Will Covid-19 reduce the life expectancy of Americans? Study projects it will be shortened by more than a year
The coronavirus pandemic has resulted in a staggering death toll in the US: over 392,100 lives have been lost as of January 16. An important question concerns the impact of this exceptional number of deaths on life expectancy for the entire nation as well as consequences for marginalized groups. Researchers now warn that the pandemic has significantly affected life expectancy.
They project that, due to the pandemic deaths last year, life expectancy at birth for Americans will reduce by 1.13 years in 2020 to 77.48 years. This is the largest single-year decline in life expectancy in at least 40 years and is the lowest life expectancy estimated since 2003, say authors from the University of Southern California (USC) and Princeton.
“Estimated reductions for the Black and Latino populations are 3 to 4 times that for Whites. Consequently, Covid-19 is expected to reverse over 10 years of progress made in closing the Black-White gap in life expectancy and reduce the previous Latino mortality advantage by over 70%,” reveals the study published in the Proceedings of the National Academy of Sciences (PNAS).
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According to the analysis, the US reduction in 2020 life expectancy is projected to exceed that of most other high-income countries, indicating that the US — which already had a life expectancy below that of all other high-income developed nations before the pandemic — will see its life expectancy fall even farther behind its peers.
The researchers say life expectancy is an important indicator of a population's health and an informative tool for examining the impact of coronavirus on survival. In the decades before the pandemic, annual improvements in US life expectancy had been small but overall life expectancy had rarely declined.
An exception was the annual reduction of 0.1 year for three consecutive years — 2015, 2016, and 2017 — which were attributed in part to increases in so-called "deaths of despair" among middle-aged whites related to drug overdoses, including opioids, as well as alcohol-related liver disease and suicide.
The projected pandemic-related drop in life expectancy is about 10 times as large as the declines seen in recent years. According to the team, the last major pandemic to significantly reduce life expectancy in a short period was the 1918 influenza pandemic, which research indicates reduced life expectancy by an extraordinary 7-12 years.
Some reduction in life expectancy may persist beyond 2020 because of continued Covid-19 mortality and long-term health, social, and economic impacts of the pandemic, say researchers. “While the arrival of effective vaccines is hopeful, the US is currently experiencing more daily Covid-19 deaths than at any other point in the pandemic," states study author Theresa Andrasfay, a postdoctoral fellow at the USC Leonard Davis School of Gerontology.
"Because of that, and because we expect there will be long-term health and economic effects that may result in worse mortality for many years to come, we expect there will be lingering effects on life expectancy in 2021. That said, no cohort may ever experience a reduction in life expectancy of the magnitude attributed to Covid-19 in 2020,” Theresa adds.
Impact on minority populations
The report estimates life expectancy at birth and age 65 for 2020 for the total US population and by race and ethnicity. The investigators used four scenarios of deaths: one in which the Covid-19 pandemic had not occurred and three others that include Covid-19 death projections by the Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington.
The results show that declines in life expectancy are likely even starker among minority populations. According to experts, Covid-19 appears to have eliminated many of the gains made in closing the Black-White life expectancy gap since 2006.
For Blacks, the team forecasts their life expectancy would shorten by 2.10 years to 72.78 years, and for Latinos, by 3.05 years to 78.77 years. Whites are also impacted, but their projected decline is much smaller — 0.68 years — to a life expectancy of 77.84 years. Overall, the gap in life expectancy between Blacks and Whites is projected to widen by 40%, from 3.6 to more than 5 years — further evidence of the disease’s disparate impact on disadvantaged populations.
Latinos, who have consistently experienced lower mortality than Whites — a phenomenon known as the “Latino paradox” — would see their more than three-year survival advantage over Whites reduced to less than one year.
“The huge decline in life expectancy for Latinos is especially shocking given that Latinos have lower rates than the White and Black populations of most chronic conditions that are risk factors for Covid-19. The generally good health of Latinos prior to the pandemic, which should have protected them from Covid-19, has laid bare the risks associated with social and economic disadvantage,” writes study co-author Noreen Goldman, the Hughes-Rogers professor of demography and public affairs at the Princeton School of Public and International Affairs.
Experts suggest that the greater toll for the Black and Latino populations arises because of both higher Covid-19 death rates and greater susceptibility to the disease at younger ages among these groups compared with Whites. “These findings underscore the need for protective behaviors and programs to reduce potential viral exposure among younger individuals who may not perceive themselves to be at high risk,” recommends Goldman.
Structural inequalities
Of the analyzed deaths for which race and ethnicity have been reported to the National Center for Health Statistics, 21% were Black and 22% Latino. Black and Latino Americans have experienced a disproportionate burden of coronavirus infections and deaths, reflecting “persistent structural inequalities” that heighten the risk of exposure to and death from coronavirus.
Potential explanations for the disproportionate burden of deaths among Black and Latino individuals reflect underlying social disparities that have been documented for decades and amplified during the current pandemic. These groups are more likely than Whites to hold low-paying jobs with little autonomy, often in industries that have suffered the largest job losses during the pandemic, creating exceptionally high unemployment rates for both groups and likely loss of health insurance, note investigators.
Many of those who retained their jobs in essential industries, such as healthcare, food retail, and meatpacking, face high exposure to a viral transmission. The authors caution that the incompatibility of their jobs with remote working, combined with low savings, likely compelled many Black and Latino workers to continue to risk exposure to coronavirus.
“Our study analyzes the effect of this exceptional number of deaths on life expectancy for the entire nation, as well as the consequences for marginalized groups. The Covid-19 pandemic’s disproportionate effect on the life expectancy of Black and Latino Americans likely has to do with their greater exposure through their workplace or extended family contacts, in addition to receiving poorer healthcare, leading to more infections and worse outcomes,” explains Andrasfay.