U.S. life expectancy falls to lowest level since mid-1990s due to COVID and drug overdoses

There is grim news about the state of America's health. The average expected lifespan for a person in this country shrank by over seven months last year, according to the CDC. That comes after an even steeper decline in 2020. The primary culprits are COVID-19 and opioid overdoses. Dr. Steven Woolf joined William Brangham to discuss the new report.

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  • Judy Woodruff:

    There is grim news today about the state of America's health. The average expected life span for a person in this country shrank by over seven months last year, according to the CDC. That comes after an even steeper decline in 2020.

    As William Brangham reports, the primary culprit's are COVID-19 and opioid overdoses.

  • William Brangham:

    Judy, because of this decline, the average American today is now expected to live just 76.4 years. That's lower than it's been in nearly twenty years.

    For more on this new report, I'm joined again by Dr. Steven Woolf. He's director emeritus of the Center on Society and Health at Virginia Commonwealth University.

    Dr. Woolf, nice to have you back on the "NewsHour," although this is sort of awful news to be talking about.

    A year-and-a-half ago, you sat here in our studio, and we had talked about a study that you had just done showing how lifespan in America had dropped by over a year. Now the CDC report comes out saying it's dropped another seven months.

    Did this report surprise you, that this trend has continued?

  • Dr. Steven Woolf, Virginia Commonwealth University:

    Well, I hate to sound like an academic, but yes and no.

    It did surprise me, in the sense that 2021, the year that these data are being reported for, was a year in which we had a vaccine available, in which many other countries — enabled many other countries to recover their losses in life expectancy that they had experienced in 2020 during the pandemic.

    Many countries saw their life expectancy increase. So to see ours continue to plummet was very worrying. It's not a surprise, in the sense that we have been tracking what we call a U.S. health disadvantage for some years, and all those problems rolled right into the pandemic.

  • William Brangham:

    One thing that really jumped out at this report to me was that, unlike in past declines, including in your own report, where some groups really fell behind and other groups held on, this seemed to be an across-the-board decline, all age groups, all demographics.

    How do you understand that?

  • Dr. Steven Woolf:

    People of color in our country were devastated by this pandemic.

    Black and Hispanic Americans, Native Americans were at much higher risk and sustained very large losses in life expectancy in 2020, much higher than in the white population. This new data shows that they continued to suffer losses, but it was actually the white population that experienced a larger decrease in life expectancy.

    Nonetheless, even with that pattern, death rates were still much higher among people of color. As to the ages affected, we had already been aware for the — for the decade preceding this pandemic that we have a problem in this country of rising death rates in the working-age population. That's people 25 to 64.

    Those groups are not experiencing increasing death rates in other countries. It's just the United States that's having this problem. So, when the pandemic struck, I wasn't entirely surprised that we had a disproportionate increase in death rates in that young and middle-age group.

    Of course, the elderly were at higher risk. So, the increase in death rates among the elderly was also, unfortunately, anticipated. What's worrying about this new report is that it's also reporting an increase in death rates in children and adolescents. That's not something we had seen before.

  • William Brangham:

    The CDC lays blame for this principally on COVID and on drug overdoses, principally linked to fentanyl.

    But there's other citations in there as well, including alcohol and alcoholism. Can you talk a little bit about that? That's not something we often talk about, about its impact on public health.

  • Dr. Steven Woolf:

    Well, again, even before the pandemic, in the years preceding it, we were very much aware of the opioid epidemic and rising death rates from drug overdoses, and alcoholism, suicides, and heart disease.

    All of those problems continued right into the pandemic. Layered upon that, though, of course, was the tremendous stresses that people experienced during the pandemic. So, individuals struggling with addiction disorders, either to drugs or alcohol, were more vulnerable to those conditions, and had reduced access to substance abuse and counseling services to address those problems.

    So, unfortunately, we have seen a disturbing rise in deaths from alcohol and drugs, but also our health care system was disrupted overall. And so people with chronic diseases have more limited access to primary care and specialty services.

    And we saw increases in death rates from heart disease and diabetes and other chronic illnesses.

  • William Brangham:

    It's just so striking to see this standard benchmark metric going down in a country as wealthy and prosperous as we are.

    And, as you're saying, we are unique compared to other similar nations. Why is that?

  • Dr. Steven Woolf:

    Well, it's not because we don't spend enough on health care.

    We are unique from other countries also in the massive amount of money we spend on health care, much higher than other countries and much higher than countries in which people live longer lives and are healthier. So this is a lesson for us that health care is only a partial answer

    It's — studies suggest it only accounts for about 10 to 20 percent of health outcomes. Our health is really shaped by our living conditions, jobs, the wages we earn, our wealth accumulation, the education that enables us to get those jobs. And we're struggling in those areas.

    And it's because of that struggle that we're seeing our health suffer as a result.

  • William Brangham:

    You're describing, then, potential remedies to arrest this decline are fundamental structural changes to American society.

    It's not just vaccines to avoid COVID deaths or naloxone to avoid overdose deaths. You're talking about something much more systemic.

  • Dr. Steven Woolf:

    If this had only happened during the pandemic, we could blame it on a virus.

    But the fact that it's been going on for so many years tells us that we, as a society, have to make a decision. We have to shift our priorities if we want to be healthier and we want our children to not die prematurely.

    The country that we live in is the richest in the world, but we have the highest level of income inequality. So, much of the resources that we need for a healthy population are not available to most of the population.

  • William Brangham:

    All right, Dr. Steven Woolf, director emeritus at the Center on Society and Health at Virginia Commonwealth University, always good to see you. Thank you.

  • Dr. Steven Woolf:

    Likewise, and thanks for giving attention to this important issue.

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