Illustrated below is the evolution of life expectancy at birth for seven Organization for Economic Co-operation and Development (OECD) countries: Canada, Hungary, Japan, Latvia, Poland, the United Kingdom, and the United States. Across the seven countries, male life expectancy at birth ranged from 64.8 years to 68.2 years in 1960, and 69.8 years to 81.1 years in 2017, demonstrating an increase in the inequality of life expectancy of almost eight years between these countries over the period. For females, the increase was approximately four years. The inequality in life expectancy is more apparent and unsettling if we consider, for example, developing countries in Africa, averaging a life expectancy of around 63 years in 2019.
Altogether, I believe greater democratization of longevity is achievable with the adoption of health technologies, while ensuring they are accessible and affordable. I am hopeful but I see several challenges ahead. Such a reality will be reliant on governments, health care professionals, and patients’ acceptance and reliance on what the future of health holds. It will also require global partnerships to build out ecosystems that will facilitate inclusive innovation.
So, period life expectancy dropped about 12 – 13% in 1918 in the U.S., mainly due to the Spanish flu, because there was an outsized effect from young adults being the main group killed by the disease (also, period life expectancy was relatively short — under 60 years!). That was a drop of about 7 years.
But life expectancy dropped only about 1 year in 2020 due to COVID impacts, and that was a decrease of less than 3% compared to 2019.
So if you want to compare the effect of the Spanish flu vs. COVID-19 on the U.S. population, all of these rates —- percentage change in period life expectancy, age-adjusted death rates, or even crude death rate — are all more reasonable choices than simply number of people who died.
Developments in life expectancy and the growing emphasis on biological and ‘healthy’ aging raise a number of important questions for health scientists and economists alike. Is it preferable to make lives healthier by compressing morbidity, or longer by extending life? What are the gains from targeting aging itself compared to efforts to eradicate specific diseases? Here we analyze existing data to evaluate the economic value of increases in life expectancy, improvements in health and treatments that target aging. We show that a compression of morbidity that improves health is more valuable than further increases in life expectancy, and that targeting aging offers potentially larger economic gains than eradicating individual diseases. We show that a slowdown in aging that increases life expectancy by 1 year is worth US$38 trillion, and by 10 years, US$367 trillion. Ultimately, the more progress that is made in improving how we age, the greater the value of further improvements.
Author(s): Andrew J. Scott, Martin Ellison, David A. Sinclair
The Spanish flu pandemic gives us the demonstration of what happens when there is a short-term large increase in mortality.
Using Social Security records of period life expectancy, there was a huge drop in life expectancy in 1918…. and then a huge increase in 1919. But going from 1917 to 1919 wasn’t really that big of a difference.
The period life expectancy drop was 12% for females, 13% for males in 1918.
Then there was an increase of 15% for females, 20% for males in 1919. The Spanish flu hit the U.S. hard in 1918, and let up in 1919.
If you compare 1919 against 1917, the life expectancy from birth increase was 1% for females, and 4% increase for males — male life expectancy was down in 1917 compared to 1916, probably related to World War I.
Now, because the pandemic produced higher death rates in 2020 compared to prior years, a period life expectancy calculated for 2020 produced lower life expectancies compared to period life expectancies calculated for prior years. That’s because it’s assumed that the elevated death rates we experienced in 2020 would apply to all future years. But if the death rates decline in 2021, then any period life expectancies calculated for 2021 would most likely be higher. And that’s certainly the hope, given that a large portion of the population has received a vaccine, which is already resulting in a dramatic decline in new infections and hospitalizations.
If you’ve survived the pandemic with your health relatively intact and if you’ve also received the vaccine, then it’s highly likely the virus won’t shorten your lifespan. Of course, new deadly variants or future deadly viruses could change that conclusion, but for now, the outlook is positive.
“Cohort life expectancies” on the other hand, are calculated for a group of people reflecting their characteristics and the experience they might expect over their lifetimes. These life expectancies are calculated in the same way as period life expectancies, except that the death rates used to estimate someone’s remaining future years are modified to reflect anticipated future changes in death rates. If you want to estimate your own remaining lifespan, a cohort life expectancy is often most appropriate.
Life expectancy in the United States between 2018 and 2020 decreased by 1.87 years (to 76.87 years), which is 8.5 times the average decrease in other high-income nations. What’s more, decreases in life expectancy among Hispanic and non-Hispanic Black people were about two to three times greater than in the non-Hispanic White population, reversing years of progress in reducing racial and ethnic disparities. The life expectancy of Black men (67.73 years) is the lowest since 1998.
Those are key findings of a study conducted by researchers at the Virginia Commonwealth University School of Medicine, the University of Colorado Population Center and the Urban Institute in Washington, D.C., and published in The BMJ — a peer-reviewed medical trade journal of the British Medical Association.
Results Between 2010 and 2018, the gap in life expectancy between the US and the peer country average increased from 1.88 years (78.66 v 80.54 years, respectively) to 3.05 years (78.74 v 81.78 years). Between 2018 and 2020, life expectancy in the US decreased by 1.87 years (to 76.87 years), 8.5 times the average decrease in peer countries (0.22 years), widening the gap to 4.69 years. Life expectancy in the US decreased disproportionately among racial and ethnic minority groups between 2018 and 2020, declining by 3.88, 3.25, and 1.36 years in Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. In Hispanic and non-Hispanic Black populations, reductions in life expectancy were 18 and 15 times the average in peer countries, respectively. Progress since 2010 in reducing the gap in life expectancy in the US between Black and White people was erased in 2018-20; life expectancy in Black men reached its lowest level since 1998 (67.73 years), and the longstanding Hispanic life expectancy advantage almost disappeared.
Conclusions The US had a much larger decrease in life expectancy between 2018 and 2020 than other high income nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. A longstanding and widening US health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism.
Indeed, new research published Wednesday in the BMJ shows just how wide that gap has grown. Life expectancy across the country plummeted by nearly two years from 2018 to 2020, the largest decline since 1943, when American troops were dying in World War II, according to the study. But while white Americans lost 1.36 years, Black Americans lost 3.25 years and Hispanic Americans lost 3.88 years. Given that life expectancy typically varies only by a month or two from year to year, losses of this magnitude are “pretty catastrophic,” said Dr. Steven Woolf, a professor at Virginia Commonwealth University and lead author of the study.
Over the two years included in the study, the average loss of life expectancy in the U.S. was nearly nine times greater than the average in 16 other developed nations, whose residents can now expect to live 4.7 years longer than Americans. Compared with their peers in other countries, Americans died not only in greater numbers but at younger ages during this period.
The U.S. mortality rate spiked by nearly 23% in 2020, when there were roughly 522,000 more deaths than normally would be expected. Not all of these deaths were directly attributable to covid-19. Fatal heart attacks and strokes both increased in 2020, at least partly fueled by delayed treatment or lack of access to medical care, Woolf said. More than 40% of Americans put off treatment during the early months of the pandemic, when hospitals were stretched thin and going into a medical facility seemed risky. Without prompt medical attention, heart attacks can cause congestive heart failure; delaying treatment of strokes raises the risk of long-term disability.
Leading causes of death among Blacks differ by sex. Among Black males, homicide and accidents (such as drug overdoses and motor vehicle accidents) combined make up almost as many deaths as deaths due to cancer. Stroke and kidney disease cause higher proportion of deaths among Black females compared to males and non-Blacks.
Populist politicians are destroying Chile’s revolutionary pension system. In 1981 Chile became the first country to privatize social security, ending the pay-as-you-go system that had been in place since 1924 and had collapsed. Now Chile’s left wants to resurrect it.
The state-run pension system was plagued by corruption and rent-seeking since its earliest days. Among the 11,395 laws passed by the Chilean Congress between 1926 and 1963, 10,532 granted pension privileges to special-interest groups, many of them politically connected. In 1968, Chilean President Eduardo Frei, a center-left Christian Democrat, described the cronyism that plagued social security as an “absurd monstrosity” that the government couldn’t afford.
Pension privatization reversed this perverse dynamic. Instead of taxing active workers to pay pensioners through the bureaucracy, the new system, created by former Labor Minister Jose Pinera, established that 10% of the employee’s salary is transferred automatically to an account under his name at one of the Administradoras de Fondos de Pensiones, or AFP. These private pension funds compete to attract workers and invest their pensions for a fee.
This has restored the link between contributions and pension benefits by making workers responsible for saving the funds that will support them once they retire. This novel system also limited corruption and rent-seeking, and Chilean taxpayers are no longer on the hook for pension deficits, which in 1981 represented 3% of gross domestic product.
Longer life expectancy is also a problem. When the AFP system was created, men retired at 65 with an average life expectancy around 67. Women retired at the age of 60 with a life expectancy around 74. Today, the retirement ages are unchanged but life expectancy has increased to 77 for men and 83 for women. This means more years of retirement have to be funded by the same years of saving.
AT THE turn of the twentieth century, a newborn white American could expect to live for around 48 years. That was 15 years longer than a newborn African-American could expect. Improvements in hygiene, medicine and other public-health measures led those numbers to rise dramatically. By mid-century, life expectancy for African-Americans had nearly doubled, to 61 years, while for white Americans it rose to 69. By 2017 the gap had narrowed further, to three and a half years: 75.3 for African-Americans, 78.8 for whites. But Hispanic Americans outlive them both, to an average of 81.8 years. In other words, both races have progressed significantly, but gaps remain. This same pattern exists across a number of metrics.
The most disturbing aspect of this pattern is not just the enduring gap in outcomes between black and white Americans, though it has narrowed markedly. It is that, as the work of Anne Case and Angus Deaton, both economists at Princeton, has shown, life expectancy fell for all demographic groups of Americans between 2014 and 2017 for the first time since 1993. The rise in mortality rates has been especially stark for whites without college degrees, owing to what they call “deaths of despair”: drug overdoses, suicide and diseases caused by heavy drinking.