The COVID-19 pandemic, which claimed more than 336,000 lives in the United States in 2020, has significantly affected life expectancy, USC and Princeton researchers have found.
The researchers project that, due to the pandemic deaths last year, life expectancy at birth for Americans will shorten by 1.13 years to 77.48 years, according to their study published Thursday in the Proceedings of the National Academy of Sciences.
That is the largest single-year decline in life expectancy in at least 40 years and is the lowest life expectancy estimated since 2003.
The declines in life expectancy are likely even starker among minority populations. For Blacks, the researchers project their life expectancy would shorten by 2.10 years to 72.78 years, and for Latinos, by 3.05 years to 78.77 years.
Whites are also impacted, but their projected decline is much smaller -- 0.68 years -- to a life expectancy of 77.84 years.
Overall, the gap in life expectancy between Blacks and whites is projected to widen by 40%, from 3.6 to more than 5 years -- further evidence of the disease's disparate impact on disadvantaged populations.
"Our study analyzes the effect of this exceptional number of deaths on life expectancy for the entire nation, as well as the consequences for marginalized groups," said study author Theresa Andrasfay, a postdoctoral fellow at the USC Leonard Davis School of Gerontology. "The COVID-19 pandemic's disproportionate effect on the life expectancy of Black and Latino Americans likely has to do with their greater exposure through their workplace or extended family contacts, in addition to receiving poorer health care, leading to more infections and worse outcomes."
COVID-19 appears to have eliminated many of the gains made in closing the Black-white life expectancy gap since 2006. Latinos, who have consistently experienced lower mortality than whites -- a phenomenon known as the "Latino paradox" -- would see their more than three-year survival advantage over whites reduced to less than one year.
"The huge decline in life expectancy for Latinos is especially shocking given that Latinos have lower rates than the white and Black populations of most chronic conditions that are risk factors for COVID-19," said study co-author Noreen Goldman, the Hughes-Rogers Professor of Demography and Public Affairs at the Princeton School of Public and International Affairs. "The generally good health of Latinos prior to the pandemic, which should have protected them from COVID-19, has laid bare the risks associated with social and economic disadvantage."
The study's authors estimated life expectancy at birth and at age 65 for 2020 for the total U.S. population and by race and ethnicity. They used four scenarios of deaths -- one in which the COVID-19 pandemic had not occurred and three others that include COVID-19 mortality projections by the Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington.
"The bigger reductions in life expectancy for the Black and Latino populations result in part from a disproportionate number of deaths at younger ages for these groups," Goldman said. "These findings underscore the need for protective behaviors and programs to reduce potential viral exposure among younger individuals who may not perceive themselves to be at high risk."
Life expectancy as an indicator of population health
Of the analyzed deaths for which race and ethnicity have been reported to the National Center for Health Statistics, 21% were Black and 22% Latino. Black and Latino Americans have experienced a disproportionate burden of coronavirus infections and deaths, reflecting persistent structural inequalities that heighten risk of exposure to and death from COVID-19.
The researchers say life expectancy is an important indicator of a population's health and an informative tool for examining the impact of COVID-19 on survival.
In the decades before the COVID-19 pandemic, annual improvements in U.S. life expectancy had been small but overall life expectancy had rarely declined. An exception was the annual reduction of 0.1 year for three consecutive years -- 2015, 2016, and 2017 -- which were attributed in part to increases in so-called "deaths of despair" among middle-aged whites related to drug overdoses, including opioids, as well as alcohol-related liver disease and suicide.
The projected pandemic-related drop in life expectancy is about 10 times as large as the declines seen in recent years.
The last major pandemic to significantly reduce life expectancy in a short period of time was the 1918 influenza pandemic, which research indicates reduced life expectancy by an extraordinary 7-12 years.
As of Wednesday, more than 10 million Americans had received their first COVID-19 vaccination dose, according to the U.S. Centers for Disease Control and Prevention. But the vaccines may not be enough to immediately reverse the impact of the disease on U.S. life expectancy.
"While the arrival of effective vaccines is hopeful, the U.S. is currently experiencing more daily COVID-19 deaths than at any other point in the pandemic," Andrasfay said. "Because of that, and because we expect there will be long-term health and economic effects that may result in worse mortality for many years to come, we expect there will be lingering effects on life expectancy in 2021."
"That said," she added, "no cohort may ever experience a reduction in life expectancy of the magnitude attributed to COVID-19 in 2020."
The study authors say they are now studying occupational exposures to COVID-19 by race and ethnicity to further comprehend its disproportionate impact.
The research was supported by the National Institute on Aging (grant number T32AG000037).
Story Source:
Materials provided by University of Southern California. Note: Content may be edited for style and length.
Journal Reference:
Theresa Andrasfay, Noreen Goldman. Reductions in 2020 US life expectancy due to COVID-19 and the disproportionate impact on the Black and Latino populations. Proceedings of the National Academy of Sciences, 2021; 118 (5): e2014746118 DOI: 10.1073/pnas.2014746118
注意：以下中文翻譯來自Google的自動翻譯，未做人工校對，僅供閱讀參考。
USC和普林斯頓大學的研究人員發現，COVID-19大流行在2020年奪走了336,000多人的生命，並嚴重影響了預期壽命。
研究人員預測，根據去年的大流行死亡病例，根據他們在《美國國家科學院院刊》上發表的研究，美國人的預期壽命將縮短1.13歲，至77.48歲。
這是至少40年以來預期壽命的最大單年下降，也是自2003年以來估計的最低預期壽命。
預期壽命的下降甚至可能在少數族裔中更為明顯。研究人員預測，對於黑人來說，他們的預期壽命將縮短2.10年，至72.78歲；對於拉丁美洲人，其預期壽命將縮短3.05年，至78.77歲。
白人也受到影響，但預計的下降幅度要小得多，為0.68歲，平均壽命為77.84歲。
總體而言，黑人和白人之間的預期壽命差距預計將擴大40％，從3.6年延長至5年以上-進一步證明了該疾病對處境不利人群的不同影響。
南加州大學倫納德·戴維斯分校老年學博士後研究員特蕾莎·安德拉斯法（Theresa Andrasfay）說：「我們的研究分析了這一異常死亡人數對整個國家預期壽命的影響以及對邊緣化群體的影響。」 「 COVID-19大流行對黑人和拉美裔美國人的預期壽命造成了不成比例的影響，這可能與他們在工作場所或擴大家庭接觸中的暴露程度增加有關，除了獲得較差的醫療保健，導致更多的感染和更糟糕的結果。」
自2006年以來，COVID-19似乎消除了許多在彌合黑人預期壽命差距方面取得的成就。拉丁美洲人的死亡率一直低於白人，這種現象被稱為「拉丁美洲悖論」，他們會看到與白人相比，超過三年的生存優勢減少到不到一年。
研究合著者休斯·羅傑斯（Nugeen Goldman）說：「考慮到拉丁美洲人在大多數慢性病中作為COVID-19的危險因素，其比率要低於白人和黑人，因此拉丁美洲人的預期壽命大幅下降尤其令人震驚。」普林斯頓公共與國際事務學院的人口與公共事務教授。「大流行前拉丁美洲人的總體健康狀況本應使他們免受COVID-19的侵擾，但暴露了與社會和經濟劣勢相關的風險。」
該研究的作者估計了美國總人口，種族和民族在2020年出生時和65歲時的預期壽命。他們使用了四種死亡場景-一種未發生COVID-19大流行，另一種則包括華盛頓大學獨立的全球衛生研究中心健康度量與評估研究所的COVID-19死亡率預測。
戈德曼說：「黑人和拉丁裔人口的預期壽命減少得更多，部分原因是這些群體年輕時的死亡人數不成比例。」 「這些發現強調了採取保護性行為和計劃的必要性，以減少可能沒有意識到自己處於高風險中的年輕人的潛在病毒暴露。」
預期壽命是人口健康的指標
向國家衛生統計中心報告的種族和種族死亡分析中，黑人佔21％，拉丁裔佔22％。黑人和拉美裔人經歷了冠狀病毒感染和死亡的不成比例的負擔，反映出持續存在的結構不平等，加劇了暴露於COVID-19並從中死亡的風險。
研究人員說，預期壽命是人口健康的重要指標，也是檢查COVID-19對生存影響的信息工具。
在COVID-19大流行之前的幾十年中，美國的預期壽命每年的改善很小，但總體預期壽命卻很少下降。一個例外是連續三年（2015年，2016年和2017年）每年減少0.1年，這部分歸因於與藥物過量相關的中年白人中所謂的「絕望死亡」增加，其中包括阿片類藥物，以及與酒精有關的肝病和自殺。
與流行病相關的預期壽命預期下降，是近幾年來下降幅度的約10倍。
最後一次在短時間內顯著降低壽命的重大流行病是1918年的流感大流行，該研究表明，預期壽命降低了7至12年的超常壽命。
根據美國疾病控制和預防中心的數據，截至周三，已有超過1000萬美國人接受了首次COVID-19疫苗接種。但是疫苗可能不足以立即逆轉該疾病對美國預期壽命的影響。
安德拉斯法說：「儘管有效疫苗的到來是有希望的，但美國目前每天的COVID-19死亡人數比大流行的任何其他地方都要多。」 「因此，由於我們預計將對健康和經濟產生長期影響，可能會導致今後許多年死亡率下降，因此，我們預計對2021年的預期壽命會有長久影響。」
她說：「也就是說，任何人都不可能經歷到預期壽命降低到2020年歸因於COVID-19的程度。」
這項研究的作者說，他們現在正在按種族和種族來研究職業接觸COVID-19的情況，以進一步了解其不成比例的影響。
這項研究得到了美國國家老齡研究所的支持（批准號T32AG000037）。