While life expectancy is rebounding in parts of the world, white deaths drive a further US drop

Life expectancy in the United States continued to drop in 2021, while rebounding from the pandemic in many other high-income countries, according to a new preliminary analysis that found the U.S. decline was driven largely deaths among white Americans.
Life expectancy is the age to which newborns could expect to live if every year of life were identical to their birth year. In 2020, that expectation dropped sharply in the United States, as it did across many nations rocked the pandemic. In 2021, as more people became vaccinated, many “peer nations” began to see life expectancies rebound, according to the new study, which has not yet been peer-reviewed.
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The researchers — public health experts in Colorado, Virginia and Washington, D.C. — thought they would find a similar trajectory in the United States. But that wasn’t so. The study estimated that U.S. life expectancy continued to drop in 2021, a total of 2.26 years from 2019.
The study’s findings about life expectancy reflect the toll of the pandemic. Out of 3,383,729 total U.S. deaths reported federal authorities in 2020, the first year of the pandemic, the leading causes of death remained heart disease and cancer. COVID-19 came third, accounting for roughly 350,000 deaths, or about 10%. In 2021, the COVID-19 toll was 478,286, according to data from The New York Times, a 38% increase.
Other top 10 causes of U.S. deaths are injuries, stroke, chronic lower respiratory diseases, Alzheimer’s, diabetes, pneumonia and kidney disease. Several are related to obesity, which is highly prevalent in the U.S. population.
In 2020, federal data shows, Black and Hispanic Americans saw the steepest declines in life expectancy. The drop was largely because of an inequitable pandemic response, the study’s authors agreed. In 2021, the life expectancy for Black Americans began to rebound slightly and remained roughly stagnant for Hispanic Americans, the study found.
The estimated overall drop in U.S. life expectancy for 2021 was driven almost entirely increased deaths in the white population, according to Dr. Steven Woolf, a professor of family medicine and population health at Virginia Commonwealth University and one of the study’s authors.
White people account for a large share of the population in states and communities that had lax pandemic restrictions, he said, and of people who opposed vaccination and restrictive policies designed to reduce viral transmission. “We have to address the elephant in the room: polarization and partisanship in how the pandemic was handled,” Woolf said.

The peer nations the researchers cited were Austria, Belgium, Denmark, England and Wales, Finland, France, Germany, Israel, Italy, Netherlands, New Zealand, Northern Ireland, Norway, Portugal, Scotland, South Korea, Spain, Sweden and Switzerland. They calculated the life expectancy figures using official counts for 2019 and 2020, and estimated for 2021 using a validated modeling method.
The approach is “reasonable,” said Noreen Goldman, a demographer at Princeton University, who was not involved in the research. However, she noted that all estimates were subject to delays in reporting and that it was important to stress that the findings were preliminary.
The U.S. life expectancy estimate for 2021 has not yet been officially reported the Centers for Disease Control and Prevention, Goldman said, and would not be for another few months at least.
Because life expectancy calculations reflect the conditions in the year they are made, they would be expected to change in coming years. For instance, between 1917 and 1918, during the influenza pandemic, U.S. life expectancy dropped precipitously, 11.8 years, but quickly rebounded.

Still, Laudan Aron, a senior fellow at the Urban Institute’s Health Policy Center and one of the authors of the study, highlighted the “U.S. health disadvantage,” a term coined in a 2013 report she helped write. “Even Americans who have access to the best of what the U.S. has to offer are not doing well when it comes to health.” They are less healthy than their counterparts in Britain, she said, and structural problems involving systemic racism and inequality can lower positive outcomes for all.
Goldman highlighted research showing that going back to 2000, the life expectancy for a 50-year-old woman in the richest fifth of U.S. counties was lower than what it would be if she lived in the poorest fifth of Japanese jurisdictions. And U.S. life expectancy has largely stagnated and declined since then, she said.