Tip/Thought of the Day

Pandemic Leads To Decreased Life Expectancy, Not Solely From Covid-19

It may not come as a surprise that the COVID-19 pandemic has impacted life expectancy throughout the world. But to the shock of many, between 2018 and 2020, the decrease in average life expectancy at birth in the U.S. was roughly 1.9 years- that’s 8.5 times the average decrease in 16 comparable countries, which was about 2.5 months. The decrease widened the gap between the U.S. and its peers to nearly 5 years. And if that wasn’t startling enough, within the U.S. the difference is even larger among Black and Hispanic Americans. Covid-19 illness wasn’t the only factor for the drop in life expectancy during 2020, though. A surge in drug overdoses, as well as a shift away from preventative care as people delayed care for fear of exposure to the virus at doctor’s offices are just two variables that led to what some experts call “A horrific decrease in life expectancy”.

As of early August 2021, the U.S. has lost more than the more than 615,000 people directly from the coronavirus. Beyond deaths directly related to the virus, disruptions in chronic disease management, delay in preventative health care, behavioral health crisis, increase in substance abuse and behavioral health crisis have all played a role in the decline of life expectancy.

Steven Woolf of the Virginia Commonwealth University School of Medicine who is an an author of the study released in June 2021(which is based off of data from the National Center for Health Statistics and includes simulated estimates for 2020), shared that a decrease this significant hasn’t been seen in the U.S. since WWII. More than 3.3 million Americans died last year, well beyond any other year in our history. Covid-19 related deaths accounted for roughly 11% of deaths, according to the CDC.

One source explains that life expectancy, is used as a metric of population health that is typically measured as of birth, is an informative tool for examining the differential impact of COVID-19 on survival as it is unaffected by the age distribution of the underlying populations. In contrast, for example, comparisons of overall (crude) death rates or proportions of deaths by race and ethnicity are biased by the fact that the Black and Latino populations in the US are younger than the white population and, all else being equal, would have fewer deaths. And yet, despite the Black and Latino community having a younger population and the consequent expectation of fewer deaths, the opposite is true in the U.S. We’ll explore that more in next week’s post.

A look at our history

The difference between the drop in U.S. life expectancy compared to that of other wealthy countries is stark. Despite U.S. health spending being up to 4x higher than similar countries, our life expectancy is still lower than in all those countries. While life expectancy for people around the world has increased, life expectancy of Americans has declined steadily since 2014.

Looking back to the Spanish Flu pandemic of 1918, American life expectancy was only 39 years. That pandemic killed over 50 million people worldwide, and roughly 675,000 Americans. After the pandemic ended, the life expectancy rose to 55 years.

Through the 1970s and 80s, life expectancy in the U.S. increased much more slowly than in other countires, but our health spending sharply increased. The chart below reflects the stark differences in spending and life expectancy between countries from 1970 to 2018.

Data from the CDC shows that the life expectancy continues to decrease. “The latest CDC data show that the U.S. life expectancy has declined over the past few years,” said CDC Director Robert Redfield, M.D. “Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide.


It’s not just Covid-19 impacting death rates

By June 30, 2020, because of concerns about COVID-19, an estimated 41% of U.S. adults had delayed or avoided medical care including urgent or emergency care (12%) and routine care (32%). Avoidance of urgent or emergency care was more prevalent among unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities.

Keep in mind that these numbers were from surveys conducted in the early pandemic days, before some of the larger waves of the pandemic ravaged the country. The consequent waves of Covid-19 cases likely led to an even higher amount of people avoiding healthcare they deemed “unnecessary” in an effort to avoid exposure to Covid-19. Now with variants like Delta racing through the country, showing higher transmission rates and proving to be formidable against even the young population, healthcare providers expect that preventative and emergency care unrelated to Covid-19 will further take a backseat due to concerns surrounding the virus.

The early data from 2020 showed that the top 10 leading causes of death in were:

  1. Heart disease
  2. Cancer
  3. Covid-19
  4. Unintentional injury
  5. Stroke
  6. Chronic lower respiratory disease
  7. Alzheimer’s disease
  8. Diabetes
  9. Influenza and pneumonia
  10. Kidney disease

Many of these health issues require regular, continued care to manage. Without preventative care and regular screenings with the guidance of providers, these concerns can quickly become deadly or seriously impact a person’s health in ways that are irreversible.

We are all overwhelmed with issues today. Financial worries have been compounded and fears for our lives and those we love occur daily. Especially as we fend our way through all the data and conflicting information to find what’s accurate and best for us. If we are not healthy we cannot attack these issues head on. That has to be our priority- our health. Staying well by using all appropriate measures- washing hands, facial masks, social distancing are absolutely imperative. But so are evaluations that detect medical issues early. It is heartbreaking to see otherwise healthy individuals suffer because they put off physical exams, routine evaluations, scans and labs that could have signaled a concern. Telemedicine only goes so far. Too often, self diagnosis is the crux of intervention. Virtual interactions don’t always include asking all the right questions, they can’t check for an abnormal blood pressure, irregular heart beats, weight gains or losses, abdominal, pulmonary or neurological findings. Only a hands-on, face to face evaluation can. Schedule yours today.



Sources:

-https://www.pnas.org/content/118/5/e2014746118

-https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020

-https://www.nbcnews.com/health/health-news/coronavirus-surges-non-covid-medical-emergencies-take-back-seat-putting-n1175871

-https://www.aafp.org/news/health-of-the-public/20181210lifeexpectdrop.html

-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523145/

-https://www.healthsystemtracker.org/brief/covid-19-repercussions-may-outweigh-recent-gains-in-u-s-health-system-performance/

-https://www.bmj.com/content/373/bmj.n1343

-https://www.cnn.com/2021/07/21/health/life-expectancy-covid-19-pandemic-cdc-study-wellness/index.html

-https://soba.iamempowered.com/johns-hopkins-report

-https://ourworldindata.org/us-life-expectancy-low

-https://apnews.com/article/science-health-coronavirus-pandemic-fac0863b8c252d21d6f6a22a2e3eab86

-https://www.npr.org/2021/02/18/968791431/american-life-expectancy-dropped-by-a-full-year-in-the-first-half-of-2020

-https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a4.htm

-https://jamanetwork.com/journals/jama/article-abstract/2774465

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