A Grim Measure of Covid’s Toll: Life Expectancy Drops Sharply in U.S.

Life expectancy in the United States fell by a full year in the first six months of 2020, the federal government reported on Thursday, the largest drop since World War II and a grim measure of the deadly consequences of the coronavirus pandemic.

Life expectancy is the most basic measure of the health of a population, and the stark decline over such a short period is highly unusual and a signal of deep distress. The drop comes after a troubling series of smaller declines driven largely by a surge in drug overdose deaths. A fragile recovery over the past two years has now been wiped out.

Thursday’s data gives the first full picture of the pandemic’s effect on American life spans, which dropped to 77.8 years from 78.8 years in 2019. It also showed a deepening of racial and ethnic disparities: Life expectancy of the Black population declined by 2.7 years in the first half of 2020, slicing away 20 years of gains. The life expectancy gap between Black and white Americans, which had been narrowing, is now at six years, the widest it has been since 1998.

“I knew it was going to be large but when I saw those numbers, I was like, ‘Oh my God,’” Elizabeth Arias, the federal researcher who produced the report, said of the racial disparity. Of the drop for the full population, she said, “We haven’t seen a decline of that magnitude in decades.”

Still, unlike the drop in life expectancy caused by the long-running, complex problem of drug overdoses, this one, driven largely by Covid-19, is not likely to last as long because deaths from the virus are easing and the population is slowly getting vaccinated. The last time a pandemic caused a major decline in life expectancy was 1918, when hundreds of thousands of Americans died from the flu pandemic. Life expectancy declined by a whopping 11.8 years from 1917 to 1918, Dr. Arias said, bringing average life spans down to 39 years. But it fully rebounded the following year as deaths eased.

Even if such a rebound occurs this time, the social and economic effects of Covid-19 will linger, researchers noted, as will the disproportionate effects on communities of color. This is all happening against a backdrop of declining life expectancy that had only briefly recovered from the drug epidemic; some researchers said that drug deaths, which began surging again in 2019 and 2020, may continue to tug life expectancy rates downward.

Dr. Mary T. Bassett, a former New York City health commissioner and professor of health and human rights at Harvard University, said that unless the country better addressed inequality, “we may see U.S. life expectancy stagnate or decline for some time to come.”

She noted that life expectancy in America began to lag behind that of other developed countries in the 1980s, a divergence that has puzzled researchers. One theory is that growing economic disparities have also made their way into the health of Americans. Life conditions that have led to worse Covid-19 rates, such as overcrowded housing and inadequate virus protections for low-wage workers, will only exacerbate that trend, Dr. Bassett said.

Life expectancy represents the average number of years that a newborn is expected to live if current death rates do not change. Declines tend to signal grave societal problems, like the sharp drop in Russia after the collapse of the Soviet Union. Declines in developed countries are rare, but the United States experienced them from 2014 to 2017 as the opioid epidemic took its toll. Before that, demographers had not seen an outright decline since 1993, during the AIDS epidemic.

But those declines, while unusual, were small — measured in small fractions of a year. Researchers knew there would be a decline last year, but the sheer magnitude in the first six months left them reeling: The drop brought life expectancy to the lowest level since 2006. The last major decline was 2.9 years between 1942 and 1943, after the United States entered World War II, Dr. Arias said.

Researchers say Thursday’s numbers are important because they are a numeric representation of the magnitude of the current coronavirus crisis. They may not represent a trend that will continue in the future, but they speak volumes about the sheer scale of the suffering many American communities are experiencing in the present, like the Brightmoor neighborhood in Detroit, where the Rev. Semmeal Thomas, 60, pastor of the City Covenant Church, has been helping his congregation come to terms with grief.

He said about 10 people he was close to have died from Covid-19, including his 40-year-old niece, who had just married and was working on her Ph.D., and the wife of his close friend, who was in her 60s. A number of middle-aged people in his church have died too. Some had pre-existing conditions, such as diabetes and hypertension, but they were managing them.

“If Covid had not come, Ruthie Harris would still be here, Jackie would still be here, Michael would still be here, Taisha would still be here,” he said. “It has given us, in the African-American community, this tremendous sense of grief.”

Covid-19 hit Black and Hispanic Americans harder than white Americans. People in those first two groups who died from the virus were also more likely to be younger, slicing into the life expectancy figures more deeply, Dr. Bassett said. She said the coronavirus mortality rate for Black people between the ages of 35 and 44, for example, was ninefold greater than for white people in the same age group, according to data from last February through July.

Over all, the death rate for Black Americans with Covid-19 was almost two times higher than for white Americans as of late January, according to the Centers for Disease Control and Prevention; the death rate for Hispanics was 2.3 times higher than for white Americans.

The 2.7-year drop in life expectancy for African-Americans from January through June of last year was the largest decline, followed by a 1.9-year drop for Hispanic Americans and a 0.8-year drop for white Americans.

Dr. Bassett said she expected life expectancy for Hispanic people to decline even further over the second half of the year, when Covid-19 death rates for that demographic continued to rise even as they dropped for white and Black Americans.

While Covid-19 was almost certainly the primary driver of the decline in American life expectancy, Dr. Arias said, drug overdoses were also a factor. Deaths from drug overdoses declined in 2018 for the first time in nearly 30 years, lifting life expectancy that year.

But the good news was short-lived. Overdose deaths shot up again in 2019 and climbed even more sharply during the first half of 2020, driven mainly by illicitly manufactured fentanyl. Although the 2020 data has not been broken down by race and ethnicity, overdose rates had been rising disproportionately among Black and Hispanic adults, particularly men. That trend has most likely continued as fentanyl has invaded supplies of heroin, cocaine and methamphetamine, and as the pandemic has curtailed access to treatment.

Dr. Dominic Mack, a professor of family medicine in Atlanta, said he did not expect the gap between white and Black life expectancy to shrink immediately once the pandemic ends. That is partly because Black Americans are disproportionately afflicted by chronic diseases like diabetes and hypertension, and because, like all Americans, they stopped getting routine medical care during the pandemic, quite likely worsening their health.

“The issue you have is not just the Covid, but the medical system fallout from the Covid,” said Dr. Mack, who also leads the National Covid-19 Resiliency Network at the Morehouse School of Medicine. “Once that’s corrected, the population still has chronic diseases that probably festered during this time, went untreated.”

In addition, he said, many people of color who were in poor health before the pandemic may suffer from long-term symptoms of the virus yet not have access to good health care, a combination that could hurt life expectancy even after the pandemic ends. So, too, could unequal access to the Covid-19 vaccines.

Even if such a rebound occurs this time, the social and economic effects of Covid-19 will linger, researchers noted, as will the disproportionate effects on communities of color. This is all happening against a backdrop of declining life expectancy that had only briefly recovered from the drug epidemic; some researchers said that drug deaths, which began surging again in 2019 and 2020, may continue to tug life expectancy rates downward.

Dr. Mary T. Bassett, a former New York City health commissioner and professor of health and human rights at Harvard University, said that unless the country better addressed inequality, “we may see U.S. life expectancy stagnate or decline for some time to come.”

She noted that life expectancy in America began to lag behind that of other developed countries in the 1980s, a divergence that has puzzled researchers. One theory is that growing economic disparities have also made their way into the health of Americans. Life conditions that have led to worse Covid-19 rates, such as overcrowded housing and inadequate virus protections for low-wage workers, will only exacerbate that trend, Dr. Bassett said.

Life expectancy represents the average number of years that a newborn is expected to live if current death rates do not change. Declines tend to signal grave societal problems, like the sharp drop in Russia after the collapse of the Soviet Union. Declines in developed countries are rare, but the United States experienced them from 2014 to 2017 as the opioid epidemic took its toll. Before that, demographers had not seen an outright decline since 1993, during the AIDS epidemic.

Over all, the death rate for Black Americans with Covid-19 was almost two times higher than for white Americans as of late January, according to the Centers for Disease Control and Prevention; the death rate for Hispanics was 2.3 times higher than for white Americans.

The 2.7-year drop in life expectancy for African-Americans from January through June of last year was the largest decline, followed by a 1.9-year drop for Hispanic Americans and a 0.8-year drop for white Americans.

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