slight increase in life expectancy," the CDC's Robert Anderson told Reuters. But it's tough to say whether that trend will last through the end of the year: Deaths usually rise during the winter months.

Even if life expectancy rebounds slightly this year, though, many observers say the latest news means America needs to reconsider both health and economic policy as the country continues to emerge from the pandemic. The trend of shortening life spans is a societal problem, after all.  "Life expectancy isn't really a prediction for a single individual," Kate Sheridan says at STAT News. "It's more like a check engine light — an indicator for the health of society as a whole."

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