When it comes to life expectancy, we don’t get what we pay for

The life expectancy of the average American dropped by 2 years in 2020, but by only a few months in peer countries. This discrepancy gets worse when you adjust for sex, race, and ethnicity. This is despite the fact that the US spends the most money on healthcare in the world. How do we get such poor health outcomes with such high spending?

Americans live shorter lives than residents of other wealthy countries.

In 2019, the average American could expect to live for nearly 79 years. In 2020, that number dropped to 77 years. This shift is the largest ever recorded in the United States, marking an additional 530,000 deaths during the first year of the COVID-19 pandemic. The United States already ranked 29 out of 38 comparable countries for average life expectancy in 2019, and the 2020 data shows that the decrease was especially pronounced here as compared to elsewhere in the world. While our life expectancy dropped by nearly 2 years, peer countries experienced only a 0.58 year drop. This becomes even more egregious when you consider that the United States also spends nearly three times as much on healthcare as comparable countries.

Men and people of color experienced greater drops in life expectancy.

The decrease in life expectancy was not even across different demographics. Males experienced a drop of 2.1 years compared to females, who experienced a drop of 1.5 years, further growing the gap between male and female life expectancy. Hispanic males had the highest death rate increase of 42.7%, followed by Hispanic females at 32.4%, when adjusting for race, ethnicity, and sex. Non-Hispanic white females had the lowest increase in death rate at 12.1%. All age groups 15 and above experienced a 15-21% increase in death rates.

What’s killing us?

Unsurprisingly, COVID. A brand-new killer virus, it claimed the third spot for leading causes of death in the United States. The remaining nine spots stayed relatively consistent, with heart disease and cancer leading the pack. While none of the leading causes other than COVID had a drastically increased rate, it’s worth considering how COVID exacerbates the risk of mortality from other causes.

A study published earlier last month found that contracting COVID increased the risk of various cardiovascular diseases, even increasing the rate of major adverse cardiovascular events such as strokes and heart attacks. This means that individuals who get COVID are at greater risk for cardiovascular-caused mortality, even if they were never hospitalized for it — especially those with long COVID

COVID outcomes have been linked to gaps in health insurance coverage, racial bias, and other factors affected by an individual’s social determinants of health. In fact, research suggests that a person’s health is primarily determined by these social factors. Investing in community projects that target hunger and nutrition, homelessness, and infectious disease provides a myriad of long-lasting health benefits that may even reduce the risk of multiple leading causes of death. Yet our social care spending is lower than most other wealthy countries.

We pay the most money into a healthcare system that is giving us some of the worst results. One of the best ways to measure the success of a society is life expectancy, and ours took a major hit during the pandemic while other nations seemed able to cushion the blow. We must truly consider whether we are making the right investments in our society and healthcare system — this most recent data suggests we are not.