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Life Expectancy

Americans' life expectancy continues to fall, erasing health gains of the last quarter century

Average American life expectancy fell from 77 to 76.4 years last year, bringing U.S. figures back to where they were in 1996, according to federal data released Thursday.

That means all the medical advances over the past quarter century have been erased, said Dr. Steven Woolf, a professor of family medicine and population health at Virginia Commonwealth University, who was not involved in the new study.

For American men, life expectancy fell by more than eight months, and for women the loss was about seven months, the study found. Life expectancy, which is actually a measure of death rates, dropped in every age category over age 1.

Though the rate of decline in life expectancy wasn't as dramatic as in 2020, Woolf said, the fall-off in 2021 was actually worse because it came on top of that year's 17% decline.

The latest decline came as other wealthy countries saw a rebound after the first year of the pandemic, Woolf said. He blames a variety of factors, including low COVID-19 vaccination rates and the general poor health of Americans.

"The fact that the United States in 2020 and 2021 did so much worse than other countries is a warning sign that this health disadvantage that America has had for many years is really getting pretty bad," he said.

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What's killing Americans?   

Causes of death remained largely the same between 2020 and 2021, led by heart disease, cancer and COVID-19, all three of which occurred more often last year.

Eight of the top 10 causes of death saw statistically significant increases in 2021 over 2020, including unintentional injury and stroke. Only Alzheimer's disease and chronic lower respiratory diseases declined among the leading causes of death.

Death rates from chronic liver disease and cirrhosis, which are often alcohol-related, also rose during the pandemic, the data showed. Woolf said people might have turned to alcohol to reduce economic, social and other stresses of the previous two years.

Drug overdoses increased during the pandemic, but Woolf doesn't like the common term "deaths of despair" because many people start taking addictive painkillers on a doctor's orders after a surgery.

Death rate increasing at younger ages  

Woolf said he's particularly concerned about the drop in life expectancy for people in middle age, who should be at the prime of their working years.

This trend began a decade before the pandemic, but COVID-19 contributed, he said, particularly for people of color. A 40-year-old with multiple health problems was more likely to die of COVID-19 than someone of the same age in better health; in essence, poor health is making the American population look older than it is, he said.

It's not clear, he said, why deaths are increasing among younger adults and children, which had been declining before the pandemic.

The race gap reversed    

The race gap reversed somewhat in 2021 as white people lost more ground than people of color, though they still live longer on average.

During the first year of the pandemic, Hispanic and Black populations experienced much higher death rates than their white counterparts. They were more likely to be exposed to COVID-19 and to die when they got infected, Woolf said.

But in 2021, "it's the white population that's done worse," he said. Death rates increased among people of color, but not as much as the 7% among white people. 

American Indians and Native Alaskans continued the "tragic losses" seen in the first year of the pandemic, he said.

"The white population, which from a medical standpoint should not be experiencing higher death rates, did," Woolf said. Other data suggests that's because white people were more likely to avoid COVID-19 vaccination.

What can be done?   

Woolf said he sees a clear path toward improving America's health, by providing what other wealthy nations provide: quality education, affordable housing, access to healthy food, reduced income inequality and greater regulation of industries that pollute or provide potentially dangerous products such as cars or guns.

"We need to make a decision as to whether we're just going to accept those losses and accept that Americans are going to be less healthy than people (in other wealthy countries) and live much shorter lives or we need to do something about it," Woolf said. "We don't lack solutions. We lack political will."

Woolf said he doesn't think it will take 25 years for Americans to regain the ground lost over the past two. Once COVID-19 deaths fall, life expectancy numbers should bounce back, he said.

"But the fact that we took a hit like that and were pushed that far back in time while other countries did not is very concerning."

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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