U.S. life expectancy dropped for the second year in a row, according to a new preprint study published in medRxiv—and the authors suggest that low vaccination rates and reduced pandemic precautions may have driven the continued decline.

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Study details and key findings

For the study, which has not yet been peer reviewed, researchers analyzed U.S. mortality data for 2019 through 2021 from CDC's National Center for Health Statistics. Life expectancy was calculated for 2019 and 2020, but a model was used to estimate life expectancy in 2021, as only provisional data is currently available.

Overall, the researchers estimated that U.S. life expectancy in 2021 was 76.6 years—a decline from 76.99 years in 2020 and 78.86 years in 2019. Over the two years of the pandemic, U.S. life expectancy saw a net loss of 2.26 years.

In 2020, the largest dips in U.S. life expectancy occurred among the Black and Hispanic populations, which saw their life expectancy decrease by 3.22 and 3.7 years, respectively. However, in 2021, only the white population saw a decline in life expectancy, with a decrease of around 0.34 years. In comparison, life expectancy among the Hispanic population remained largely steady, while the life expectancy among the Black population saw a small increase of 0.42 years.

In addition, men saw greater declines in life expectancy than women for both 2020 and 2021. However, in 2021, only white men and women saw small declines in life expectancy, while Hispanic and Black men and women saw small increases in life expectancy.

The researchers also analyzed mortality data from 19 peer countries. Compared with the other countries, including France, Germany, and Israel, the United States saw a significantly larger drop in life expectancy over the past two years.

In 2020, the United States saw a 1.9-year drop in life expectancy, while peer countries saw an average decrease of 0.4 years. And in 2021, peer countries had an average increase of 0.28 years compared with the United States' 0.4-year drop.

Since the pandemic, the difference in average life expectancy in the United States and other peer countries has widened to more than five years—up from three years in 2019.

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According to the study's authors, the continued decline of U.S. life expectancy in 2021 may have been due to a lack of Covid-19 vaccination, as well as reduced pandemic safety precautions, that contributed to increased mortality rates.

"The deaths that occurred in 2021 were a product not only of a lack of vaccination, which was a huge factor, but also being in places that didn't observe policies like masking and social distancing that prevented transmission of the virus," said Steven Woolf, a professor of population health and health equity at Virginia Commonwealth University and one of the study's authors.

Separately, Gregg Gonsalves, an epidemiologist at the Yale University School of Public Health who was not involved in the study, said that while greater vaccine coverage may have helped reduce deaths, "an overriding desire to put the pandemic behind us for over a year now ... shaped our decisions to forgo basic protections at a personal and community level, throwing us all into harm's way" and driving down life expectancy in the United States.

Lower Covid-19 vaccination rates also likely helped widen the life expectancy gap between the United States and other wealthy, peer nations. Both the delta and omicron variants "swept through the other comparison countries, but none of them experienced the same loss of life we saw in the United States," Woolf said.

Other factors that could have widened the life expectancy gap include the prevalence of chronic illnesses, such as diabetes and obesity in the United States, as well as rising inequality, systemic racism, and financial insecurity.

"Simply speaking, the United States has failed to keep pace with the improvements in life expectancy enjoyed in other peer countries," said Ryan Masters, a sociologist at the University of Colorado and the study's lead author. " ... We're really bucking the trends here in a negative way." (Stein, "Shots," NPR, 4/7; Lonas, The Hill, 4/7; Reed, Axios, 4/8; Achenbach/Keating, Washington Post, 4/7)