In 2018, we published Longevity: Trends and Challenges which could be described as the classic “good news bad news” story. The good news was that life expectancy in the U. S. had risen from 47.3 to 78.9 years over the period 1900 to 2014. The bad news was that it then actually decreased slightly in 2015 and 2016. The explanation for this unfortunate turn in events was twofold: 1) progress in treating major killers such as heart disease and cancer seemed to have leveled out, at least temporarily 2) there was a surge in deaths attributable to obesity, opiates, and to a lesser extent, Alzheimer’s.
We now have several more years of data, and most important, early indications of the impact of Covid-19. From the peak of 78.9 years in 2014, life expectancy declined to 78.6 years by 2017 before recovering to 78.7 in 2018 and 78.87 in 2019. These obviously aren’t large changes but at least the trend was in the right direction. Then the pandemic arrived. Early projections are that average life expectancy fell 1.13 years in 2020, the largest one-year decline in forty years. The most disconcerting statistics are that the life expectancy for white Americans fell by .68 years whereas the decline was 2.1 years for Blacks and 3.05 years for Hispanics.
This large decrease in life expectancy is partially a function of the 500,000 deaths attributable to Covid-19, but 2020 also saw approximately a 38% increase in overdose deaths dues to all of the stresses associated with the shutdown in the economy, unemployment, social isolation, and so on.
The combination of vaccines and some signs of herd immunity are sources of considerable optimism, both for our health and the economy. However, our paper on Longevity and a subsequent one on Income Inequality both pointed to the need for a national dialogue on income and health inequality, and the urgency of that discussion has only increased with the sad data on Covid-19 mortality.