By Christopher Cheney
Compared to 21 peer countries, the United States experienced a large decrease in life expectancy from 2019 to 2020, and life expectancy dipped sharply for Hispanic and Black U.S. populations, a new research article indicates.
In 2020, there were more deaths from COVID-19 in the United States than any other country, and Americans had relatively high COVID-19 mortality rates. Before the pandemic, the United States had one of the lowest life expectancy rates among high-income countries.
The new research article, which was published by JAMA Network Open, examined data for three racial and ethnic groups that account for most of the total U.S. population: Hispanic, non-Hispanic Black, and non-Hispanic White. The 21 peer countries in the study were Austria, Belgium, Canada, Denmark, England and Wales, Finland, France, Germany, Israel, Italy, Netherlands, New Zealand, Northern Ireland, Norway, Portugal, Scotland, South Korea, Spain, Sweden, Switzerland, and Taiwan.
The study generated several key data points:
- From 2019 to 2020, life expectancy in the United States fell by a median of 1.87 years, from 78.86 years to 76.99 years.
- The Hispanic (3.70-year decrease) and non-Hispanic Black (3.22-year decrease) U.S. populations experienced significantly larger decreases in life expectancy than the non-Hispanic White U.S. population (1.38-year decrease).
- Hispanic men (4.31-year decrease) and non-Hispanic Black men (3.54-year decrease) had the largest drops in life expectancy in the United States, compared to a 1.53-year decrease among non-Hispanic White men.
- In the 21 peer countries, life expectancy fell by a mean of 0.58 years.
- In 2020, the mean life expectancy in the peer countries was 4.51 years higher than U.S. life expectancy (81.50 years versus 76.99 years).
- In the 21 peer countries, Spain experienced the largest decrease in life expectancy, falling 1.43 years. There were increases in life expectancy in New Zealand, South Korea, and Taiwan.
“The large and highly racialized decreases in U.S. life expectancy underscore the growing U.S. health disadvantage relative to peer countries and the need for policies that prioritize health and equity,” the research article’s co-authors wrote.
Assessing decrease in U.S. life expectancy
Stagnation and decreases in U.S. life expectancy since 2010 are due to multiple factors, the research article’s co-authors wrote. There has been increasing mortality rates among young and middle-aged adults from causes including drug overdoses, cardiometabolic diseases such as diabetes, and other chronic illnesses.
Compared to peer countries, there are several systemic factors that contribute to the “U.S. health disadvantage,” the research article’s co-authors wrote.
- The United States ranks low on social and economic conditions such as education, poverty, and affordable housing
- The United States ranks low on health-promoting environments and infrastructure such as walkability and access to healthy food
- The United States ranks low on social well-being such as racial segregation and social isolation
- The United States ranks low on healthcare access and health insurance
“In contrast to policies adopted by its peers, U.S. social welfare spending is less equitable and less beneficial to children and families. The United States also lacks universal healthcare and provides weaker protections for public health and safety,” the research article’s co-authors wrote.
The systemic shortcomings in the United States made the country susceptible to high mortality rates during the coronavirus pandemic, the research article’s co-authors wrote.
“These preexisting conditions, combined with mismanagement of federal, state, and local pandemic responses and factional public resistance to practices to prevent viral transmission, drove U.S. death rates above those experienced by other countries. The excess deaths included not only those attributed to COVID-19 but also non-COVID deaths associated with social and economic disruptions of the pandemic, along with inadequate or delayed care of acute emergencies and chronic illnesses and behavioral health crises that fueled a record increase in fatal drug overdoses,” they wrote.
During the pandemic, conditions were ripe for a large decrease in life expectancy among Hispanic and non-Hispanic Black Americans, the research article’s co-authors wrote.
“The large decreases in life expectancy among Hispanic and Black populations reflect their higher risk of hospitalization and death from COVID-19 and vulnerability to conditions causing non-COVID deaths. The racialized health inequities that were conspicuous in 2020 have existed for generations, the products of systemic racism, segregation, and exclusionary policies. Historic and current conditions have systematically blocked racial and ethnic minority groups from access to healthcare, social and economic mobility, and environmental conditions that determine health and life expectancy,” they wrote.
Christopher Cheney is the senior clinical care editor at HealthLeaders.