Progress Stalled? The Uncertain Future of Mortality in High‐Income Countries

Abstract

Steady and significant improvements in life expectancy have been a bright spot for human progress for the last century or more. Recently, this success has shown signs of faltering in some high‐income countries, where mortality improvements have slowed or even reversed since the early 2010s. Combined with the large mortality shock of the COVID‐19 pandemic, guaranteed forward progress feels less certain. We review mortality trends in high‐income countries since 2000 through the COVID‐19 pandemic. While deteriorating mortality in the United States has received the most attention, countries including the United Kingdom, Canada, the Netherlands, Greece, and Germany are also seeing slowdowns. Before COVID‐19, these slowdowns largely reflected stalling improvements in cardiovascular disease mortality and increases in deaths from external causes in young and midlife for the worst‐performing countries. We discuss prospects for the future of mortality in high‐income countries, including lingering impacts of the COVID‐19 pandemic, challenges and opportunities related to the obesity epidemic, and emerging reasons for both optimism and pessimism. While biological limits to increased life expectancy may eventually dominate long‐term trends, human‐made social factors are currently holding many countries back from already achievable best‐practice life expectancy and will be key to near‐term improvements.