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U.S. life expectancy at birth drops to 77 years for 2020


All 50 states and D.C. post decrease, while women expected to outlive men overall.

U.S. life expectancy at birth drops to 77 years for 2020

The COVID-19 pandemic and drug overdose deaths pushed down life expectancy in the United States in 2020.

Compared to the year before, Americans’ life expectancy at birth dropped to 77 years, with the age 74.2 years for men and 79.9 years for women, according to the latest National Vital Statistics Report from the National Vital Statistics System (NVSS) within the U.S. Department of Health and Human Services.

“Overall, life expectancy in the United States declined by 1.8 years from 2019 to 2020, mostly due to the COVID-19 pandemic and increases in unintentional injuries (mainly drug overdose deaths),” the report said.

Among the 50 states and Washington D.C., Hawaii was at the top with an average life expectancy at birth of 80.7 years. Women had life expectancy of 83.8 years and men had life expectancy of 77.6 years.

At the bottom was Mississippi, with an average life expectancy at birth of 71.9 years. It was 68.6 years for men and 75.2 years for women, according to the NVSS figures.

States in the South generally had the lowest life expectancy, although that group included D.C., Indiana, Missouri, New Mexico, Ohio, and Oklahoma. Those with the longest expected lives generally were in the West – California, Hawaii, Idaho, Oregon, and Washington – and the Northeast – Connecticut, Massachusetts, New Hampshire, Rhode Island, and Vermont.

On the decline

The decline in average life expectancy from birth was not the same for every state. New York posted the greatest decrease, dropping three years from 80.7 in 2019 to 77.7 in 2020. Hawaii had the smallest drop, from 80.9 in 2019 to 80.7 in 2020.

Oregon, Washington, Maine, and New Hampshire all had decreases less than a year, while 13 states had decreases of two years or more: South Carolina, Michigan, Kentucky, Indiana, Alabama, Texas, Illinois, New Mexico, Mississippi, Arizona, New Jersey, Louisiana, and D.C.

Ages of the sexes

Women had longer life expectancy in every state and D.C.

“The difference in life expectancy between the sexes in the United States was 5.7 years in 2020, ranging from a high of 7.0 years in D.C. to a low of 3.9 years in Utah,” the report said. “With a few exceptions, the states with the largest differences by sex are those with lower life expectancy at birth, while the smallest sex differences are found mostly among states with higher life expectancy.”

Worldly perspective

Hawaii and Mississippi, which NVSS ranked as the top and bottom states, respectively, matched those in a Commonwealth Fund report, “Americans, No Matter the State They Live In, Die Younger Than People in Many Other Countries,” published earlier this month. It compared life expectancy among the 50 states, D.C. and other developed nations that are part of the Organisation for Economic Co-operation and Development.

The Commonwealth Fund report called for a strong commitment to community-based primary care, universal insurance coverage, fewer administrative burdens, and well-resourced social services to support patients. Its report and the NVSS figures did not match exactly for ranks, but generally graded states similarly for longer and shorter life expectancy.

What comes next?

The report did not speculate whether life expectancy figures might change for the worse for 2021, in which the COVID-19 pandemic and the opioid crisis continued.

The National Center for Health Statistics has estimated drug overdose deaths jumped to an estimated record 107,622 in 2021, up almost 15% from 93,655 deaths estimated in 2020. A JAMA Internal Medicine study published in July found COVID-19 was the third-leading cause of death in the United States, behind heart disease and cancer, from March 2020 to October 2021.

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Michael J. Barry, MD