• Posted December 22, 2021

COVID Helps Drive Nearly Two-Year Decline in U.S. Life Expectancy

COVID-19 is now the third leading cause of death for Americans and has shortened life expectancy by nearly two years, a drop not seen since World War II, a new government report shows.

Life expectancy dropped from 78.8 in 2010 to 77 in 2020 as the age-adjusted death rate increased 17%, going from 715 deaths per 100,000 people in 2019 to 835 deaths per 100,000 in 2020, researchers from the U.S Centers for Disease Control and Prevention found.

"We haven't seen a decline like this since 1943," said Robert Anderson, chief of mortality statistics at CDC's National Center for Health Statistics (NCHS).

"Normally, we don't see fluctuations of more than two or three tenths in a year. So, any sort of change of this magnitude is really quite unusual. And we can attribute the bulk of this decrease in life expectancy to COVID-19," he said.

Death rates increased for all age groups aged 15 and older. The leading causes of death were heart disease and cancer, followed by COVID-19. Other causes of death were drug overdoses and other unintentional injuries, followed by stroke, chronic lower respiratory diseases, Alzheimer's disease, diabetes, influenza, pneumonia and kidney disease.

"There was a large increase in unintentional injury, mortality, and most of those are drug overdose deaths," Anderson said. Overdose deaths dipped in 2017 and that was "encouraging," he added.

But they have risen again: "The bulk of the increases are due to the synthetic opioid category, most of which is illicit fentanyl," he noted.

There were also increases in cardiovascular deaths, heart disease and stroke and, in particular, Alzheimer's disease. Also, increases in deaths were seen in diabetes and pneumonia. "Those are the causes really driving this and, of course, the largest driver is COVID-19, which we didn't have before," Anderson said.

He also said that COVID-19 may be playing a role in these other deaths, as some causes of death may have been misreported.

On top of that, some of the increase in deaths may also have been caused by people not getting health care because of fear of COVID and not going to doctors or hospitals. "It's likely that there's a big chunk of these extra deaths that are in that category," Anderson said.

The one bright spot in the report was that the death rate for infants decreased nearly 3% from 2019, a record low of 542 infant deaths per 100,000 live births, Anderson said.

Anderson noted that preliminary mortality numbers for 2021 look at least as bad as 2020, and "probably a little worse." This may not, however, mean another drop in life expectancy, he added. "We're not going to see the dramatic changes that we saw from 2019 to 2020."

As for the future, Anderson thinks that rising COVID vaccination rates will have an effect. Yet, with COVID's ability to mutate, there's no guarantee that the situation will improve.

It might not take a lot, however, to push life expectancy back to where it was, he said. "It really will depend on how long it takes to pull out of this situation. If by some miracle, COVID goes away in 2022, it could bounce back very quickly."

That same pattern was seen in the flu pandemic of 1918, where life expectancy dropped from 51 to 39, but returned to 55 in 1919, he explained.

"If COVID goes away in early 2022, we could see a very quick bounce back to what we would consider more normal life expectancy," Anderson said.

"But it's impossible to predict, really," he added. "The next pandemic could be worse. And hopefully, it's another 100 years before we see anything like this."

Anderson's team published its findings Dec. 22 in an NCHS data brief, Mortality in the United States, 2020.

Dr. Eric Cioe-Pena, director of Global Health at Northwell Health in New Hyde Park, N.Y., said the decline in life expectancy is probably due to a variety of factors.

"I think that like everything, this is a multi-factorial problem that has multiple causes," he said. "Both lack of access to care because of fear around COVID or overwhelmed health systems may also be contributing to a secondary cause of mortality since the pandemic began."

Cioe-Pena also believes that COVID has made this a global phenomenon. "I do believe this is a worldwide trend and, in many ways, may be magnified in low- and middle-income countries," he said.

More information

For more on life expectancy in the United States, head to the U.S. Centers for Disease Control and Prevention.

SOURCES: Robert Anderson, PhD, chief, Mortality Statistics, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention; Eric Cioe-Pena, MD, director, Global Health, Northwell Health, New Hyde Park, N.Y., report: NCHS data brief, Mortality in the United States, 2020, Dec. 22, 2021