COVID-19 Pandemic Drives “Massive” Decrease in US Life Expectancy – Largest Decrease Since World War II

COVID-19 has widened the gap in life expectancy between racial groups and between the US and similar countries.

According to new research from Virginia Commonwealth University, the University of Colorado Boulder and the Urban Institute, life expectancy in the US fell by 1.87 years between 2018 and 2020, a drop not seen since World War II.

The numbers are even worse for people of color. While life expectancy among white Americans fell by an average of 1.36 years in 2020, it fell by 3.25 years among black Americans and 3.88 years among Hispanic Americans.

The data will be published today (June 23, 2021) in The BMJ, a journal published by the British Medical Association.

Other countries also saw a decline in life expectancy between 2018 and 2020, but the loss of life expectancy in the US was 8.5 times the average for 16 comparable countries. The declines for minorities were 15 to 18 times greater than in other countries.

The chart in Figure 1 provides life expectancy estimates for 2010-18 and 2020 for the US and the average for 16 high-income countries. The US started the decade with a life expectancy short of 1.88 years compared to comparable countries. This gap widened over the decade, reaching 3.05 years in 2018. Between 2018 and 2020, the gap widened significantly to 4.69 years: the 1.87-year decline in life expectancy in the US was 8. 5 times the average decline in comparable countries (0.22 years). Credit: VCU Center for Society and Health/The BMJ

“When the pandemic came, my naive assumption was that it wouldn’t have a major impact on the pre-existing divide between the US and peers,” said Steven Woolf, MD, lead author of the study and director emeritus of VCU’s Center on Society and Health. . “It was a global pandemic and I assumed every country would be hit. What I did not expect was how badly the US would fare during the pandemic and the massive death toll the US would experience.”

The death toll in the US has surpassed 600,000, according to the Coronavirus Resource Center at Johns Hopkins University. According to previous research led by Woolf, excessive deaths, exceeding the official count, could be contributing to the impact of the pandemic.

Life expectancy trends in the US were already “very concerning,” Woolf said. Since the 1980s, improvements in life expectancy in the US have not kept pace with those of comparable countries. Around 2010, life expectancy in America reached a plateau and then declined for three consecutive years. It continued to rise in other countries.

Figure 2 compares the changes in life expectancy in the US in 2010-18 and 2018-20 with those of comparable countries, based on gender, race and ethnicity. Credit: VCU Center for Society and Health/The BMJ

“The gap has been widening for a while,” Woolf said. Then COVID-19 hit, and the United States had one of the world’s highest per capita death rates. Black and Hispanic communities were hit harder than white populations. Woolf’s paper is the first to show the significance of the widening gap in life expectancy. Previous reports only included data from the first half of 2020 and provided no comparison with comparable countries.

“To give some perspective, when life expectancy dropped a few years ago, it was a drop of about 0.1 year per year that was front page news,” said Woolf, C. Kenneth and Dianne Wright Distinguished Chair of VCU. in population health and health equity. “That’s the kind of rise or fall we’re used to every year.”

Woolf called the 1.87-year drop in life expectancy “huge” by comparison.

“It’s like we haven’t seen anything since World War II,” he said. “1943 was the last time the US had such a big drop in life expectancy.”

Figure 3 shows how changes in life expectancy have contributed to the gap between the US and peers. For example, Figure 2 shows that the life expectancy of American women increased by 0.21 years in 2010-18, but as the life expectancy of women in the peer countries increased even more (0.98 years), the gap widened by 0.77 years (Figure 3). Credit: VCU Center for Society and Health/The BMJ

Six countries in the authors’ comparison group saw their life expectancy increase in 2020 – places like New Zealand, Finland and Norway. Other countries fared poorly: Italy and Spain saw losses in life expectancy. But no one came close to the US

“The disorganized approach to the pandemic in the US had a lot to do with governance,” said Woolf, a professor in the Department of Family Medicine and Public Health at the VCU School of Medicine. “Our constitution delegates public health powers to states, so we had 50 response plans. Many lives were lost because so many decisions were driven by politics and ideology. COVID-19 has exposed many of the systemic problems that have fueled the long-term decline in Americans’ health.

“And when vaccination takes us past the pandemic and COVID-19 is in the rearview mirror, those systemic issues will still be with us,” Woolf said.

Included in those issues are racial health inequalities and the role of systemic racism. The most shocking statistic for Woolf was the life expectancy data for black and Hispanic Americans. It is known that COVID-19 had a disproportionate impact on people of color, but the effect on life expectancy for those groups was “shocking,” he said.

Black men’s life expectancy, in particular, reached its lowest level since 1998.

“It’s a big setback because the US has been making progress for many years in closing the black and white death gap,” Woolf said. “And Hispanic Americans enjoyed longer life expectancies than whites for years, but that advantage was almost completely negated by COVID-19.”

Data on Native Americans, who also experienced very high death rates during the pandemic, were not examined in the study due to insufficient data.

“In many ways, the US has turned a corner in its response to COVID-19, but the data emerging on pandemic health disparities is urgent and valuable in helping us understand the impact on our communities,” said Dean Peter Buckley, MD from the VCU School of Medicine. “The disparities in life expectancy between America and other countries and between racial groups reported in Dr. Woolf’s paper are worrisome, and I hope the numbers are a wake-up call for the healthcare community and beyond.”

Reference: “Effect of the 2020 covid-19 pandemic on life expectancy between populations in the US and other high-income countries: Simulations of preliminary mortality data” by Steven H Woolf, Ryan K Masters and Laudan Y Aron, June 23, 2021, The BMJ.
DOI: 10.1136/bmj.n1343

Co-authors on the paper are Ryan Masters, Ph.D., an assistant professor at the University of Colorado Boulder, and Laudan Aron, a senior fellow at the Urban Institute.

Woolf receives partial funding from the National Institutes of Health’s National Center for Advancing Translational Sciences, which supports the Wright Center for Clinical Translational Research, where Woolf plays a role in community engagement.