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U.S. life expectancy drops for the second consecutive year in 2021

<em></em>Flags at the Washington Monument commemorate Americans who died from  COVID-19. In 2021, life expectancy in the U.S. fell for the second year in a row.
Spencer Platt
Getty Images
Flags at the Washington Monument commemorate Americans who died from COVID-19. In 2021, life expectancy in the U.S. fell for the second year in a row.

The CDC blames COVID for half the decline, with the second largest contributor being accidental injuries — primarily drug overdoses, which killed a record-breaking 107,000 Americans last year.

Life expectancy in the U.S. fell in 2021, for the second year in a row.

In the first two years of COVID, the estimated American lifespan has shortened by nearly three years. The last comparable decrease happened in the early 1940s, during the height of World War II.

Centers for Disease Control and Prevention officials blamed the pandemic for about half the decline in a year when vaccinations became widely available but new coronavirus variants caused waves of hospitalizations and deaths.

The second largest contributor was deaths from accidental injuries — primarily from drug overdoses, which killed a record-breaking 107,000 Americans last year.

Other contributors were longstanding problems: suicide, heart disease and chronic liver disease.

In 2019, someone born in the U.S. had a life expectancy of nearly 80 years. In 202o, because of the pandemic, that dropped to 77 years. In 2021 life-span dropped again — to 76.1 years. And for some Americans, life expectancy is even lower, according to a provisional analysis from the CDC.

"The results of this study are very disturbing," says Dr. Steven Woolf, a professor of population health and health equity at Virginia Commonwealth University. "This shows that U.S. life expectancy in 2021 was even lower than in 2020," he says.

Other high-income countries have seen a rebound in life expectancy, which Woolf says makes the U.S. results, "all the more tragic."

One of the most dramatic drops in life expectancy in 2021 was among American Indian and Alaskan Native people. Between 2020 and 2021 the life expectancy for this group fell by almost two years, from 67.1 in 2020 to 65.2 in 2021.

"That's horrific," Woolf says. "The losses in the Native American population have been terrible during the COVID-19 pandemic. And it reflects a lot of barriers that tribal communities face in getting access to care," he says.

White Americans also saw a larger decrease in life expectancy in 2021 than Black and Hispanic Americans. This was the reverse of what happened in 2020 when Hispanic Americans saw a 4 year decline and Black Americans saw a 3 year drop. Life expectancy for white Americans declined by a year in 2021 to 76.4. Black Americans saw a 0.7 year decline to 70.8 years, Hispanic Americans saw a 0.2 year decline to 77.7 years. Asian Americans saw a 0.1 year decline to 83.5 years.

Woolf says the greater drop in life expectancy for white Americans could reflect attitudes in some parts of the country to vaccines and pandemic control measures. The U.S. health care system is fragmented he points out — public health is determined by the states, which means there were 50 different pandemic response plans. The states which were more relaxed about COVID restrictions and have lower vaccination rates saw higher excess deaths during the delta and omicron surges than states which had more aggressive vaccination campaigns, masking and other mitigation requirements.

Death rates from COVID-19 in counties that went heavily for Donald Trump saw higher death rates than counties that favored President Biden, according to an NPR analysis.

The report also suggests gains against suicide are being undone.

U.S. suicides rose from the early 2000s until 2018. But they fell a little in 2019 and then more in 2020, the first year of the pandemic. Experts had wondered if that may have been related to a phenomenon seen in the early stages of wars and national disasters in which people band together and support each other.

The new report said suicide contributed to the decline in life expectancy in 2021, but it did not provide detail. According to provisional numbers from a public CDC database, the number of U.S. suicides increased last year by about 2,000, to 48,000. The U.S. suicide rate rose as well, from 13.5 per 100,000 to 14.1 — bringing it back up to about where it was in 2018.

"The COVID-19 pandemic has in effect wiped out the health gains that the U.S. has made in the 20th century," says John Haaga, a member of Maryland's Commission on Aging. "To have this second year of crash basically wiping out the meager gains made during the century is really pretty shocking," he says.

The U.S. has been lagging for years in making improvements in things like heart disease — the country's No. 1 killer — and the life expectancy gap between the U.S. and other countries has been growing for decades, Haaga says.

"A lot of much poorer countries do much better than us in life expectancy," he says. "It's not genetics, it's that we have been falling behind for 50 years."

Information from the Associated Press was used in this report.

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Jane Greenhalgh is a senior producer and editor on NPR's Science Desk.
Selena Simmons-Duffin reports on health policy for NPR.