COVID-19 and fatal drug overdoses fueled a second-straight drop in U.S. life expectancy in 2021, newly released government data confirms.
More than 3.4 million resident deaths were reported in the U.S. during 2021, according to an analysis released Thursday by the Centers for Disease Control and Prevention’s National Center for Health Statistics – approximately 80,500 more than occurred in 2020.
The age-adjusted death rate increased by 5.3%, from 835.4 deaths per 100,000 people in 2020 to 879.7 per 100,000 in 2021, the final data shows. That resulted in a drop of more than half a year in life expectancy at birth – from 77 years in 2020 to 76.4 years in 2021 – and led to the lowest level for U.S. life expectancy since 1996.
Nearly 60% of the decrease in life expectancy from 2020 to 2021 was due to deaths from COVID-19, report co-author and NCHS statistician Kenneth Kochanek tells U.S. News. In 2020, Kochanek says, deaths from the disease contributed to 61% of what was a 1.8-year decrease in life expectancy from 2019. That marked the largest single-year drop in U.S. life expectancy since World War II.
“The impact of COVID-19 is obvious,” Kochanek says. “The impact of COVID is just so excessive compared to other causes of death – it’s really what’s driving mortality right now.”
The gap in life expectancy between women and men increased slightly from 5.7 years in 2020 to 5.8 years in 2021. Life expectancy for men saw a 0.7-year drop in 2021 to 73.5 years. Women saw a 0.6-year drop to 79.3 years in 2021.
By race and ethnicity, American Indian or Alaska Native females had the largest proportional increase in mortality rate, with a rise of 7.3% from 1,152.9 deaths per 100,000 population in 2020 to 1,236.6 per 100,000 in 2021, according to the report. They were followed closely by white males – whose mortality rate increased by 7.2% to 1055.3 per 100,000 – and white females, whose mortality rate rose by 6.9% to 750.6 per 100,000.
The death rate also rose by 6.1% among American Indian or Alaska Native males, who had the highest mortality rate among racial or ethnic groups in 2021 at nearly 1,718 deaths per 100,000. At the same time, the mortality rate among Hispanic males decreased by 2.1% to 915.6 per 100,000 population in 2021. The same rate fell by 1.8% among Black males to 1,380.2 per 100,000.
Overall, nine of the 10 leading causes of deaths in 2020 retained their same ranking in 2021, with death rates increasing for eight causes and decreasing for only two. Chronic liver disease and cirrhosis became the ninth-leading cause of death with 56,585 reported fatalities in 2021, while influenza and pneumonia dropped out of the top 10.
As in 2020, COVID-19 was the third-leading cause of death in the U.S., responsible for 416,893 fatalities in 2021, according to the analysis. The death rate from COVID-19 rose by 22.5% year over year – marking the largest increase of any cause of death over that time – and the disease accounted for 12% of total deaths in 2021 compared with 10.4% in 2020.
“If this continues, then where is life expectancy going to go?” Kochanek says. “If you can answer that question you can answer what’s going to drive mortality, because if it keeps increasing it’s going to be a major player.”
The report also showed that the nation’s infant mortality rate remained relatively unchanged in 2021 at 543.6 infant deaths per 100,000 live births.
For the time being at least, the current year appears to hold slivers of better news regarding U.S. mortality: The Associated Press reported earlier this month that preliminary data through the first 11 months of 2022 point to the country seeing fewer deaths than in 2020 or 2021, due in large part to the pattern of deaths from COVID-19. Early data also indicates drug overdose deaths in the U.S. stopped climbing earlier this year, according to the AP.
In 2021, meanwhile, Kochanek says COVID-19 deaths, combined with those caused by accidents or unintentional injuries – a category that includes unintentional fatal drug overdoses – together contributed to nearly 80% of the decrease in life expectancy in 2021. The rate of death from unintentional injuries rose by 12.3% from 2020 to 2021, according to the NCHS analysis.
According to the CDC, drug overdose deaths account for more than a third of all accidental deaths in the U.S. A second NCHS report released Thursday showed that 106,699 fatal drug overdoses occurred in the U.S. in 2021 – a 16% increase from the prior record high of 91,799 deaths in 2020. The overdose mortality rate rose by 14% year over year – from 28.3 deaths per 100,000 to 32.4 – and more than 90% of overdose deaths in 2021 were unintentional, according to the report.
Outside of methadone, synthetic opioids like fentanyl drove much of the mortality increase, with the death rate tied to such drugs increasing 22%, from 17.8 per 100,000 in 2020 to 21.8 per 100,000 in 2021. The rate of drug overdose deaths involving cocaine also rose by 22% to 7.3 deaths per 100,000 people in 2021, while the rate tied to overdoses involving drugs like methamphetamine increased by 33% to 10.0 per 100,000.
The mortality rate from drug overdoses involving heroin dropped by 32% year over year, from 4.1 per 100,000 to 2.8.
The report shows that the rate of drug overdose deaths increased significantly across all age groups 25 years and older in 2021, with the largest percentage year-over-year rise among adults 65 years and over at 28%. That age group also had the lowest rate of drug overdose deaths in 2021 at 12.0 per 100,000.
Among racial and ethnic groups, the rate of drug overdose deaths increased across populations from 2020 through 2021, with the exception of Asian individuals. Native Hawaiian or other Pacific Islander people experienced the largest percentage increase at 47% to reach a mortality rate of 20.1 per 100,000. American Indian or Alaska Native individuals had the second-largest increase at 33% and the highest rate of overdose death at 56.6 per 100,000.
Overall, Kochanek says what happens in terms of the COVID-19 pandemic and drug overdose deaths in the coming years will greatly influence the trajectory of U.S. mortality.
“Those two players obviously are affecting life expectancy significantly,” Kochanek says.
U.S. News – News