U.S. life expectancy dropped for the second year in a row in 2021, reaching the lowest level seen in 25 years, according to final mortality data released by CDC's National Center for Health Statistics (NCHS).

Report details and key findings

For the report, researchers at NCHS analyzed final mortality data from 2021 to estimate Americans' life expectancy at birth and any changes over time. Previously, NCHS had released life expectancy findings based on provisional death records.

Overall, the researchers found U.S. life expectancy had dropped to 76.4 years in 2021—a 0.6-year decline compared to 2020 and the lowest figure since 1996. Since 2019, U.S. life expectancy has dropped by 2.4 years.

For men, life expectancy decreased by 0.7 years from 2020 to 2021, going from 74.2 years to 73.5 years. Women also saw a similar decline of 0.6 years, going from 79.9 years in 2020 to 79.3 years in 2021.

Although the overall decline in life expectancy in 2021 was less severe than it was in 2020, the drop was still significant since life expectancy typically only changes by 0.1 or 0.2 years.

According to Robert Anderson, chief of mortality statistics at NCHS, the current decline in life expectancy is largely being driven by the pandemic, so while the decrease is not necessarily surprising, it is "substantial."

In 2021, Covid-19 continued to make up a significant portion of deaths in the America and was the third-leading cause of death in the country behind heart disease and cancer for the second year in a row. Almost one in eight deaths were due to Covid-19 in 2021, up from one in 10 deaths in 2020.

Deaths from drug overdoses also increased significantly, reaching a new record in 2021. Roughly 107,000 died of a drug overdose in 2021, which increased the age-adjusted death rate for overdoses by 14% from 2020 and 50% from 2019.

Many of these drug fatalities were due to synthetic opioids, such as fentanyl. Between 2020 and 2021, deaths from fentanyl overdoses jumped 22%.

"These data are very tragic but not surprising," said Nora Volkow, director of the National Institute on Drug Abuse. "The pandemic had a magnifying effect on an already-devastating overdose crisis, and exacerbated many of the stressors in society that make people more vulnerable to taking drugs."

As a whole, the age-adjusted death rate in the United States increased by 5.3% from 835.4 deaths per 100,000 people in 2020 to 879.1 deaths per 100,000 in 2021. Across racial and gender demographics, most groups saw their age-adjusted death rates increase in 2021 except for Hispanic males and non-Hispanic Black males (2.1% decrease and 1.8% decrease, respectively).

Commentary

So far, it is unclear what U.S. life expectancy will look like in the long term. Although preliminary data from 2022 suggests that Covid-19 deaths have declined, this does not necessarily mean that life expectancy will rebound quickly since other causes of death, including heart disease and stroke, are also increasing.

"These are the things that need to be watched carefully in the coming years, both in terms of surveillance data and in terms of final data as well," Anderson said. "They need to be monitored to see how things are progressing post-pandemic."

"I'd like to think that we will go back to at least a trend of increasing life expectancy," Anderson added. "But, how long it will take for us to get back to 2019, it's hard to know."

According to Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research, the Covid-19 pandemic, as well as rising drug addiction and overdoses, should be a "wake-up call" for the government.

"It clearly is what's cutting into the health of our communities, unlike almost anything we've seen before," he said.

"We have treatments and tools available [to combat the opioid epidemic], but we must prioritize taking them off the shelf and using them to their full potential," Volkow said. "To curb the overdose crisis, it is crucial that we put this same urgency and infrastructure into action to accelerate discoveries in addiction science, provide treatment and support for people with substance use disorders, and deploy prevention interventions to save lives." (McPhillips, CNN, 12/22; Noguchi, "Shots," NPR, 12/22; Kekatos, ABC News, 12/22; Mahr, Politico, 12/22; Xu et al., CDC, accessed 12/22)