The Washington PostDemocracy Dies in Darkness

Opinion Plunging life expectancy was a natural result of the pandemic. But there were other causes, too.

In January, hundreds of lights at the National Mall paid tribute to those Americans who have died during the coronavirus pandemic. (Salwan Georges/The Washington Post)
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Though not entirely surprising given the harrowing death toll of the covid-19 pandemic, the latest figures on life expectancy in the United States nevertheless stunned when they came out this past week. Between 2019 and 2020, the age a baby born in the United States could expect to reach decreased by 1.5 years, from 78.8 to 77.3, according to the Centers for Disease Control and Prevention. This was the largest one-year drop since 1943, a time when combat in World War II was intensifying. Life expectancy decreased by about three years for both Black and Latino Americans, partly reflecting enduring inequalities in access to health resources. On this broad indicator of public health, progress in the United States had already plateaued in the past decade (after steady improvement in the previous 50 years) and trailed most of its peer nations in the Organization for Economic Cooperation and Development, ranking 28th out of 37 in 2018.

The surge in covid-19 deaths caused three-quarters of the decline in life expectancy — that is, roughly 1.125 of the 1.5 years — according to the CDC report. It’s important to understand the implications of this fact for the near future. Increases or decreases in life expectancy represent the net impact of increases and decreases of specific causes of death, such as infectious disease, chronic illness and accidents. Therefore, the hundreds of thousands killed by the new cause of death known as covid during 2020 — a highly unusual event — were bound to send life expectancy plummeting. By the same token, the negative impact of covid on life expectancy should diminish in 2021 if the number of deaths continues to decline as it did during the first half of 2021. Two caveats apply: First, covid is now endemic, as is influenza, and even if controlled by vaccines and other measures, it will continue to cause at least some deaths until there is a cure. Second, the United States must step up vaccination efforts and otherwise remain vigilant to make sure that covid death is, indeed, kept to a minimum.

It may take some time for life expectancy to regain its pre-pandemic level. This is doubly true due to additional disturbing trends embedded in the CDC report. Specifically, both death from homicide and “unintentional injuries” — the category that includes drug overdoses — rose considerably. Combined, they accounted for 14 percent of the total 1.5-year decline in life expectancy, or 0.21 years. For comparison, all by itself that figure is greater than each of the two most recent life expectancy decreases the United States suffered, when it fell by 0.15 years annually from 2014 to 2016.

Drug overdose deaths rose from a staggering 72,151 in 2019 to an unconscionable 93,331 in 2020, according to a separate CDC report issued on July 14, a nearly 30 percent increase. Fentanyl and other synthetic opioids accounted for 57,550 of these deaths, yet methamphetamine and cocaine seemed to be making fatal comebacks as well. The pandemic seemed to increase stress and isolation among those with addiction and make it more difficult to access treatment. Thus did an acute new public health crisis exacerbate a chronic one, which is no less urgent for being so awfully familiar.

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