COVID-19 helped erase 1.8 years from the average American’s life expectancy in 2020, according to the latest federal mortality data released Wednesday, marking the greatest change in the American lifespan since World War II. During that one brutal year, COVID-19 became the third-most common cause of death in the United States, with one out of 10 fatalities due to the virus.
“A loss of two years seems limited, but that’s rolling back decades and decades of progress,” said Dr. Zinzi Diana Bailey, a social epidemiologist at the University of Miami’s Miller School of Medicine. “We are going backwards.”
In 2020, before the COVID vaccines were widely available, life expectancy plummeted to 77 years, down 1.8 years from 78.8 years in 2019 for the entire population, the new data shows.
To produce these findings, researchers gathered and analyzed the nation’s death certificates, tallying up how many people died and the underlying cause of each death. There were nearly 529,000 more deaths in the U.S. than in the previous year, for a total of more than 3.3 million, the Centers for Disease Control and Prevention reported.
One bright spot in the data: Despite the average American living a shorter life and millions forgoing health care out of fear of catching or spreading the coronavirus, the infant mortality rate fell 2.9 percent to a record low.
Here are four takeaways on the tectonic shift in American longevity.
1. Life expectancy plummeted
Changes in U.S. life expectancy normally move at a more glacial pace – at incremental tenths of a year. For example, in 2019, the average American was expected to live a tenth of a year longer than in the previous year. Improved access to health care was showing marginal but long-term benefits.
The coronavirus pandemic upset that steady trend, said Dr. Amesh Adalja, an epidemiologist at Johns Hopkins University’s Center of Health Security.
This is not the first time that new health threats have dramatically altered the average U.S. life span. Following the 1918 influenza pandemic, life expectancy fell by 11 years. The last time this drop happened was in 1943 as a result of lives lost during World War II, said Robert Anderson, who oversees the mortality statistics branch of the CDC’s National Center for Health Statistics.
“When you have a pandemic that creates such a disruptive effect on people’s lives, you’re going to see deaths directly from the virus, as well as cascading deaths that occur because of the disruptions that occurred to normal health,” Adalja said. “It’s not surprising.”
2. These groups were most affected
Looking across age groups, death rates increased for all people in the U.S. age 15 or older in 2020. While people ages 85 or more died more frequently than the rest of the population, people aged 35-44 were prone to the biggest increase in death rates.
Those who died in 2020 reflected long-running disparities in access to care and health outcomes that the pandemic further revealed and worsened. Overall, Black men died at rates greater than any other racial or ethnic group. Adjusted for age, death rates among Hispanic men increased by 43 percent and in Hispanic women by 32 percent, faster than other groups. White men and white women died at a significantly slower pace than all groups measured.
Overall, these numbers grew slightly worse compared to the early data from that year, Anderson said. During the first half of 2020, Black men lost three years of life expectancy, more than any other group, according to that CDC report. Anderson said what the overall drop in life expectancy meant for specific demographic groups is still coming into focus, with final data expected early next year.
3. A new, major cause of death
Heart disease and cancer are still the most common killers in the U.S., according to the latest data. Heart disease was linked to 168 deaths out of 100,000 people, while cancer caused 144 deaths per 100,000. Occasionally, the two causes swap places year to year, but together they were responsible for nearly 40 percent of all deaths in 2020.
During the coronavirus’ first year, COVID-19 made an astounding – and terrible – debut – as the third-leading cause of U.S. deaths. At 85 deaths per 100,000 people, it outpaced more familiar health problems such as stroke, Alzheimer’s disease and diabetes. Because physicians were learning how to identify patients infected with coronavirus in real time and may have misdiagnosed them, Anderson said these death figures are “almost certainly an undercount.”
Suicide dropped off the list of 10 most frequent causes, but that had more to do with hundreds of thousands of people dying from the coronavirus than fewer suicides taking place. According to the National Center for Health Statistics, which works within CDC to compile these data, 46,000 people in the U.S. killed themselves in 2020, a decline of 1,500 such deaths from 2019, Anderson said.
4. The infant mortality rate actually decreased
In a glimmer of good news, the nation’s rate of infant mortality decreased 2.9 percent, dipping to “a record low” in CDC records of 541.9 deaths for every 100,000 live births.
Throughout 2020, medical experts voiced alarm that many pregnant women were not getting the recommended prenatal care. Many clinics dramatically curtailed or temporarily suspended in-person visits out of concern that people might catch or spread the virus.
Telemedicine filled in many gaps in care, but it also highlighted where people had issues accessing reliable internet. Advocates of greater telehealth access said the pandemic helped make clear the need for broadband internet access across the country.
Birth defects led to one out of five infant deaths in the U.S. in 2020, followed by disorders linked to premature birth and low birth weight. Sudden infant death syndrome became the third leading cause of death for young children in the U.S., outpacing unintentional injuries.
The data did not specifically address racial disparities for Black infants, who historically have died at greater rates than other babies in the U.S. Those disparities are “telling us something about our systems,” Bailey said. She pointed to “structural inequities” that expose society’s most vulnerable members – newborn babies – to risk of untimely death based on the color of their skin. She pointed to policy decisions, such as social distancing and masking, that helped prevent infants from getting sick and dying not only from COVID-19 but also established illnesses, such as influenza.
“How much death we have and how much disease we have is related to what we’re prioritizing as a society,” she said.