Declining life expectancy in the US continued to decline in 2021 due to COVID and drug overdoses

If the length of our lives is a good measure of our well-being, then the United States is in trouble.

The average life expectancy for an American born in 2021 was just under 76 years and 5 months — more than six months less than in 2020, according to a new government report. It was the lowest number of its kind since 1996 and follows about a decade of stagnation in life Extending our lifespan by years.

The numbers, released Thursday by the Centers for Disease Control and Prevention, mark the second straight year of a decline in average life expectancy, a streak not seen in more than a century.

The pandemic has played a major role in this trend. COVID-19 deaths rose from 350,831 in 2020 to 416,893 in 2021, allowing the new disease to maintain its position as the third leading cause of death in the US behind heart disease (695,547 deaths) and cancer (605,213 deaths).

But the CDC made it clear that the coronavirus wasn’t the only nagging impact on America’s life expectancy.

In 2021, there were 106,699 drug overdose deaths in the United States, the CDC’s National Center for Health Statistics said in a separate report released Thursday. That’s a dramatic increase since 2020, a year when fatal overdoses had already reached an all-time high of 91,799.

While deaths from cocaine and methamphetamine increased in 2021, the steepest increase in overdose deaths – 22% – was attributed to synthetic opioids such as fentanyl.

The new numbers suggest drug-related deaths have increased five-fold over the past two decades, according to the CDC.

When accounting for deaths from all causes, the age-adjusted death rate for Americans last year was 879.7 deaths per 100,000 people, a 5.3% increase from 2020.

In each age group, mortality rates continued to be highest among Black and Hispanic men, and among men and women who identify as Native American/Alaska Native. However, 2021 saw a notable improvement in the health of Black and Hispanic populations compared to White Americans.

After adjusting for age, the researchers found that white women and men were more likely to die in 2021 than they were in 2020. In contrast, black and Hispanic men were less likely to die last year than the year before and the death rates for Women in both groups luck steadily.

Dr. Stephen Woolf, a Virginia Commonwealth University researcher who tracks Americans’ health, said the apparent reversal in death trends between white Americans and communities of color is something of a mystery.

But “there’s an obvious hypothesis that’s some kind of elephant in the room,” said Woolf, who was not involved with the CDC reports. Early COVID-19 death rates were highest among Latino and Native American/Alaska Native communities, an experience that appears to have prompted them to get vaccinated in 2021, Woolf said. In contrast, “many white populations believed they were either at lower risk, or had political objections to vaccination or mask wearing.”

As waves of disease swept across the country, the result of differential immunization coverage would mean that white Americans would begin to see higher COVID-19 death tolls, which would translate into lower life expectancies.

The age at which people died in the past year also explains how the average life expectancy at birth fell from 77 years in 2020 to 76.4 years in 2021.

The pandemic has of course taken the heaviest toll on seniors, particularly those aged 75 and older. But these victims are closer to their predicted end of life than other Americans. Statistically, the death of a child, or even the death of a 45-year-old, will impact the nation’s average life expectancy more than the death of an 80-year-old.

But COVID-19 mortality rates for middle-aged and younger adults reached higher levels in 2021 than in 2020. And in both years, drug overdose rates were highest in adults aged 25 to 54. Combined, trends like these contributed to a remarkable finding: that between 2020 and 2021, mortality rates increased for all age groups except infants.

When statisticians compared the historical probability of death at each age to actual deaths in 2021, they found that those aged 35-44 saw a 16.1% increase in premature deaths, the largest increase of any age group. Mortality rates increased by 13.4% for 25-34 year olds and by 12.1% for 45-54 year olds.

Even for children between the ages of 1 and 4, mortality rates were 10% higher in 2021 than in 2020.

Barring some bumps along the road, life expectancy in the US has been on an upward trend since 1900, when newborn Americans could expect to live at 47.3 years. The one major exception: Average life expectancy collapsed in 1917 and 1918, when a world war and a flu pandemic reduced average life expectancy from 54.5 years in 1915 to 39.1 years in 1918.

America’s steady increase in life expectancy began to falter around the year 2000, as deaths from drugs, suicide, gun violence, and chronic diseases began to rise steadily. By 2010, the United States had lost its lead over most other prosperous countries, and American life expectancy was beginning to fall behind.

As of 2020, the average life expectancy of newborn Americans was 4.7 years less than their peers in other affluent countries — closer to averages in Peru and Thailand than countries like France, Israel or South Korea.

With the world’s third-highest COVID-19 death rate, the United States was unlikely to close the gap in 2021. Two years of declining life expectancy may not turn out to be the beginning of a long-term trend. But Woolf said the ongoing impact of the pandemic on mental and physical health, the ongoing scourge of addiction and the outrage in gun violence do not bode well for aligning US life expectancy with that of our peers.

“The experience of other countries tells us that it didn’t have to be that way,” Woolf said. Countries that have introduced COVID-19 vaccines and other public health measures and managed medical care more equitably “have shown that it is possible to have an epidemic with a different outcome,” he said.

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