The latest Centers for Disease Control and Prevention report on mortality in the United States shows that life expectancy at birth rose from 77.5 in 2022 to 78.4 in 2023. While this 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 the improvement in life expectancy in 2024 will 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 comparatively elevated incidence and prevalence of cardiovascular disease, obesity, and diabetes, as well as high levels of drug overdoses, gun violence, 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 as the figure below shows, since 1980 the gap between the U.S. and its peers has widened substantially.
Moreover, U.S. life expectancy lags far behind comparable, wealthy nations 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. Yet its mortality and morbidity outcomes are relatively mediocre.
Also, what stands out is the gross inequality that exists across America with regard to inequality. The figure below illuminates the differences in sharp relief.
Narrowing the focus to women, researchers project that female life expectancy in West Virginia in 2050 will be below the 1990 level and that there will be little change in the states Arkansas, Oklahoma, South Dakota and Utah. While other states are estimated to fare better in varying degrees, persistent inequality constitutes a major challenge.
Public health in America faces enormous challenges, not least of which are shrinking budgets at the federal and state levels. And the problems aren’t just related to what the healthcare system can deliver directly. There are issues with people’s dietary regimens, general lack of exercise, and “diseases of despair,” such as suicide, alcoholism, and illicit drug use, that account for a proportionately large socioeconomic component.
Whether the controversial nominee for Secretary of the Department of Health and Human Services, Robert F. Kennedy Jr., can make Americans healthy again remains to be seen. While Kennedy’s ideas to improve nutrition have backing in the public health community, they could clash with the vested interests of the food industry. Moreover, other initiatives Kennedy may undertake could undermine key pillars of public health in America, making it difficult to achieve the goal of closing the life expectancy gap between the U.S. and its peers.
