U.S. life expectancy continued drop in 2021, report finds

Life expectancy in the United States, which declined dramatically in 2020 as the coronavirus spread throughout the country, continued to go down in 2021, according to a new analysis that shows America faring worse during the pandemic than 19 other wealthy countries — and failing to see a life expectancy rebound despite the arrival of effective vaccines.

The study, written by public health experts in Colorado, Va. and Washington, D.C., and posted online but not yet peer-reviewed, found that the continued decline in life expectancy in 2021 came largely among white Americans.

That was a reversal of the trend from 2020.

Then, the decline in life expectancy among all Americans was far more pronounced in Hispanic and Black Americans than in whites, a reflection of the disproportionate impact of the virus on communities of color and chronic health disparities.

But the 2021 data turned that trend on its head.

The authors of the report speculate that vaccine hesitancy and the much-documented resistance to pandemic restrictions among some white Americans and in states with disproportionately white populations could be a factor in that reversal of the 2020 racial and ethnic pattern.

Across all groups, life expectancy dropped to 76.60 years in 2021. That figure compares to 76.99 in 2020 and 78.86 in 2019. These are historically unusual drops.

White life expectancy dropped about a third of a year in 2021, the report found. Hispanic life expectancy was essentially flat, a statistically insignificant change, after having dropped 3.7 years in 2020.

Black Americans showed a modest rebound of .42 years in 2021, after seeing a decline of 3.22 years in 2020. The report does not include estimates for Asian Americans, Native Americans or other demographics due to data limitations.

The declines in 2020 “were enormous,” the study’s lead author, Ryan Masters, a sociologist at the University of Colorado, said. “For example, the largest total decline in U.S. life expectancy occurred in 1943 [2.9 years], when U.S. deaths peaked in World War II.

The 2020 declines among the Hispanic and non-Hispanic Black populations surpassed this historical decline from World War II.”

The 2020 decline, which was much more severe than what was seen in other wealthy countries, continued in 2021 to the surprise of study co-author Steven Woolf, a public health physician and director emeritus of the Center On Society and Health at Virginia Commonwealth University.

A year ago, he said, he gave interviews discussing the dismal 2020 numbers and assumed the newly approved vaccines would reverse the overall downward trend.

“I was naively optimistic that we might begin to rebound and start making our way back to pre-pandemic levels,” Woolf said.

The study was posted Thursday on the medRxiv preprint server that has been the repository of more than 17,000 pandemic-related research papers over the past two years.

Woolf said the study will be submitted imminently to a scientific journal.

The researchers used modeling to analyze the changes in U.S. life expectancy, relying heavily on official data for 2018-2020 and provisional data for 2021 from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

Woolf said previous reports using the same modeling have been proved accurate when final numbers from the CDC were published.

In recent years the United States has seen life expectancy flatten.

The country has a “health disadvantage,” as public health experts put it, compared to other wealthy countries that have seen greater gains in life expectancy.

“Simply speaking, the United States has failed to keep pace with the improvements in life expectancy enjoyed in other peer countries,” Masters said.

Masters said that social factors are probably drivers in both the long-term erosion of life expectancy in the United States compared to peer countries and in the pandemic years.

They include rising inequality, systemic racism and financial insecurity.

“Most of this catastrophic swing in life expectancy has to do either with people dying from the virus itself or secondary consequences produced by the pandemic,” Woolf said.

What’s significant, he added, was that vaccines were available starting in late 2020, but the decline continued.

The role of vaccine hesitancy in the decline of white life expectancy is speculative, the study authors acknowledge.

“It’s hard to imagine that willingness to be vaccinated is not a piece of that puzzle,” said Laudan Aron, a senior fellow at the Urban Institute and co-author of the study.