US life expectancy plummets in 2021 as covid and drug-related deaths soar

Notably, every age group in the United States – from young children to the elderly 85 and over – has seen its death rate increase. Men, women and most racial groups lost ground. In some previous years, even when overall life expectancy has declined, some groups have progressed.

“This one is kind of bad news across the board,” said Eileen Crimmins, a professor of gerontology at the University of Southern California who studies life expectancy around the world. “Since 1996, we have not progressed. It’s amazing, considering how much we’ve learned about medicine, how much we’ve spent.

The government announced last week that healthcare spending in 2021 reached nearly $13,000 per person.

The data reinforces a trend line in US longevity falling relative to that of its peers. A child born in the United States in 2019, for example, could expect to live to be 78.5 years old, according to the World Health Organizationwhile a Japanese child born that year had a life expectancy of 84.5 years, Belgians lived to 81.4 and Swedes to 82.4.

A total of 3.46 million people died in the United States in 2021, 80,502 more than the previous year. Covid killed 416,893 people and drug overdoses were responsible for 106,699 deaths – slightly less than the more than 107,000 the government had cited based on preliminary data. At birth, women could expect to live 79.3 years in 2021, and men could expect to live to 73.5 years – lifespans that have fallen sharply from 2020.

In 2021, heart disease and cancer, the two leading causes of death in the United States, have changed little. The top ten causes of death remained the same, with the exception of influenza and pneumonia, which dropped from the list as part of the US population wore masks to protect against the coronavirus. Liver disease, often linked to alcohol consumption and viruses, has replaced influenza and pneumonia.

The 2021 decline was the second consecutive decline for the United States and the continuation of a trend that began in the middle of the last decade, when “deaths of despair” – those caused by drug overdoses, suicide and alcoholism – increased markedly.

This also contrasted with the rebound in life expectancy rates in some other countries as they curtailed the covid pandemic better control with vaccines and masking. A study of 29 countries published in August in the journal Nature Human Behavior found that eight people experienced a significant “rebound” in their life expectancies in 2021.

They included Belgium, Switzerland, Spain, France and other mainly Western countries, the United States was among the 12 where life expectancy continued to decline. They included Germany, Chile, Bulgaria, Greece and Estonia, among others.

“With the vaccine available and other pandemic control measures, many other countries have recovered,” said Steven Woolf, professor of family medicine and population health at the University of Commonwealth of Virginia. “The fact that it’s happened in other countries tells us it’s possible to do it.”

But few other countries have faced hundreds of thousands of covid deaths, coupled with an unrelenting epidemic of drug overdoses largely caused by illicit trafficking. synthetic opioid fentanyl. Drug overdoses rose 14% last year and quintupled in two decades. These overdoses claimed more lives last year in all age groups 25 and older, and in all groups except Asian men.

Fentanyl did about two-thirds of the damage. The Drug Enforcement Administration announced Tuesday that it has seized 379 million doses of fentanyl in 2022, enough “to kill everyone in the United States,” according to DEA Administrator Anne Milgram. Yet authorities estimate that they only catch 5-10% of the illegal fentanyl that crosses the southern border.

Methamphetamine and cocaine deaths have also risen sharply Last year. Experts have speculated that fentanyl may be involved in some of these deaths because it is present in the drug supply, causing some users to ingest it unknowingly.

Magdalena Cerda, a professor in the Department of Population Health at NYU Grossman School of Medicine, said people who believe they are using cocaine or methamphetamine may not take precautions. like having naloxone, an opioid overdose antidote, or fentanyl test strips on hand.

“People think they’re only taking cocaine or meth, but they’re also taking fentanyl,” she said.

Many people die from overdoses have multiple drugs in their systems.

“It’s certainly heartbreaking,” said R. Kathryn McHugh, chief of psychology at McLean Hospital in Massachusetts. “That’s 106,000 people with families who are no longer there.”

The data shows that fentanyl appears to replace heroin, a much less potent opioid. Deaths from the drug fell 32% from the previous year, the government reported.

As they have for years, experts have cited the anomalies of life in the United States as they try to explain the country’s declining life expectancy. These include lack of universal health care, high death toll from gun violence, widening income gap between rich and poor, consumption of unhealthy food, weak government support housing and child care and many other social and economic factors.

“My contention is that there are choices that we make as a society and that policymakers make in the United States that other countries don’t make,” said VCU professor Woolf.

McHugh and Cerda called for scaling up treatment efforts to tackle the ever-worsening drug epidemic by improving access to drugs such as buprenorphine, methadone and naltrexone. They also said the United States should expand the use of harm reduction techniques by expanding the distribution of naloxone, syringe services and fentanyl test strips.

“A lot of the tools that we need, we already have,” McHugh said. “We just need to deploy them better.”