Life expectancy gap in U.S. widens to 20 years due to "truly alarming" health disparities, researchers say

CDC: U.S. life expectancy is declining, with COVID-19 a key factor

Life expectancy in the United States varies by more than 20 years depending on your race and ethnicity and where you live, according to new research. The authors call the level of health disparities "truly alarming."

In the study, published Thursday in The Lancet, researchers analyzed death records from the National Vital Statistics System and population estimates from the National Center for Health Statistics from 2000 to 2021. 

Large disparities in life expectancy were apparent throughout the study period but grew more substantial over time, particularly during the first two years of the COVID-19 pandemic, the authors noted. 

"The extent and magnitude of health disparities in American society are truly alarming in a country with the wealth and resources of the USA," senior author Christopher J.L. Murray said in a news release. "These disparities reflect the unequal and unjust distribution of resources and opportunities that have profound consequences on well-being and longevity, especially in marginalized populations."

In 2000, life expectancy ranged from an average of 70.5 years for Americans at the lowest end to 83.1 years for those in the highest group — a difference of 12.6 years. The gap widened to 13.9 years in 2010, jumped to 18.9 years in 2020, and now in the latest data, 20.4 years in 2021.

During those two decades, the study says, "US life expectancy has shifted in the wrong direction, falling further behind that of most other peer wealthy nations."

In 2000, the groups with the lowest average life expectancy included Black Americans in non-metropolitan and low-income counties in the South, as well as in highly segregated metropolitan areas; and American Indian or Alaska Native individuals in the West. The group with the highest average life expectancy was Asian Americans. 

Between 2000 and 2010, life expectancy increased for all groups except for American Indian or Alaska Native individuals in the West, who saw a about a 1-year decline. For White and Latino populations, outcomes varied depending on the locations where they lived. For example, White Americans in low-income counties in Appalachia and the Lower Mississippi Valley had lower life expectancies than those in other areas.

By 2021, after the impacts of the pandemic, the gaps grew substantially wider, with Asian American life expectancy averaging 84 years while American Indian or Alaska Native people in the West averaged 63.6 years. Life expectancy among non-Hispanic Black Americans fell to 71.0 years, from 74.8 just two years earlier, with significant variations depending on where they lived.

"During the COVID-19 pandemic, historically marginalised populations experienced the highest mortality rates and horrific losses in life expectancy," the authors wrote.

To help address these disparities, Murray said, "Policymakers must take collective action to invest in equitable health care, education, and employment opportunities and challenge the systemic barriers that create and perpetuate these inequities so that all Americans can live long, healthy lives regardless of where they live and their race, ethnicity, or income."

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