Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data

Abstract

Objective To estimate changes in life expectancy in 2010-18 and during the covid-19 pandemic in 2020 across population groups in the United States and to compare outcomes with peer nations. Design Simulations of provisional mortality data. Setting US and 16 other high income countries in 2010-18 and 2020, by sex, including an analysis of US outcomes by race and ethnicity. Population Data for the US and for 16 other high income countries from the National Center for Health Statistics and the Human Mortality Database, respectively. Main outcome measures Life expectancy at birth, and at ages 25 and 65, by sex, and, in the US only, by race and ethnicity. Analysis excluded 2019 because life table data were not available for many peer countries. Life expectancy in 2020 was estimated by simulating life tables from estimated age specific mortality rates in 2020 and allowing for 10% random error. Estimates for 2020 are reported as medians with fifth and 95th centiles. Results Between 2010 and 2018, the gap in life expectancy between the US and the peer country average increased from 1.88 years (78.66 v 80.54 years, respectively) to 3.05 years (78.74 v 81.78 years). Between 2018 and 2020, life expectancy in the US decreased by 1.87 years (to 76.87 years), 8.5 times the average decrease in peer countries (0.22 years), widening the gap to 4.69 years. Life expectancy in the US decreased disproportionately among racial and ethnic minority groups between 2018 and 2020, declining by 3.88, 3.25, and 1.36 years in Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. In Hispanic and non-Hispanic Black populations, reductions in life expectancy were 18 and 15 times the average in peer countries, respectively. Progress since 2010 in reducing the gap in life expectancy in the US between Black and White people was erased in 2018-20; life expectancy in Black men reached its lowest level since 1998 (67.73 years), and the longstanding Hispanic life expectancy advantage almost disappeared. Conclusions The US had a much larger decrease in life expectancy between 2018 and 2020 than other high income nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. A longstanding and widening US health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism.

Impact of COVID-19 on excess mortality, life expectancy, and years of life lost in the United States

“…Fig 6 compares the decrease in life expectancy between our study and two other studies: Andrasfay and Goldman, and Woolf, Masters, and Aron [ 6 , 7 ]. All three studies used a life table to calculate the current life expectancy, but the methods differ in the reference that they compared the current life expectancy to.…”

“…The impact of the pandemic on excess mortality on the entire population of the United States has been studied extensively, including reports from the CDC, Financial Times, Our World in Data, and published articles by Woolf et al, and Islam et al [ 1 – 5 ]. On the other hand, there have been fewer studies on the impact of pandemic on life expectancy, including published articles by Andrasfay and Goldman, and Woolf, Masters, and Aron [ 6 , 7 ]. At present, there have been no studies that examined the years of life lost due to the COVID-19 pandemic to our knowledge.…”

Racial and ethnic differentials in COVID-19-related job exposures by occupational standing in the US

“…In the United States, Black, Latino, and Native American adults have experienced substantially higher rates of COVID-19 infection and mortality during 2020 than Whites and Asians [ 1 – 7 ]. Researchers and journalists argue that the differences are due, at least in part, to two work-related factors: (1) Black, Latino, and Native American workers are more likely to hold jobs that have to be done at their workplace rather than remotely, and (2) Latino and Black workers face greater risks of exposure to COVID-19 in their jobs than others [ 3 , 8 – 18 ].…”

US life expectancy plunged in 2020, especially in Hispanic and African Americans

“…The gap in life expectancy between the US and 16 peer countries has grown since 2018 from 1.9 to 4.7 years, showed research published in The BMJ in May 4…”