By Evan Bush, NBC News

November 3, 2021


The United States had the second-steepest decline in life expectancy among high-income countries last year during the pandemic, according to a study of death data spanning several continents.

The only country studied that saw a starker overall trend was Russia.

The study, published Wednesday in The BMJ (formerly the British Medical Journal), assessed premature death in 37 countries, comparing observed life expectancy in 2020 with what would have been expected for the year based on historical trends from 2005-2019. Life expectancy dropped in 31 of these countries during the pandemic.

The U.S. trend was among the worst.

U.S. men saw life expectancy fall by nearly 2.3 years. Women lost more than 1.6 years of life expectancy.

The measurements provide one of the most comprehensive views of the human cost of the pandemic and illuminates its effects on different age groups and genders. One surprise: The drop in life expectancy in the U.S. was driven by the deaths of young people, said Dr. Nazrul Islam, a researcher at the University of Oxford and the study’s lead author.

In the U.S., “we have lost a huge amount of people at a young age. That’s really, really sobering,” Islam said.

The paper’s findings suggest that the U.S. did a relatively poor job protecting young people during the pandemic, that the country’s life expectancies have dropped at a faster pace than any time since at least World War II and that the U.S. is falling further behind many other rich countries when it comes to a key measure of health.

Disease was not the only factor. Homicides and drug overdose deaths rose last year, too, said Bryan Tysinger, a research assistant professor in health policy at the University of Southern California, who was not part of the BMJ study, suggesting that the pandemic’s effects on social structures were a large part of the trend.

“It continues to be striking how poorly the U.S. has handled the Covid pandemic,” Tysinger said. “The U.S. should not be leading or nearly leading excess deaths in a pandemic like this.”

Early in 2020, Covid primarily killed older U.S. adults in densely populated Covid hot spots. But since the delta variant took hold, the disease has shifted it burden toward those who have not gotten the shot, NBC News analysis shows. Data says younger, Southern, rural and white populations are now at more risk.

The study evaluated 15 years of death data from 37 countries.

In every country studied, life expectancy trended upward between 2005 and 2019. Then Covid struck.

Thirty-one countries saw declines in life expectancy. Altogether, the researchers believe these country’s populations lost about 28 million years of life.

The largest losses in life expectancy were observed in Russia, the U.S., Bulgaria and Lithuania.

Denmark, Iceland and South Korea saw no significant change in life expectancy. Despite the pandemic, New Zealand, Taiwan and Norway achieved gains.

Countries with stricter Covid restrictions, higher trust in government and recent experience managing epidemics seemed to fare better in 2020, Tysinger said.

In the U.S., young people’s deaths sent life expectancies plummeting. That makes the country an outlier.

“It reveals the U.S. did a poor job protecting younger individuals or they were more susceptible compared to other countries,” said Theresa Andrasfay, a postdoctoral researcher of gerontology at USC, who was not involved in the study.
Andrasfay said it could mean that the country was worse at protecting essential workers or that working-age people had more conditions that put them at greater danger from Covid, she added.

Prior research, including some by Andrasfay, suggests that life expectancy reductions have been larger in Black and Latino populations than in white populations.

Andrasfay said that could be due to factors like higher exposure rates for Covid among essential workers, inequitable access to health care and differing rates of health conditions that heighten risk for Covid.

In recent years, life expectancies in the U.S. have stagnated. During the past five years, the country saw reductions as significant as about one-tenth of a year.

“At the time, that was considered a really big loss,” Andrasfay said.

Until 2020, the U.S. had not seen life expectancies drop so significantly since World War II, Andrasfay said, though that data then was less reliable than it is today. The 1918 pandemic, which killed young people at outsize rates, sent life expectancy figures tumbling from 7 to 10 years, she added.

“The fact that the U.S. did so much worse in 2020 means we’re even further behind our peer countries,” Andrasfay said.
Islam said the pandemic set life expectancy for U.S. men back nearly two decades.

“Life expectancy in 2020 was comparable to life expectancy, in men, back to 2002,” Islam said. “Everything we have achieved over the last 19 years was sort of lost.”

Last year’s life expectancy data reflected how well countries managed the initial bout of Covid with tools like lockdowns, social distancing and public health messaging.

“In 2021 and going forward, it might be vaccine uptake and distribution that distinguishes which countries are successful and which are not,” Andrasfy said.