Life expectancy falls for second straight year due to COVID-19, drug overdoses, CDC report finds

Accelerating deaths from COVID-19 and drug overdoses fueled a second straight year of worsening life expectancy, down to the shortest it has been since 1996, the Centers for Disease Control and Prevention said Wednesday.

The estimates, published in a new report now analyzing the "final data" on American death certificates tracked by the CDC's National Center for Health Statistics, make official a steep decline first reported by the agency based on "preliminary data" back in August.

The final estimates differ only slightly from the provisional ones released earlier this year. At the time of the August report, federal authorities had already received data on more than 99% of death certificates for 2021.

Americans born in 2021 are expected to live 76.4 years, the report's authors now estimate. That is down from a peak of 78.8 years in 2019.

Death rates worsened for every age group. Adjusted for age, the death rate climbed by 5.3% from 2020 to 2021. That is smaller than the 16.8% increase from 2019 to 2020, for the first year of the COVID-19 pandemic.

The shift also reflects a widening gap relative to America's international peers, most of whom had already outpaced the U.S. before the pandemic. 

An analysis published by the Kaiser Family Foundation earlier this month tracked life expectancy "rebounding in most comparable" large and rich countries for 2021 as America's dropped. The U.S. continues to rank lowest among countries with large economies.

COVID-19 was the third highest cause of death in the U.S. for 2021, behind heart disease and then cancer. 416,893 Americans had the disease as the underlying cause on their death certificates, up from 350,831 in 2020.

The disease appears on track to remain a leading cause of death for 2022, though smaller than in previous years of the pandemic.

So far this year, 233,523 death certificates blaming COVID-19 have been reported to the agency. The U.S. is averaging 386 new COVID-19 deaths per day. 

Overdose deaths 

Behind COVID-19, the second largest increase in causes of death last year was from "unintentional injuries," which climbed 12.3% to 64.7 lives lost per 100,000 people.

That includes drug overdoses, which the NCHS said accounts for a third of deaths in the category and largely accounts for the acceleration seen in 2021. 

106,999 drug overdose deaths occurred, the agency said in a separate report published Wednesday, or 32.4 per 100,000 people.

Rates of overdose deaths are now fivefold worse than two decades ago. 

The highest rate of drug overdose deaths in 2021 remained in adults from 35 to 44 years old. Seniors ages 65 and older had the lowest rate of deaths, but saw "the largest percentage increase" relative to 2020.

Rates of drug overdose deaths worsened among every racial group except Asian people. American Indian or Alaska Native people continue to see the highest rates of deaths and among the largest percentage increases.

Broken down by the kind of drug linked to each overdose, the NCHS data shows the rate of deaths continuing to climb steeply for opioids overall as well as synthetic opioids, like fentanyl. 

Among deaths linked to stimulants, cocaine has now been overtaken for another year by other "psychostimulants with abuse potential" like methamphetamine. Compared to 2020, the death rate climbed 33% in this latter category.

Heroin was the only drug highlighted by the agency to see a lower death rate in 2021.

However, preliminary CDC data for this year suggests drug overdoses may also be slowing this year. 107,735 deaths may have happened for the 12 months ending July 2022.

"Today's data represents a steady slowing of the rate of increase in overdose deaths for the ninth month in a row, and a decrease in 12-month rolling totals for the fourth month in a row," the White House said in a statement earlier this month following the new release.