An August report from the U.S. National Center for Health Statistics, a branch of the Centers for Disease Control and Prevention (CDC), paints a glaringly disturbing picture of life expectancy for the American population. For the years 2020 and 2021 the U.S. experienced its sharpest decline in life expectancy in 100 years, falling especially heavily on American Indians and Alaskan Natives. In 2021, the average American could expect to live 76.1 years, a decline from 2020 of 0.9 years. Worse, there was a decline of 1.9 years in that period for American Indians and Alaskan Natives to levels not seen since 1944.
Deaths from Covid-19 account for most of that decline, but a substantial amount also came from unintentional accidents, mostly overdoses. These data are dismaying on their own, but behind them are other disturbing facts. A New York Times article published just after the release of the CDC mortality report extensively quoted Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, who noted that the decline in life expectancy in the U.S. was more severe and is continuing for longer than in other high-income countries. Quoting from the article:
“None of them experienced a continuing fall in life expectancy like the U.S. did, and a good number of them saw life expectancy start inching back to normal,” Dr. Woolf said.
Those countries had more successful vaccination campaigns and populations that were more willing to take behavioral measures to prevent infections, such as wearing masks, he said, adding: “The U.S. is clearly an outlier.”
It thus appears that the portion of the steep decline in life expectancy that is attributable to Covid-19 is worse in the U.S. than in other high-income countries and this can be ascribed to our general lack of preparedness and to the political divisiveness that made following public health recommendations a matter of partisan ideology instead of evidence-based practice. Many Americans sadly have fallen for misinformation about the pandemic and believe that face masks don’t reduce the risk of transmitting and acquiring disease (they do) and that vaccinations are unsafe and ineffective (they are in fact both safe and effective). The price Americans are paying for listening to misinformed voices is obviously profound.
A second sad truth that can be gleaned from the CDC life expectancy data concerns the fate of American Indians and Native Alaskans. Again quoting the New York Times story:
Average life expectancy in these populations is now “lower than that of every country in the Americas except Haiti, which is astounding,” said Noreen Goldman, professor of demography and public affairs at the Princeton School of Public and International Affairs.
While it is true that the bulk of the reason for the decline in life expectancy among American Indians and Native Alaskans is due to the Covid-19 pandemic, that doesn’t explain why these communities suffered a much greater effect than other groups. Experts explain that the reason for this is that American Indians and Native Alaskans have higher rates of underlying conditions like diabetes and obesity, which make Covid-19 deadlier. Once again from the New York Times story:
Longstanding health problems — rooted in poverty, discrimination and poor access to health care — left Native Americans and Alaska Natives particularly vulnerable to the virus, said Dr. Ann Bullock, former director of diabetes treatment and prevention at the federal Indian Health Service agency and a member of the Minnesota Chippewa Tribe.
As of 2019, 5.7 million people were classified as American Indian or Alaskan Native, groups of people who experience some of the worst health outcomes in the U.S. As Dr. Bullock explains in the quote above, this is largely due to structural racism and adverse social determinant of health, like crowded living conditions and poor access to healthcare.
In 2019, an American could expect to live to be 79 on average. In 2021 that average lifespan was down to 76. Black Americans had a life expectancy of only 71 in 2021; American Indians and Native Alaskans even lower at 65. While other countries’ mortality statistics have rebounded from Covid-19, the U.S. continues to have high death rates, due in part to vaccine hesitancy. We also do worse than other high-income countries in surviving heart disease, chronic liver disease, and cirrhosis and we have experienced an outbreak of drug overdoses and suicides, the latter fueled in part by our refusal to control private gun ownership.
The health of Americans compared to citizens of comparable countries is not good. Our fragmented, profit-driven healthcare system makes accessing healthcare difficult for millions, even those who have health insurance. We place the highest burdens on minority groups, offering them the worst access to healthcare and depriving them of many things that are associated with improved health outcomes. Our Critica readers will agree that this situation is morally wrong and intolerable. We can hope that the Covid-19 pandemic taught us that we need to be better prepared for the next infectious disease outbreak, but even accomplishing that will not fix the fundamental reasons that groups like the American Indians and Alaskan Natives living among us have the most dismal healthcare outcomes and the highest mortality rates. Perhaps the fact that we are dying younger in recent years will persuade us that it is time to make major structural changes in our healthcare system and the way we treat marginalized communities.