BOSTON — To date, Covid-19 has killed about half a million Americans, so it should come as no surprise the pandemic has depressed a number that, in good times, is a source of national pride: the U.S. Life Expectancy.
The Centers for Disease Control and Prevention reports that, overall, life expectancy dropped a full year between 2019 and the first six months of 2020 -- from 78.8 years to 77.8 years. It’s the biggest drop since the Second World War.
“This one-year drop in life expectancy is unprecedented in modern demographic history,” said Andrew Stokes, PhD, global health professor at the Boston University School of Public Health. “So I would say that this qualifies as a mortality crisis of proportions that we have not seen in a long time.”
In the same period, males, overall, lost 1.2 years; females, 0.9 years. But the drop was much worse when the numbers were broken down specifically to Black and Hispanic Americans.
“Among black men, the drop in life expectancy is closer to three years and Hispanic males it’s 2.4 years,” said John McDonough, DrPA, MPA, a professor of public health at the Harvard School of Public Health. “So this is enormous. And remember this is just the first six months of last year and we know that the case rate and the mortality rate went significantly higher for the last six months of 2020. So this is just an early warning.”
McDonough said the life expectancy numbers are an ongoing reminder that the overall state of public health in the U.S. continues to be poor.
“What is exploding is obesity,” he said. “And particularly morbid obesity is just growing at alarming rates. And so what are we doing to ourselves as a population? And what are we doing as a public to try to reverse this trend? The signs are not promising.”
What has also increased over the past year -- and what the pandemic laid bare -- health disparities divided along racial lines.
“The gap in life expectancy has increased to six years between non-Hispanic white and black communities,” said Stokes. “That’s a gap that we haven’t seen since 1998.”
The life expectancy gap can be traced to differences in rates of disease between races, Stokes said.
“Due to social and economic factors, we have severe disparities in diabetes and hypertension, in the incidence of cardiovascular disease,” said Stokes. “Really what we’re seeing with Covid-19 is kind of a magnification of these existing disparities that relate back to social and structural factors.”
Stokes said that unlike the 1918 pandemic, when life expectancy numbers rebounded, that will probably not happen after Covid -- at least not right away.
“We do not think it will be a complete rebound in this case due to the very severe interruptions in care that have occurred, especially during the early surge in cases,” Stokes said. “Hospitals were overwhelmed, cases of cancer were missed, people living with diabetes were not receiving diabetes care. So unfortunately we think that some of these inequities, these decrements in life expectancy will persist.”
One way the numbers could improve, McDonough said, is through a national commitment to public health. But even after going through as searing an experience as a pandemic, he admits it’s an open question whether that will happen.
“Will we go back to obliviousness or will we come back and say we really need a national effort to improve the health of all Americans in a serious and aggressive way?”
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