of Centers for Disease Control and Prevention (CDC) recently updated its estimates of how the COVID-19 pandemic has affected life expectancy in the United States, and the news is not good. We already knew that 2020, the first year of the pandemic, was devastating in the United States, causing more deaths than any other country. The decline in US life expectancy in 2020 was the largest the US has experienced since World War II.of CDC Life expectancy in the United States is now reported to have fallen further in 2021. Combined, these two years mean that life expectancy dropped by her 2.7 years, the largest decline in a century.
A reduction in US life expectancy in 2021 was avoided. We know this because no other high-income country has experienced such losses. Through the COVID-19 pandemic, Americans have a much higher mortality rate than people in other rich countries.According to one study Among the United States and 19 peer countries, life expectancy in the United States decreased by 1.9 years in 2020, while life expectancy in other countries decreased by 0.6 years.
In 2021, when a COVID-19 vaccine became available, most countries reversed their losses and life expectancy increased by an average of 0.3 years, but US life expectancy continued to plummet.
There are several possible reasons for the poor US performance in 2021. Some countries have performed better in distributing and administering COVID-19 vaccines and maintaining pandemic measures such as wearing masks. While many Americans resisted such measures, their populations were often docile.
Americans lack universal access to a healthcare system overwhelmed by the surge affecting not only COVID-19 treatment, but other health care issues.according to CDCCOVID-19 was responsible for only 74% of the decline in life expectancy in the United States in 2020, according to the report. Deaths from chronic diseases such as heart disease and diabetes also increased during the pandemic.death from drug overdose broke the record.
It’s tempting to view this calamity as a one-off exception, and to think that now that the pandemic seems to be waning, health in the United States will return to normal. , a return to “normal” would leave the United States in a precarious place.
The tragedy that Americans have higher mortality rates than people in other countries is by no means a new phenomenon. It started decades ago. Life expectancy has increased over the past century, but in the United States it began to slow in the 1980s. Life expectancy in the United States fell below the average for high-income countries in the 1990s, leveled off in 2010, and then began to decline, while other countries continue to rise.
According to one studyThe gap in life expectancy between the United States and 16 peer countries widened from 1.9 years in 2010 to 3.1 years in 2018, according to the WHO. The US death toll during the COVID-19 pandemic further widened the gap.According to another story studyby 2021, the gap between the US and 19 peer countries widened to 5.3 years.
Life expectancy is not the only health disadvantage in the United States. The United States has a high mortality rate from many illnesses and injuries, as well as an epidemic of obesity, chronic disease, and disability. Racial and ethnic health disparities are unacceptably large, but poor health in the United States is not caused by marginalized groups. Americans die at a higher rate than whites in other countries. Unhealthy diets, obesity, the opioid epidemic, and guns all contribute to America’s health disadvantage, but there is no single cause that can explain the breadth of America’s health disadvantage. There is none.
The underlying cause is probably systemic. To explain the worsening health of Americans, we need to look upstream. Potential causes include not only deficiencies in the U.S. health care system, but also the socioeconomic conditions, particularly those facing middle-class and low-income communities in the U.S., poor health in the physical and social environment. situation is included.
Perhaps the most underlying driver of America’s health disadvantage is policy and politics. In contrast to policies in other countries that have resulted in better health, the United States has weakened its support for education, health care, affordable housing, and the financial well-being of families. All of these have a huge impact on your health. U.S. employers are less likely to offer decent wages, paid vacation, and other benefits that workers enjoy in healthier countries. U.S. regulators are unlikely to restrict industries that could threaten public health or limit the marketing of dangerous products ranging from opioids to offensive weapons. They are less proactive than more inclusive societies in confronting systemic barriers to opportunity based on ethnicity and other prejudices.
Federalism and the devolution of power to the states are also contributing factors. Since the 1990s, the gap in life expectancy across the 50 states has widened. With increasing political polarization, especially over the past decade, states with progressive and conservative tendencies have very different views on policies affecting health and safety, from the expansion of Medicaid to tobacco control. I started taking an approach.
This was vividly seen during the COVID-19 pandemic, when the state’s policy response was highly partisan. The Republican governor showed partisan goodwill by questioning the scientific evidence and resisting the order.
Other countries can implement national plans to deal with health problems, including pandemics — federalism requires the US to have 50 response plans.
Americans have experienced fragmented healthcare, labor policies, taxes, and welfare assistance, and now the polarization extends to abortion policy, gun control, and even student learning in the classroom.
Solving the health disadvantages of the United States may seem overwhelming, especially given the deep-seated root causes. But other countries are showing what is possible. The improved health and longer lifespans enjoyed by the world’s largest democracies, from Australia and Canada to dozens of countries in Europe and East Asia, are likely due to worsening health outcomes for Americans. This indicates that it is a problem with Policy makers and voters can choose to change policy, but that requires political will. Decisions are needed on how to put health ahead of competing personal, political, and corporate interests.
As with most challenges, the first step is recognizing problems that haven’t yet occurred. Health disadvantages in the United States are not common knowledge. Many Americans live with misconceptions and do not realize that their children are destined for a shorter lifespan. Her 10 states in the US have lower life expectancy than countries like Bosnia, Cuba and Iran. Palestinians have longer life expectancies than those in West Virginia and Mississippi.
The COVID-19 pandemic was a wake-up call exposing the darker side of American exceptionalism that endangers lives. Americans deserve to know the facts and make informed choices when faced with policy and election decisions that may affect their health and survival.
Stephen H. Wolfe He is Professor of Medicine at Virginia Commonwealth University School of Medicine, Director Emeritus of the Center for Social and Health Studies, and a member of the National Academy of Medicine. Follow Wolf on Twitter. @Shwolf.
