The coronavirus pandemic probably caused the worst decline in life expectancy in the US since the second world war, with disproportionately worse declines for Black and Hispanic Americans, new research published in the British Medical Journal has found.
Between 2018 and 2020, life expectancy for Americans declined 1.87 years, 8.5 times worse than the average decline in life expectancy in 16 peer nations, and the most precipitous decline since the second world war.
The decline is expected to exacerbate the gap in life expectancy between the US and other developed nations, some of which have seen increases in life expectancy even amid the pandemic.
“When the pandemic came, my naive assumption was that it would not have a big impact on the pre-existing gap between the US and peer countries,” said Dr Steven Woolf, the study’s lead author and director emeritus of Virginia Commonwealth University’s Center on Society and Health.
“It was a global pandemic, and I assumed that every country would take a hit. What I did not anticipate was how badly the US would fare in the pandemic, and the enormous death toll that the US would experience,” he said.
More than 600,000 people have died in the Covid-19 pandemic in the US since 2020, a toll that continues to grow even as vaccination efforts have substantially decreased new cases and deaths. Racial and ethnic minorities and low-income people have suffered disproportionately, with higher rates of infection and death.
The research, authors said, “draws attention to the root causes of racial inequities in health, wealth and wellbeing. Foremost among these root causes is systemic racism”, the authors wrote. They added that, “extensive research has shown that systems of power in the US structure opportunity and assign value in ways that unfairly disadvantage Black, Hispanic, Asian, and Indigenous populations, and unfairly advantage White people.”
The research published by BMJ found Hispanic and Black individuals were substantially more affected by the pandemic, losing 3.88 and 3.25 years of life expectancy respectively, compared with a decline of 1.36 years for white individuals.
The research is a collaboration between Woolf and researchers at the University of Colorado and the Urban Institute in Washington DC. The findings largely agree with peer-reviewed research published in other journals, which have cited the potential for large declines in US life expectancy compared with peer nations as a result of the disjointed American response to the pandemic.
Researchers compared life expectancy data from 2010-2018 to simulated life expectancy data from 2020, using a tool developed for the pandemic by researchers with the Human Mortality Database, an internationally focused life expectancy research project based out of the demography department of the University of California Berkeley and the Max Planck Institute for Demographic Research in Germany.
They found the US fared substantially worse than peer nations. Between 2010 and 2018, the gap in life expectancy between the US and peer nations grew from 1.88 years to 3.05 years. In 2020, that gap grew again by 1.87 years, an enormous decline that widened the gap between the US and peer nations to 4.69 years.
The dramatic declines in life expectancy among Black and Hispanic individuals erased more than a decade of progress in eliminating the racial gap in life expectancy. Black men in America can now expect to live 67.73 years, on par with life expectancy for this group in 1998.
Researchers could not estimate the impacts on life expectancy for Native Americans, Pacific Islanders or Asian people – though they too were substantially affected – because the National Center for Health Statistics does not collect data for these racial groups.
Over the last year, researchers and experts have linked the US’s extraordinary death toll to issues as longstanding and complex as unequal opportunities for people of color and underinvestment in public health. Authors also noted that a substantial but unknown proportion of people infected with Covid-19 may have “long-haul” symptoms.
“The pandemic will have short and long term effects on the social determinants of health, changing living conditions in many communities, and altering life course trajectories across age groups,” authors wrote. “Fully understanding the health consequences of these changes poses a daunting but important challenge for future research”.
The US government response to the pandemic under former president Donald Trump was also widely seen as botched with a too slow realization of the pandemic’s seriousness and the promotion of unfounded conspiracy theories.
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