COVID-19, drug overdoses drag down U.S. life expectancy in 2021

Life expectancy in the United States dropped in 2021 to 76.1 years, with COVID-19 and the drug overdose deaths due to the opioid epidemic largely to blame.

The National Center for Health Statistics published its report “Provisional Life Expectancy Estimates for 2021,” just days after a similar analysis calculated American life expectancy dropped in 2020, confirming figures that were estimated last year.

Life expectancy at birth was 76.1 years, down 0.9 years from 2020 life expectancy of 77 years. For males, life expectancy at birth was 73.2 years, down a full year from the 2020 figure of 74.2 years. For females, life expectancy at birth dropped to 79.1 years, decreasing 0.8 years from 79.9 the year before. All the figures were at levels not seen since 1996.

Since 2019, total population life expectancy in the United States has decreased 2.7 years, or by 3.1 years for males and 2.3 years for females, the report said.

COVID-19 accounted for 50% of the negative contribution toward life expectancy overall.

U.S. Food and Drug Administration Commissioner Robert M. Califf, MD, referred to the new figures during his online press conference of Aug. 31 to announce FDA emergency use authorization for bivalent COVID-19 vaccines and boosters.

“So this is a remarkable opportunity to improve our life expectancy and reduce the toll of mortality in our population,” he said, encouraging people to get vaccinated or boosted before a projected fall surge.

In 2021, unintentional injuries accounted for 15.9% of the negative drag on life expectancy. The report stated: “Increases in unintentional injury deaths in 2021 were largely driven by drug overdose deaths.”

Opioid deaths were estimated at 107,622 in 2021, 15% more than in 2020. While it appeared COVID-19 hospitalizations and deaths could drop over time, at least one model predicted the opioid crisis will get worse before it gets better, claiming up to 500,000 lives over the next decade.

For the 2021 life expectancy calculation, other negative factors were heart disease (4.1%), chronic liver disease and cirrhosis (3%) and suicide (2.1%).

The decrease in life expectancy would have been greater but for offsetting effects of decreasing mortality due to influenza and pneumonia (38.5%), chronic lower respiratory diseases (28.8%), Alzheimer’s disease (18.3%), perinatal conditions (6.3%) and Parkinson’s disease (2.3%), according to the federal report.

Among racial and ethnic groups, the non-Hispanic American Indian Alaska Native (AIAN) population had the largest decrease, from 67.1 years in 2020 to 65.2 years in 2021. That was the same life expectancy of the total U.S. population in 1944.

The report noted the data were preliminary and could change.

Death data generally are more than 99% complete three months after the date of death, but timeliness of death certificate data varies by jurisdiction, age and cause of death. For example, death certificates may be delayed due to investigations of deaths involving infants, drug overdoses or other injuries, the report said.