The combination of the COVID-19 pandemic and high levels of opioid overdose deaths drove life expectancy in the United States down for the second consecutive year in 2021, with a child born in that year expected to live 76.4 years, the lowest figure since 1996, according to data from the U.S. Centers for Disease Control and Prevention.
By comparison, Americans born in 2019, the year before the pandemic took hold, could expect to live 78.8 years.
In 2019, the U.S. experienced 715.2 deaths per 100,000 people. In 2021, that rate had climbed by 23%, to 897.7.
While most countries in the world experienced a decrease in life expectancy during the pandemic, it was particularly pronounced in the U.S. And while many advanced economies, including France, Belgium, Switzerland and Sweden saw their life expectancy rates recover to pre-pandemic levels in 2021, death rates in the U.S. continued to climb.
Heart disease, cancer and COVID-19 remained the top three causes of death in 2021, unchanged from the preceding year. In 2021, the U.S. also recorded 106,699 deaths attributed to drug overdoses, or more than 30 per 100,000 people.
Since 2001, when the rate was below 10 per 100,000, the rate has increased every year.
Overdose deaths have an outsized effect on average life expectancy because victims are disproportionately young.
Differences by gender, race
Women in the U.S. have a higher life expectancy than men, on average. In 2021, a girl born in the U.S. could expect to live 79.3 years, while a boy could expect to live 73.5 years.
An American who turned 65 in 2021 could expect to live another 18.4 years on average, while women could expect to live 19.7 years longer - for men the number remained unchanged from 2020 - at 17 years.
Dividing the population by sex, race and Hispanic origin highlights stark disparities in death rates. Among men, American Indian and Alaska Native men had the highest rate of deaths per 100,000 people in 2021, at 1,717.5
The next-highest death rate was for Black men, at 1,380.2. White men experienced 1,055.3 deaths per 100,000, Hispanic men experienced 915.6, and Asian men just 578.1.
Among females, death rates were highest for American Indian and Alaska Native women, at 1236.6 per 100,000, followed by Black women, at 921.9. White women experienced 750.6 deaths per 100,000, followed by Hispanic women at 599.8. Asian women had the lowest death rate of any subgroup, with 391.1 per 100,000.
Compared to other wealthy industrialized nations, particularly in Europe, U.S. life expectancy is not only lower, but also is getting worse.
A study published in the journal Nature Human Behavior in October charted the stark differences between the U.S. and many European nations. While almost all countries in Europe experienced a sharp decline in life expectancy in 2020, the first full year of the pandemic, many had returned to 2019 levels by the following year.
Among them, Sweden, Switzerland, Belgium and France all saw life expectancy rebound to near pre-pandemic levels in 2021. Other countries, including the U.K., Portugal, Austria, Italy, the Netherlands, Spain, Slovenia and Iceland had all recovered some, but not all the lost life expectancy.
Alone among wealthy European countries in posting two back-to-back declines was Germany, though its combined fall in life expectancy, less than one year in total, was far smaller than in the U.S.
Other European countries, mostly former Soviet states, also saw consecutive yearly declines, including Croatia, the Czech Republic, Estonia, Hungary, Lithuania and Poland, though none of those saw a decline as sharp as in the U.S.
The only European countries with a steeper drop in life expectancy than the U.S. from 2019 to 2021 were Bulgaria and Slovakia.
The differences in life expectancy between the U.S. and other wealthy countries is even more stark when compared with industrialized countries in the Asia-Pacific region.
Data collected by the World Bank shows that a child born in wealthy countries in that region, including Hong Kong, Japan, Singapore, Australia and New Zealand had a life expectancy of 82 years or more in 2020.
Public health failure
Life expectancy declines in the U.S., particularly regarding deaths related to COVID-19, is especially frustrating to experts, who note the widespread availability of vaccines and the fact that medical professionals have far more knowledge about how to fight the disease than they did at the beginning of the pandemic.
"It is absolutely a public health failure and a political failure," Noreen Goldman, the Hughes-Rogers professor of Demography and Public Affairs at the Princeton University School of Public and International Affairs, told VOA.
"It's certainly due, in part, to a lack of public health infrastructure, a lack of any kind of national coordination of our strategies during the pandemic, high politicization of vaccination and higher [vaccine] refusal rates in the U.S. than most other high-income countries," she said.
Goldman said there are other complicating factors, not the least of which is the lack of universal health care, which is present in all other wealthy nations. Other factors play a role as well, including the high prevalence of other medical conditions, such as obesity and diabetes, which are associated with poorer COVID-19 outcomes.