U.S. life expectancy drop caused by more than pandemic

COVID-19 played a role, but the larger story is an unhealthy and inequitable society, says a Carolina expert.

Group of plastic figurines of all ages looking at an hour glass.
While the U.S. experienced tremendous COVID-19 mortality during the past two years, declining life expectancy is also due to drug-related deaths, suicide, liver disease, traffic accidents, homicides and heart disease. (Shutterstock image)

Life expectancy at birth in the United States is now 76.1 years, the lowest level since 1996, according to a recent CDC report. 

Provisional data showed there was a 0.9 year drop in 2021. Paired with a 1.8 year drop in 2020, the U.S. experienced the biggest two-year decline in life expectancy since 1921-1923. 

Robert Hummer, Howard W. Odum Distinguished Professor of Sociology and Carolina Population Center faculty fellow, studies U.S. mortality and health disparities. 

Robert Hummer

Robert Hummer, Howard W. Odum Distinguished Professor of Sociology and Carolina Population Center faculty fellow.

The Well sat down with Hummer to discuss reasons behind the steep decline, what these trends say about our society and what could be done to potentially push life expectancy back in the right direction. 

What is life expectancy? How is it calculated? 

Life expectancy is the average length of life that a hypothetical set of people would experience if they lived their entire life based on the age-specific mortality rates of a particular year.  

There’s a death rate for people who are between ages zero and one, people between ages one and two and so forth. Every year, those age-specific death rates change, and life expectancy is calculated based on those age-specific death rates in a single year. 

What factors led to this historic drop in U.S. life expectancy? 

Life expectancy in the U.S. declined nearly two years from 2019-20 and approximately one year from 2020-21. Over the last two years, then, we’ve experienced nearly a three-year decline in life expectancy. That is an enormous drop; we had not seen something like that in the U.S. for many decades.  

Obviously, we have to think about COVID-19. The U.S. experienced a tremendous amount of COVID-19 mortality both in 2020 and 2021. We’re seeing that in 2022 to date as well. But the story is not all COVID-based. We’ve also seen increases in rates of mortality due to drug-related deaths, suicide, liver disease, traffic accidents, homicides and even heart disease over the last two years.  

What conclusions can we draw from these findings? 

One of the takeaways here is we’ve had a pandemic, it’s been terrible, and far too many people have died and continue to die, even after vaccines became available. Our vaccine uptake has been far too low. But we also need to think about how it’s not just COVID-19. We can go back for several decades in the United States and see life expectancy stagnating and then starting to decline.  

Even prior to the pandemic, there were small declines in U.S. life expectancy during the 2010s. When we overlay COVID-19 on top of other issues — the opioid and obesity epidemics, increases in suicide and so forth, it’s really a story of an unhealthy society. 

Importantly, these life expectancy declines are not happening equitably across the population. There have been especially big declines among the Alaska Native and American Indian populations, the Black and Hispanic populations, as well as the low-educated and low-income populations, increasing the already very large life expectancy disparities in our country. 

So, with COVID-19 hitting the United States, where our life expectancy is already among the lowest of all high-income populations and which is characterized by very high levels of racial, ethnic, income and educational inequalities, we’re seeing the ramifications of health shocks playing out in a society where inequalities are massive and our social and economic safety nets are not very sturdy.  

What steps do you think could be taken to bring these numbers back in the right direction? 

Our society does a really good job developing technical solutions to health problems, such as creating vaccines, developing surgical procedures for heart disease and developing medications for mental health issues. And our cancer death rates are among the best in the world because we’re good at innovating and developing technical solutions. We have to keep developing those technical solutions, but we also need to be much more aggressive in developing social and economic solutions to our health problems as well.   

This includes reducing racial, ethnic and income inequalities, curbing racism, making sure every kid gets a decent education and enhancing programs like minimum wage and access to child care. If we do those things, new health problems or pandemics will cause much less destruction compared with the tremendously unequal society we currently live in. 

We have to focus on inequality issues that are so harmful for population health. You see it in our life expectancy statistics. We can’t just focus on the technical solutions; we can’t buy ourselves out of the health issues we’re facing. They’re too big and complex and our country is too fractured and too unequal in order to do that.