LIFE EXPECTANCY FELL IN 2021 FOR THE SECOND YEAR IN A ROW

Interview with NCHS Mortality Statistics Chief Robert Anderson

HOST: In 2020, the United States experienced the biggest one-year drop in life expectancy since World War II, mostly due to the pandemic.  All 50 states had declines in life expectancy that year.  These declines were detailed in a new report released in mid-August.  On the last day of the month, NCHS released new estimates for 2021, showing life expectancy dropped nearly one more year for the country from the 2020 level.

There were some significant differences between the declines that took place in 2020 and those which occurred in 2021, particularly among different race/ethnic groups.

We talked to NCHS Mortality Statistics Chief Robert Anderson about this and other matters related to the two new studies on life expectancy.

HOST:  So there are two new reports out this month on life expectancy – the first was a report on 2020 life expectancy by state.  First of all, how did the arrival of the pandemic impact life expectancy on the country as a whole in 2020?

ROBERT ANDERSON:  Well by the time we got to the end of 2020, life expectancy had dropped almost two years, it was like 1.8 years, and COVID was, you know, largely responsible for that decline.

HOST:  So what were some of the striking declines in life expectancy from 2019 to 2020 at the state level.

ROBERT ANDERSON:  Certainly there was some state variation in the change in life expectancy, but you know overall we saw declines for every state from 2019 to 2020.  Overall the change was I said almost two years, 1.8 years, a 1.8 year decline from 2019 to 2020 overall, but then if you look at the declines by state of course they vary from about a three-year decline to about a two-year decline. So it’s quite a bit of variation in the decline in life expectancy, although we did see declines for all states.

HOST:  So presumably, the states with the largest declines in life expectancy during 2020 were also the states that have the highest mortality from COVID?

ROBERT ANDERSON:  That’s essentially correct.  I mean it’s a little more complicated than that because there’s some other things going on.  We saw increases for some other causes of death and of course increases in drug overdose deaths also had an impact, but overall COVID-19 was the primary factor.

HOST:  And so I guess the converse would be true as well – states with the smallest declines in life expectancy in 2020 were those states that had lowest mortality from COVID – would that be correct?

ROBERT ANDERSON:  Yeah that’s essentially correct.

HOST:  Now are there any other interesting findings in the state life expectancy report?

ROBERT ANDERSON:  Yeah you know the declines, if you look at things on a regional basis you see larger declines in the South, Southwest and in the Northeast. Well, New York, New Jersey in particular.  And then you know a much smaller declines in the upper Northeast – you know, Maine, New Hampshire, Vermont.  And in the Northwest – Washington, Oregon, Idaho, that area.  And of course that corresponds as we said with the level of COVID mortality in those states during 2020.

HOST:  So turning to the 2021 national report – did the decline in life expectancy continue in year two of the pandemic?

ROBERT ANDERSON:  It did… We saw an additional decline of nearly a year – 0.9 years overall – so yeah, we saw an additional decline in life expectancy.

HOST:  And so I guess this lines up with the fact that there were more COVID-19 deaths in 2021 than in 2020 right?

ROBERT ANDERSON:  That’s right, yeah that’s what we expected – because of the higher mortality in 2021 compared with 2020, we expected an additional decline in life expectancy.  And in fact that’s what we’re seeing.

HOST:  And what about the disparity between the sexes and life expectancy?  It’s always existed but it appears the pandemic has widened that gap.

ROBERT ANDERSON:   Yeah that’s right.  Typically, men have lower life expectancy than women and that’s because men have higher mortality than women overall.  And we do know that men were disproportionately affected by the pandemic – COVID-19 death rates were higher for men than for women – and so it’s not surprising that we would see a slightly larger disparity between males and females during the pandemic.

HOST:   So what race ethnic groups saw the biggest decline in life expectancy during 2021?

ROBERT ANDERSON:   From 2020 to 2021, the American Indian population really was most affected – there was a 1.9 year decline in life expectancy.  That’s followed by the non-Hispanic white population by about a year.  Then non-Hispanic black population about 7/10 of a year… and then the Hispanic population and the Asian population – the declines were much smaller during 2021. A 0.2 year decline for the Hispanic population, about a 0.1 year decline for the Asian population.

HOST:  Now over the span of the entire pandemic, what has been the cumulative impact on life expectancy among those race ethnic groups?

ROBERT ANDERSON:  Yeah I think that’s an important question.  Overall, the decline in life expectancy is about 2.7 years, a nearly three-year decline which is quite substantial.  And then quite a lot of variability by race and ethnicity.  For the American Indian population, the decline was 6.6 years from 2019 to 2021.  That’s just astounding.  For the Hispanic population it was a 4.2 year decline; for the black population about a four-year decline; for the white population, 2.4 years and for the Asian population 2.1 years.

HOST:  So it sounds like for the Hispanic population there is a lot more of an improvement I guess in 2021 is that correct?

ROBERT ANDERSON:  I’m not really sure I would say it was an improvement. The decline wasn’t as large in 2021 as it was in 2020, that’s true, but it did not improve – it continued to drop, just didn’t drop by as much.

HOST:  So besides COVID, were there any other leading causes of death that contributed to this decline in life expectancy?

ROBERT ANDERSON:  Yes – the main one is unintentional injuries, and this is mostly drug overdoses.  You know, there’s some other causes that’re grouped with unintentional injuries, includes motor vehicle accidents and falls and things like that.  But what really stands out in terms of sort of increasing mortality and which is responsible for the decline in life expectancy would be the drug overdose deaths so it’s second to COVID-19 in terms of its impac.

HOST:  And a lot of people would say that that increase in overdose deaths may or may not be indirectly tied to the pandemic stress right?

ROBERT ANDERSON:  Yeah it’s hard to say for sure exactly how it’s related or whether individual cases are related, but you know we were seeing sort of a flattening and even slightly declining drug overdose death rates just prior to the pandemic and of course a quite steep increase in drug overdose mortality during the pandemic.  So it’s hard to tie it directly because we started to see increases late in 2019 before the pandemic became, before it emerged, but then once it did, once the pandemic did emerge, then the increase in drug overdose mortality really went up quite steeply.

HOST: Any other points of either of these reports you like to make?

ROBERT ANDERSON:  Well I’ll just mention with the 2021 report, that the data are provisional still.  The data for 2021 probably won’t be final until December, that’s our target date for release of the 2021 final data.  So there could be some slight differences once we finalize the data, but at the point at which we cut the data to produce this report we had more than 99% of deaths so I don’t expect any substantial differences between this provisional report and what we will have based on our final data.

HOST:  Dr. Anderson thank you for joining us.

ROBERT ANDERSON: Thank you very much.

MUSIC BRIDGE:

HOST:  Overall, August was an extremely busy month at NCHS.  The month started off with a new report on physical therapy, speech therapy, and rehabilitative and occupational therapy among veterans compared with non-veterans, using data from the National Health Interview Survey.  The study showed that veterans are more than 50% likelier than non-veterans to have had any of these therapies.  The same week, NCHS released its latest annual report on fetal mortality in the United States for 2020.  A total of 20,854 fetal deaths at 20 weeks of pregnancy or longer were reported in 2020.

Another study, using NHIS data, looked at organized sports participation among U.S. children ages 6-17.  The study showed that over half of kids in this age group participate in organized sports.

On August 18th, NCHS released the latest monthly data on drug overdose deaths in the country, documenting that over 109,000 overdose deaths occurred in the United States during the one-year period ending in March 2022.

The official public use file for births in the United States for 2021 was released on August 29, accompanied by a Data Brief summarizing the key findings from these final data.  On the same day, the quarterly provisional release of infant mortality data was released in an interactive data visualization for the web, featuring full-year 2020 numbers. The post neonatal mortality rate in the U.S. increased in 2020 from the same point in 2019.  The post neonatal mortality rate is the number of deaths among infants between 28 and 364 days of age per 1,000 live births.

And last, a new report using data from the 2020 National Health Interview Survey shows that about one-quarter of adults in the United States age 18 and over have met the national physical activity guidelines for both aerobic and muscle-strengthening activities.