Even before the coronavirus disease 2019 (COVID-19) pandemic occurred, the US was mired in a 40-year population health crisis. Since 1980, life expectancy in the US has increasingly fallen behind that of peer countries, culminating in an unprecedented decline in longevity since 2014.1 Life expectancy at birth in the US in 1980 was 73.6 years, in 2014 was 78.9 years, and in 2018 was 78.7 years. These long-standing trends have been driven by increasing mortality among working-age adults, specifically those of lower socioeconomic status. While working-age adults with a 4-year college degree have experienced gains in life expectancy, those with only a high school diploma have experienced a decline.2 Similarly, the gap in longevity between the top and bottom 5% of the household earnings distribution has increased by 2.6 years from 2001 to 2014, with life expectancies at 40 years of age in these 2 groups of 79.7 and 89.4 years, respectively, in 2014.3 At the same time, differences in longevity continue to be pronounced across racial and ethnic groups, led by elevated rates of mortality among Black and American Indian adults.1 The persistent widening of socioeconomic gradients in life expectancy, even as per capita expenditures on health care have increased substantially, suggest that social and economic forces are likely to be the central drivers of the decline in US life expectancy.
Venkataramani AS, O’Brien R, Tsai AC. Declining Life Expectancy in the United States: The Need for Social Policy as Health Policy. JAMA. 2021;325(7):621–622. doi:10.1001/jama.2020.26339
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: