US life expectancy continued to decline in the second year of the COVID-19 pandemic

Emma Arceneaux

A provisional report from the US Centers for Disease Control and Prevention (CDC) estimates that life expectancy dropped for the second year in a row, falling by 0.9 years in 2021. In 2020, the decline was 1.8 years, making the two-year total 2.7 years. The COVID-19 pandemic has reduced US life expectancy at birth to 76.1 years, the lowest level since 1996 and the largest two-year reduction since 1923. Such is the result of “learning to live” with COVID-19.

The report is a damning indictment of the homicidal response to the pandemic that has characterized the Trump and Biden administrations. Biden—who was elected in large part because of popular revulsion at Trump’s callous and anti-scientific response to COVID-19 and who was armed with effective vaccines from the beginning of his term—stands thoroughly exposed. He is a ruthless representative of the ruling class in its war against the working class. If the profit interests of corporate America and the financial markets require the subordination of all considerations of protecting human life from a deadly virus, Biden is more than willing.

John McClung sits in a break room where his wife, Jennifer, is remembered on a bulletin board on the floor where she worked as a nurse at Helen Keller Hospital in Sheffield, Alabama, on March 7, 2022. [AP Photo/David Goldman] [AP Photo/David Goldman]

Had the pandemic been brought to an end as Biden promised and had even basic mitigation measures been enacted and maintained, life expectancy in 2021 should have begun to recover from its devastating decline in 2020. 

However, in 2021, when Biden had at his disposal not only life-saving vaccines but also a Democratic majority in both houses of Congress, as well as the support of much of the population who elected him on the promise of “following the science,” 460,000 people needlessly died, a 20 percent increase from 2020. In 2022, 220,000 people have died so far, bringing the cumulative official death toll in the United States to 1.07 million.

The report was published against the backdrop of the Democratic administration’s systematic dismantling of all remaining mitigation measures, including the ending of free COVID-19 testing, as part of its “forever COVID” policy.  This agenda has been critically aided by the CDC itself, most recently with its latest COVID-19 guidelines, which removed quarantine, testing and contact tracing recommendations in most settings, creating the conditions for widespread transmission as tens of millions of children across the US return to schools with virtually no mitigations in place.

COVID-19 was the single greatest contributor to the decrease in life expectancy, accounting for 50 percent of the untimely deaths. The second greatest contributor was “unintentional injuries” at 15.9 percent, about half of which was attributable to overdose deaths, according to Robert Anderson, the chief of the mortality statistics branch of the National Center for Health Statistics, speaking to STAT news. Heart disease (4.1 percent), chronic liver disease and cirrhosis (3.0) and suicide (2.1) were other contributing factors. As a reflection of the deepening social immiseration of the population, overdose deaths rose dramatically in both 2020 and 2021, by 30 and 15 percent respectively, with a record 108,000 people dying in 2021.

Horrific in and of itself, the decline by 0.9 years was actually moderated by a decrease in deaths attributed to a number of other causes, most significantly “influenza and pneumonia” and other “chronic lower respiratory diseases,” which declined by 38.5 and 28.8 percent, respectively. These decreases are largely the result of the limited public health measures that were in place in 2021, including what remained of mask mandates, social distancing measures and remote learning options. As these measures are universally abandoned, respiratory viruses such as influenza will be able to more freely circulate, and deaths in these categories could very well climb again, leading to what some are calling a “double-whammy” of flu and COVID-19.

It is revealing that the report is presented entirely in race and gender terms, with no analysis of the impact of socio-economic factors. The most precipitous drop by racial group occurred among non-Hispanic American Indians or Alaskan Natives, whose life expectancy fell 1.9 years in 2021. Since 2019, life expectancy for this demographic fell by a catastrophic 6.6 years, from 71.8 to 65.2. In this group, COVID-19 and unintentional injury each accounted for roughly 21.4 percent of contributing causes, while “residual” causes [other factors] accounted for the largest portion, at 29.9 percent.

The omission of socio-economic factors is all the more glaring given that for the population as a whole, one-quarter of the decline in life expectancy was attributed to such “residual” causes without any explanation. One can assume, given the impact on the job markets, loss of wages, and intensification of the class struggle, that poverty and such social factors weighed heavily in the residual column.

Refuting the narrative pushed by the petty-bourgeois purveyors of identity politics, for 2021, the second greatest decrease in life expectancy by racial group was the 1.0 year lost by the non-Hispanic white population. Indeed, a number of important reports that have examined the relationship between socio-economic status and COVID-19 mortality demonstrate clearly that the pandemic is fundamentally a class issue affecting workers of all racial backgrounds.

A pre-print epidemiological study released in April by researchers in California reviewed US COVID-19 mortality data from 2020 by industry and occupation. They found that essential workers died at nearly twice the rate (1.96 times) of non-essential workers, with the highest death rates among workers in accommodation and food services; transportation and warehousing; agriculture, forestry, fishing and hunting; mining; and construction.

Another study published in the Journal of Environmental Research and Public Health by researchers in Florida analyzed the deaths of 70,000 working age adults (25 to 64) from COVID-19 in the US in 2020. They found that 68 percent of deaths occurred among those defined as having a “low socioeconomic position (SEP),” namely those employed in labor, service and retail jobs. Further, the death rate among the low-SEP population was five times higher than among the high SEP population.

Finally, a study published in the Journal of the American Medical Association in July examined specifically the relationship between life expectancy and income over the course of the pandemic among residents of California. Already before the pandemic, in 2019, there was an 11.52-year gap in life expectancy between the highest and lowest income percentiles. This gap widened dramatically during the pandemic, to roughly 15.51 years in 2021.

The decrease in life expectancy is part of an international trend, with global life expectancy estimated to have dropped by 1.64 years since the beginning of the pandemic, the first decline since the United Nations began tracking this figure in 1950. Almost universally, capitalist governments throughout the world have pursued the “herd immunity” strategy of mass infection. Those that initially adopted a “mitigationist” approach based on minimal and inadequate measures to slow transmission, including the Biden administration, abandoned even the pretense of infection control during the Omicron surge last winter. 

However, countries in the Asia-Pacific region which sought to eliminate the virus, including China, experienced a growth in life expectancy during 2020 and 2021. These “positive experiences” underscore the immediate benefit of an elimination-eradication strategy, which only the International Committee of the Fourth International has continued to demand.

Even before the pandemic, advances in global life expectancy began to slow as a result of the decades-long social counter-revolution following the dissolution of the USSR in 1991, which saw the vast eruption of American imperialist war abroad and class war at home. The COVID-19 pandemic, which the World Socialist Web Site has analyzed as a trigger event, rapidly exacerbated the underlying contradictions of the world capitalist system and has led to a social and political crisis of historic proportions. This crisis is expressed not only in the pandemic but also in deepening attacks on democratic rights, the reckless war provocations against Russia and China, and finally the upsurge of the class struggle in the US and globally.

As Robert Hummer of the University of North Carolina commented to the Associated Press, life expectancy is “the most fundamental indicator of population health in this country.” That the wealthiest country in the world, which saw the enrichment of its billionaires by over $2 trillion during the pandemic, has been incapable of providing the resources to protect the population from preventable disease and death, proves that this rotting social economic system has reached the end of its rope.

The grave implications of the ruling class’ demand that the population be forced to accept perpetual mass infection and death cannot be overstated. What has taken place is the start of a catastrophic reversal of nearly 80 years of progress in public health, not just in the United States but internationally.