Life Expectancy: Explaining Declines in the U.S.

By Karen Sternheimer

The Centers for Disease Control and Prevention (CDC) issued a report last year indicating that life expectancy in the United States dropped about 2.7 years between 2020 and 2021, “the biggest two-year decline in life expectancy since 1921-1923.”

What is life expectancy, how does it vary, and why has it declined?

What is it?

Life expectancy is a measure used by demographers and epidemiologists to estimate the average length of someone’s life within a specific population. The measure is calculated to estimate how long someone born that year is likely to live, or one’s life expectancy at birth. They also measure age-specific life expectancy, based on an individual’s current age, the number of years they are likely to live.

Life expectancy measures have practical applications; they are used when calculating life insurance premiums, and can help people predict the number of years they may need to save for retirement, for instance.

If you take a look at this CDC life expectancy table, you will notice that it not only has estimates based on race, but on race, ethnicity, and (binary) sex. In 2021, the data upon which this table was calculated, it showed that infants had an average life expectancy of 76.1 years; in 2019 it was 78.8 years.

How does it vary?

A closer look at the 2021 table reveals stark differences in life expectancy by sex and race. The life expectancy for females was nearly 6 years longer than for males. Native Americans’ life expectancy was nearly 11 years shorter than the average American at birth. By contrast, an Asian American’s life expectancy at birth was about 7 years longer than the average American’s.

Where you live matters. As you can see in the map below, there are pronounced patterns of differences in life expectancy based on geography. Sociologists and other social scientists study the social determinants of health, defined by the CDC as “nonmedical factors that influence health outcomes.” CDC focuses on five categories: economic stability, education, health care access and quality, neighborhood, and social contexts. A Harvard Medical School blog gives several examples:

Those with the shortest life expectancies in the US tend to have the most poverty, face the most food insecurity, and have less or no access to healthcare, all factors that contribute to lower life expectancy. Additionally, groups with lower life expectancy tend to have higher-risk jobs that can’t be performed virtually, live in more crowded settings, and have less access to vaccination, which increases the risk of becoming sick with or dying of COVID-19.

Source: https://www.cdc.gov/surveillance/blogs-stories/life-expectancy.html

Why has life expectancy declined?

The obvious answer is the COVID-19 pandemic, which of this writing has killed 1,128,404 Americans. But life expectancy has been increasing in other wealthy nations since 2020, so what is going on in the U.S.?

An NPR story detailing this trend summarized some of the differences between the U.S. and its peer nations:

Americans eat more calories and lack universal access to health care. But there's also higher child poverty, racial segregation, social isolation, and more. Even the way cities are designed makes access to good food more difficult.

The article also points to “factors like teen pregnancy, drug overdoses, HIV, fatal car crashes, injuries, and violence,” based on a report titled "Shorter Lives, Poorer Health."

FDA Health Commissioner Robert Califf recently told the Associated Press that health misinformation should be added  to this list:

Growing “distortions and half-truths” surrounding vaccines and other medical products are now “a leading cause of death in America.”

“Almost no one should be dying of COVID in the U.S. today,” … noting the government’s distribution of free vaccines and antiviral medications. “People who are denying themselves that opportunity are dying because they’re misinformed.”

Life expectancy, like life itself, is a product of both individual and social factors. We are well aware of the personal choices we are encouraged to make, but we often overlook social factors that shape how long we live. Policy decisions that influence our access to health care—and the quality of that health care—is often harder to see than personal choices. Even our choices are shaped by larger forces: whether we have access to high-quality nutritious foods we can afford, the time and the space to exercise, the types of jobs we might get, and if we are exposed to environmental hazards are largely shaped by larger social forces.

What other social forces shape life expectancy?

Comments

[Kristyn]

Thank you for this information, it goes well with a focus on healthcare inequality I teach in my Multicultural Studies course. The map patters line up with other social policies that have lead to inequality that has played a role in unequal access to quality healthcare and subsequently different patterns of life expectancy.

[Territorial io]

Thank you for the information about the healthcare inequality.

[1v1.lol unblocked]

The life expectancy patterns on the maps are consistent with those found when looking at the effects of various social policies that have contributed to inequality in healthcare access.