Study reveals stark life expectancy disparities across the United States

· News-Medical

Stark differences in life expectancy have widened over two decades

Despite efforts to reduce health inequalities, the life expectancy gap between the Americas was 12.6 years in 2000 and grew even larger during the 2000s and 2010s (reaching 13.9 years in 2010 and 15.6 years by 2019), and accelerated to 20.4 years after the first two years of the COVID-19 pandemic (see table in notes to editors).

In 2000, Black Americans living in rural, low-income counties in the South (America 9) and Black Americans living in highly-segregated cities (America 7) had the lowest life expectancy (around 70.5 years for both populations), while Asian Americans (America 1) had the highest life expectancy, living on average 83.1 years.

Between 2000 and 2010, life expectancy increased for every America except for American Indian and Alaska Native (AIAN) people living in the West (America 10), who had the shortest lifespan in 2010 after a one-year drop in life expectancy from 72.3 years in 2000 to 71.2 years in 2010.

During this time, the three Black Americas (6, 7, and 9) showed some of the largest gains in life expectancy, increasing by as much as 3.7 years, with Black Americans living in other counties (America 6) exceeding the life expectancy of White Americans living in low-income counties in Appalachia and the lower Mississippi Valley (America 8) from 2010 onwards, except in 2020.

"The gap between life expectancy at birth for Black and White Americans may never have been narrower than it was in the mid-2010s," said co-author Thomas Bollyky from the Council of Foreign Relations, Washington DC, USA. "It's likely that long-term improvements in education available to Black children and young adults in recent decades, as well as reductions in homicide rates and deaths from HIV/AIDS-;causes of death that have disproportionately impacted Black Americans-;may have contributed to these noteworthy gains for Black Americans."

However, in the following decade (2010-2019), improvements in life expectancy at birth for the three Black Americas (Americas 6, 7, and 9)-;as well as all the other Americas-;largely stalled (see table in notes to editors). This pattern may be explained by an increase in drug overdose deaths and homicides as well as a slowdown in reductions in cardiovascular disease deaths, likely related to increases in obesity.

Widening racial life expectancy gap during the first two years of the COVID-19 pandemic 

The COVID-19 pandemic precipitated a staggering drop in life expectancy for all the Americas and substantially widened racial disparities in lifespan. For example, while Black Americans living in highly segregated cities (America 7) and Black Americans living in rural, low-income counties in the South (America 9) were expected to live an average 74.9 years and 72.5 years, respectively, in 2019, this fell by approximately 4.0 years in 2020. For White (the majority), Asian, and AIAN people living in other counties (America 3), the corresponding decline was only 1.4 years-;from 79.3 years in 2019 to 77.9 years in 2020.

Marginalised groups already had lower life expectancy, and the pandemic further increased the gap. By 2021, Asian Americans (America 1) still had the longest life expectancy at birth, living on average 84 years-;a striking 20.4 years longer than AIAN people living in the West (America 10), who had the lowest life expectancy at 63.6 years.

Alarming health crisis for American Indian and Alaska Native people in the West

What is driving these disparities in life expectancy?

Source:

The Lancet

Journal reference: