Pandemic Drives Largest Decrease in U.S. Life Expectancy Since 1943

“To give some perspective, when the decline in life expectancy was happening a few years ago, it was a decrease of about 0.1 years each year that was making front-page news,” said Woolf, VCU’s C. Kenneth and Dianne Wright Distinguished Chair in Population Health and Health Equity. “That’s the kind of increase or decrease that we’re accustomed to each year.”

Woolf called the 1.87-year decline in life expectancy “massive” by comparison.

“It’s like nothing we’ve seen since World War II,” he said. “1943 was the last time the US had such a large decrease in life expectancy.”

Six countries in the authors’ comparison group saw their life expectancy increase during 2020 — places like New Zealand, Finland and Norway. Other countries did poorly: Italy and Spain saw losses in life expectancy. But none came close to the U.S.

“The disorganized handling of the pandemic in the U.S. had a lot to do with governance,” said Woolf, a professor in the Department of Family Medicine and Population Health at the VCU School of Medicine. “Our Constitution delegates public health authority to states, so we had 50 response plans. Many lives were lost because so many decisions were driven by politics and ideology. COVID-19 exposed a lot of the systemic problems that have been fueling the long-term decline in the health of Americans.

“And when vaccination gets us past the pandemic, and COVID-19 is in the rear view mirror, those systemic issues will still be with us,” Woolf said.

Included in those issues are racial health inequities and the role of systemic racism. The most jarring statistic for Woolf was the data on life expectancy for Black and Hispanic Americans. It’s well-known that COVID-19 had a disproportionate impact on people of color, but the effect on life expectancy for those groups was “jolting,” he said.

Life expectancy in Black men in particular reached its lowest level since 1998.

“It’s a big setback because, for many years, the U.S. had been making progress in closing the Black-white mortality gap,” Woolf said. “And Hispanic Americans, for many years, enjoyed higher life expectancies than whites, but that advantage was almost completely erased by COVID-19.”

Data on Native Americans, who also experienced very high death rates during the pandemic, was not examined in the study because of inadequate data.

“In many ways, the U.S. has turned a corner in its response to COVID-19, but the data emerging on pandemic health disparities is urgent and valuable in helping understand the impact on our communities,” said Peter Buckley, M.D., dean of the VCU School of Medicine. “The life expectancy gaps between America and other countries and between racial groups reported in Dr. Woolf’s paper are worrisome, and I hope the numbers serve as a wake-up call for the health care community and beyond.”