San Diego Union-Tribune

U.S. LIFE EXPECTANCY CONTINUED TO FALL IN 2021

COVID, overdoses drive down average lifespan, CDC says

- BY MELISSA HEALY

If the length of our lives is a good measure of our wellbeing, the United States is in some trouble.

The average life expectancy for an American born in 2021 was just shy of 76 years and 5 months — more than half a year shorter than it was in 2020, according to a new government report. It was the lowest such figure since 1996 and follows roughly a decade of stagnation in adding years to our lifespans.

The numbers, released Thursday by the Centers for Disease Control and Prevention, mark the second consecutiv­e year of decline in average life expectancy, a streak that hasn’t happened in more than a century.

The pandemic has played a major role in that trend. COVID-19 deaths increased from 350,831 in 2020 to 416,893 in 2021. That allowed the new disease to maintain its position as the third-leading cause of death in the U.S., behind heart disease (695,547 deaths) and cancer (605,213 deaths).

But the CDC made clear that the coronaviru­s was not the only corrosive influence on America’s life expectancy.

The year 2021 saw 106,699 drug overdose deaths in the United States, the CDC’s National Center for Health Statistics said in a separate report released Thursday. That’s a dramatic spike from 2020, a year in which fatal overdoses had already reached a historic peak of 91,799.

While deaths caused by cocaine and methamphet­amine rose in 2021, the steepest hike in overdose deaths — 22 percent — was attributed to synthetic opioids such as fentanyl.

The new figures indicate that drug fatalities have risen fivefold over the last two decades, the CDC said.

Considerin­g deaths from

all causes, the age-adjusted mortality rate for Americans last year was 879.7 deaths per 100,000 people, up 5.3 percent from 2020.

For every age group, death rates continued to be highest among Black and Latino men, and among men and women who identify as American Indian/ Alaska Native. However, 2021 saw a notable improvemen­t in the health of Black and Latino population­s relative to White Americans.

After researcher­s accounted for age, they found that White women and men were more likely to die in 2021 than they were in 2020. By contrast, Black and Latino men were less likely to die last year than the year before, and death rates for women in both groups held steady.

Dr. Stephen Woolf, a researcher at Virginia Commonweal­th University who tracks Americans’ health status, said the apparent reversal of death trends between White Americans and communitie­s of color was something of a mystery.

But “there’s an obvious hypothesis that’s sort of the elephant in the room,” said Woolf, who was not involved in the CDC reports. Early COVID-19 death rates were highest among Latino and American Indian/Alaska Native communitie­s, an experience that appears to have prompted them to get vaccinated in 2021, Woolf said. By contrast, “many White population­s either believed they were at less risk, or had political objections to getting vaccinated or wearing masks.”

Indeed, CDC data from fully vaccinated Americans who shared their racial and ethnic identities suggest that about 64 percent of American Indians and Alaska Natives and 57 percent of Latino Americans were fully vaccinated as of this month, compared with 51 percent of White Americans.

As waves of illness swept across the country, the result of a vaccinatio­n rate disparity would be that White Americans would begin to experience higher COVID-19 death tolls, which would translate into a lower life expectancy.

The ages at which people died last year also help explain how average life expectancy at birth dropped from 77 years in 2020 to 76.4 years in 2021.

The pandemic, of course, has taken its heaviest toll on senior citizens, especially those 75 and older. But these victims are closer to their predicted life’s end than other Americans. As a statistica­l matter, a child’s death, or even the death of a 45-year-old, will put a deeper dent in the nation’s average lifespan than the passing of an octogenari­an.

But COVID-19 mortality rates for middle-aged and younger adults reached higher levels in 2021 than in 2020. And in both years, drug overdose rates were highest for adults ages 25 to 54. In combinatio­n, trends like these contribute­d to a striking finding: Between 2020 and 2021, death rates increased for every age group other than for infants.

When statistici­ans compared the historic probabilit­y of death at each age with actual deaths in 2021, they found that 35- to 44-yearolds experience­d a 16.1 percent increase in premature deaths, the biggest jump of any age group. The death rates for people 25 to 34 increased 13.4 percent, while those for people 45 to 54 rose by 12.1 percent.

Even for children between 1 and 4 years old, mortality rates in 2021 were 10 percent higher than in 2020.

Aside from a few bumps along the road, U.S. lifespans have followed an upward course since 1900, when newborn Americans could expect to live 47.3 years. The one major exception: Average life expectanci­es plummeted in 1917 and 1918, when a world war and a flu pandemic conspired to reduce average life expectancy from 54.5 years in 1915 down to 39.1 years in 1918.

America’s steady life expectancy gains began to stagnate around 2000, when deaths from drugs, suicides, gun violence and chronic illnesses began a steady upward climb. By 2010, the United States had lost its edge over most other affluent countries and American lifespans began falling behind.

By 2020, the average longevity of newborn Americans was 4.7 years lower than their counterpar­ts in other wealthy places — closer to the averages seen in Peru and Thailand than to those of countries like France, Israel or South Korea.

With the world’s thirdhighe­st COVID-19 mortality rate, the United States was unlikely to close the gap in 2021. Two years of declining life expectancy may not prove to be the start of a long-term trend. But Woolf said the lingering mental and physical health effects of the pandemic, the continuing scourge of addiction, and the outsize toll of gun violence do not augur well for bringing U.S. life expectancy in line with our peers.

“The experience of other countries tells us it wasn’t inevitable that it had to be this way,” Woolf said. Countries that embraced COVID-19 vaccines and other public health measures, and that administer­ed medical care more equitably, “have shown it was possible to have an epidemic and have a different outcome,” he said.

 ?? LISA RATHKE AP ?? Deb Walker, of Chester, Vt., visits the grave of her daughter, who died in March 2021 of a drug overdose.
LISA RATHKE AP Deb Walker, of Chester, Vt., visits the grave of her daughter, who died in March 2021 of a drug overdose.

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