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Life Expectancy In The U.S. Sees Largest Decline In Decades After Covid-19

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BM.GE
25.01.21 18:30
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Covid-19 has left a devastating trail of destruction as over 400,00 Americans have now lost their lives. President Biden recently warned that the U.S faces over 600,00o deaths in the coming months, with the CDC projecting that there will be over 500,000 deaths by mid February. Sobering numbers that make us numb with each passing day.
 
The reality is that some of the darkest months lie ahead, as disappointments and frustrations in the speed and efficiency of the vaccine rollout continue to mount as vaccine shortages have become widespread.
 
With this as a backdrop, new research from USC and Princeton now finds that Covid-19 deaths have reduced life expectancy in the U.S. at birth for Americans by 1.13 years to 77.48 years of age, lower than any year since 2003. (The study also projected a .87 year reduction in life expectancy at age 65.) While this may not seem like a significant decline, think again. This decline represents the greatest single-year drop in life expectancy in at least 40 years.
 
Certainly this is an impressive figure, but declines in life expectancy are likely even more significant among Black and Latinos communities. The study found that for Black people, life expectancy would shorten by 2.1 years and for Latinos by 3 years. Meanwhile, the decline in white life expectancy is projected to be .68 years.
 
For the study, researchers used statistical modeling to estimate the effect of the pandemic deaths among these different populations on their projected life expectancy in 2020, comparing it to the past several decades.
 
Yet, while the results of the study are certainly concerning, they are not unexpected. Based on recent data, it is estimated that Blacks have died at 1.5 times the rate of whites from Covid-19. Additional figures indicate that 1 in 735 Black Americans and 1 in 595 Native Americans has died from Covid-19.
 
What the study does indicate is that life expectancy is a barometer of the health of a population; it also serves as an example of the effects of Covid-19 on the ability of a population to survive and sustain itself.
 
And what it illustrated in clear terms are the disparities in access to healthcare among different racial groups in the U.S. Specifically, 21% of deaths in the study, for which race and ethnicity were reported, occurred among Black people, while 22% of deaths for which race and ethnicity were reported, occurred among Latinos. 
 
These two groups, in particular, have experienced a disproportionate number of Covid-19 cases and deaths. This is ultimately related to their greater workplace exposure, presence of multigenerational housing, along with the effects of their reduced access to healthcare resulting in more infections and deaths.
 
Overall, systemic inequalities in access to healthcare, employment and housing have directly impacted cases and death rates in communities of color. With multigenerational housing, such households are more likely to be overcrowded; and persons in these households often have jobs with closer and more frequent contact to others at risk or infected with Covid-19, less able to work remotely—all factors contributing to increased rates of infection. This is accentuated by the fact that rates of underlying health conditions (hypertension, obesity and diabetes) are significantly elevated in these populations, leading to increased rates of severe Covid-19 infection.
 
In the years leading up to the pandemic, life expectancy in the U.S. had, for the most part, been increasing over the last several decades, related to continued advancements in medical care, vaccinations, low infant mortality, declining smoking rates, along with more effective and widespread cancer screening. That said, there had been slight declines noted in more recent years, specifically linked to the opioid crisis. But such a significant decline that we just witnessed in 2020 has been uncommon to say the very least.
 
 The effect of the decline associated with Covid-19, the study projects, will be nearly ten times the effect seen associated with any recent minor declines over the past several decades.
 
In addition, it’s also important to note that the study did not include the impact of excess mortality or excess deaths (deaths due to delayed or forgone medical care, fear of contracting Covid-19, loss of health insurance) on life expectancy, choosing instead to base their projections and calculations on the mortality conditions that existed in 2017, and balancing the effects of such an underestimate of excess mortality due to harvesting. 
 
Harvesting refers to the disproportionate effects of excess mortality on older, frail individuals who would have otherwise died from non-Covid-19 ailments. (It should also be mentioned that estimates of excess mortality suggest that deaths attributed to Covid-19 account for only two-thirds to three-fourths of all excess deaths in the U.S.)
 
That said, if we continue to vaccinate less than 1 million people a day and are unable to implement rapid testing and universal masking, we may not be able to erase the significant impact of the virus on life expectancy going forward.
 
The reality is that the next few months will be a difficult period, with the expectation that thousands of daily deaths will continue. With the B.1.1.7 strain being more transmissible—and possibly more virulent—and likely becoming dominant throughout the U.S. by March, revisions of the vaccine may be required in the next year to accommodate for this and other emerging strains in South Africa and Brazil .
 
It also is quite clear that COVID-19 will result in economic and health challenges for many years to come, requiring an aggressive and coordinated approach. Scaling up production of vaccines through the Defense Production Act (DPA) is imperative. Delivering vaccines to people by utilizing FEMA to develop vaccination clinics will augment the effort going forward.
 
To be clear, communication between the states and federal government will be crucial in order to make this partnership strong and effective. The Biden administration will make a federally coordinated effort a priority in order to reverse the course and trajectory of the pandemic. This has already included several executive orders including a federal mask mandate, involvement of FEMA in the vaccination delivery efforts, along with the pledge for 100 million people vaccinated in 100 days.
 
Beyond its effects on reducing life expectancy, Covid-19 will also result in long term physical and psychological effects. In fact, a nationwide survey conducted in June of 2020 found that nearly one-third of Black Americans knew someone who had died of COVID-19. 
 
Patients with lingering symptoms for months (and possibly years) after initial infection, or Long Covid, will also pose a challenge for the U.S. healthcare system by creating a group of patients with chronic cardiac and neurologic conditions which will require coordinated long term care. These patients will likely have an impact on life expectancy over the next several decades.
 
Source: Forbes