Approximately 525,000 more deaths occurred in the United States in 2023 than would have been expected based on pre-2010 mortality trends. The large number of excess deaths can be attributed to many different diseases and conditions. Cardiovascular disease continues to top the causes of mortality, along with cancer. But medical errors, overdose fatalities, gun deaths, infant mortality and other causes all contribute to the troublesome trend. U.S. life expectancy has been largely stagnant for 15 years.
The Centers for Disease Control and Prevention report on mortality in the U.S. shows that life expectancy at birth rose from 77.5 in 2022 to 78.4 in 2023. While the bump between 2022 and 2023 is good news and signals a continued bounce-back from significant declines in 2020 and 2021 owing to the COVID-19 pandemic, the figure is still below the 2010 level. And preliminary data suggest that compared to 2023 the improvement in life expectancy in 2024 could be much smaller, as the rebound appears to be losing steam.
Over the next 25 years, life expectancy in the U.S. is projected to rise by approximately two years—far less than in other wealthy, industrialized nations, according to a study published in The Lancet and carried out by the Institute for Health Metrics and Evaluation. Specifically, U.S. life expectancy is forecast to increase from its 2023 level to 80·4 years in 2050. This modest gain will see the U.S. fall from 49th to 66th globally in life expectancy rankings.
Life expectancy is an estimate of the average number of years a baby born in a given year might expect to live, given death rates at that time. It’s considered a fundamental measure of a population’s health.
A newly released report by the Bloomberg American Health Initiative highlights some of the reasons why the sharp divergence between U.S. life expectancy and its peers will likely persist, including the relatively elevated incidence and prevalence of cardiovascular disease, obesity and diabetes, as well as high levels of drug overdoses, gun deaths, motor vehicle fatalities and infant and maternal mortality. These help to explain, for example, the 2.7-year gap in life expectancy between the U.S. and the United Kingdom.
Other rich countries such as Japan, Korea, Portugal, the U.K. and Italy all currently enjoy a life expectancy of 80 years or more. And since 1980 the gap between the U.S. and its peers has widened substantially.
A Journal of the American Medical Association study analyzing 170 health indicators for U.S. children from 2007–2023 paints an especially sobering picture for the nation’s youth, as infant mortality is 1.8 times higher than other wealthy nations; firearms are a top cause of death; obesity, anxiety and depression are rising relative to peers.
What has alarmed policymakers for decades is that the U.S. experiences comparatively subpar life expectancy despite spending considerably more on healthcare. In fact, the U.S. spends much more in absolute and per capita terms on healthcare than any other nation.
Health and Human Services Secretary Robert F. Kennedy Jr. has spoken of a “life expectancy crisis.” He points to chronic diseases as the main underlying problem. Specifically, he cites rising rates of obesity, diabetes and cancer, as well as autoimmune diseases, neurodevelopmental disorders, Alzheimer’s, asthma and addiction.
Kennedy blames poor diets and environmental toxins for the increase in chronic disease rates. It follows that he’s focused on chronic disease prevention, with a special emphasis on nutrition and removing certain ingredients and additives from food and beverages. Diet has invariably been integral to the Make America Healthy Again movement that Kennedy began.
MAHA is taking aim at artificial dyes, pesticides, and additives, while trying to shift American eating habits away from ultra-processed foods. Kennedy is planning a public awareness campaign on the links between ultra-processed food and diabetes.
While Kennedy’s ideas to improve nutrition have some backing in the public health community, they could clash with the vested interests of the food industry as well as other Trump administration policies.
Kennedy and his allies say Europe’s food regulations help explain its lower rates of chronic disease, but experts suggest they may be overlooking European policies with possibly more impact, such as universal access to healthcare, a lower poverty rate and less exposure to air pollution. Additionally, Kennedy may be ignoring certain areas which could ameliorate the stagnant life expectancy trend, such as policies targeting gun violence, infant and maternal mortality, motor vehicle fatalities and medical errors.
Equally important are courses of action that would tackle “diseases of despair,” such as suicide, alcoholism and illicit drug use. Kennedy says he’s determined to “prevent addiction,” but steep budget cuts passed by Congress may undermine his efforts at curbing substance abuse disorders.
Public health in America faces enormous challenges, not least of which are shrinking budgets at the federal and state levels. Experts across the political divide agree that addressing stagnant life expectancy requires sustained government funding of a wide range of initiatives that affect public health.
