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San Francisco Chronicle
a day ago
- Health
- San Francisco Chronicle
Life expectancy for Californians still lower than before COVID — here's why
Life expectancy for Californians has yet to rebound to pre-pandemic levels, and is still nearly one year shorter than it was before COVID-19, new research shows. In 2024, life expectancy for Californians was 80.54 years — 0.86 years less than the 81.4 it was in 2019, according to the study, published Wednesday in JAMA. Prior to the start of the pandemic, life expectancy in the state had been rising steadily; it fell sharply in 2020 (to 79.3) and 2021 (to 78.48) before rising again in 2022 (79.56) and 2023 (80.28). But the 2024 data suggest that this progress is flatlining — a sign that COVID continues to have lingering effects on population-level health, despite the fact that it is no longer top of mind for most people. 'The reason why that's important is that the pandemic is still having effects on our health, even though everyone may have mentally moved on and wants to forget about it,' said study co-author Janet Currie, a professor of economics at Yale. 'It's still with us.' The analysis, led by researchers at Yale, Northwestern, UCLA and Virginia Commonwealth University, used preliminary California data for 2024. National life expectancy data for 2024 is not yet available. In California, 2024 marked the first time since the pandemic began that drug overdoses and cardiovascular disease both accounted for a greater share of the life expectancy decline than COVID. Drug overdoses accounted for 20% of the overall life expectancy decline, cardiovascular disease accounted for 16%, and COVID accounted for 13%. That is the largest proportion of decline attributed to cardiovascular disease in several years. The rise in cardiovascular-related deaths, which include deaths from heart attacks and stroke, is 'puzzling,' Currie said. Some of it could be due to people not seeking health care during the early stretches of the pandemic, such as those who avoided the hospital even when they were having a heart attack or stroke, for fear of the virus. It may also be linked to rising obesity rates or long COVID, the latter of which can lead to inflammation and can be associated with higher rates of heart disease. Drug overdoses skyrocketed during the pandemic but declined between 2023 and 2024 — accounting for 36% and 20% of the life expectancy drop, respectively. 'That's a piece of good news,' Currie said. COVID has accounted for less and less of the life expectancy drop over time. In 2021, it accounted for 62% of the deficit. That fell to 36% in 2022, 16% in 2023 and 13% in 2024, the study found. Out of all racial and ethnic groups, Hispanic residents experienced the biggest drop in life expectancy during COVID — more than five years, from 82.55 in 2019 to 77.37 in 2021 — but also rebounded relatively quickly in 2022 and 2023. Asian residents continue to have the highest life expectancy — 85.51 years in 2024, compared to 81.11 for Hispanic residents, 79.94 for white residents and 73.42 for Black residents. Economists study life expectancy because how long people expect to live impacts how much they need to save for retirement. And federal programs like Social Security and Medicare must factor in life expectancy when estimating costs. Life expectancy in the U.S. improved significantly over the 20th century, Currie noted. Those gains happened in spurts thanks to advances like clean water, the development of antibiotics, major innovations in treating heart disease and cancer, and improvements in preventing infant mortality.
Los Angeles Times
5 days ago
- Health
- Los Angeles Times
Life expectancy in California still hasn't rebounded since the pandemic
During the COVID-19 pandemic, the virus caused life expectancy in California to drop significantly. It's now been over two years since officials declared the pandemic-related public health emergency to be over. And yet, life expectancy for Californians has not fully recovered. Today, however, the virus has been replaced by drug overdoses and cardiovascular disease as the main causes driving down average lifespans. A new study published in JAMA by researchers from UCLA, Northwestern, Princeton and Virginia Commonwealth University finds that Californians lived, on average, nearly a year less in 2024 than they did in 2019. The shortfall of 0.86 years signals that only about two-thirds of the state's pandemic-era losses of 2.92 years have been reversed. Using mortality data from the California Comprehensive Death Files and population estimates from the American Community Survey, the researchers calculated annual life expectancy from 2019 to 2024, breaking the figures down by race, ethnicity, income and cause of death. While the COVID-19 virus was the primary factor in life expectancy declines during the pandemic's peak, accounting for 61.6% of the life expectancy gap, its impact has significantly lessened. In 2024, COVID-19 accounted for only 12.8% of the life expectancy gap compared to 2019, while drug overdoses and cardiovascular disease contributed more — 19.8% and 16.3%, respectively. For Black and Hispanic Californians, recovery has been even slower. Life expectancy for Black residents in 2024 remained 1.48 years below 2019 levels, while for Hispanic residents it was 1.44 years lower. In contrast, the gap for white residents was 0.63 years, and for Asian residents, who have the highest life expectancy in the state at 85.51 years, it was 1.06 years. Overall, the life expectancy for Black Californians in 2024 was under 73.5 years, more than a dozen years lower than that of Asian Californians. Janet Currie, a co-author of the study and professor at Princeton University, noted that these disparities are especially striking. 'You saw the very big hit that Hispanic people and Black people took during the pandemic,' she said, 'but you also see that Black people in particular are still not caught up.' She added that while Hispanic populations saw a faster rebound, they too remain behind. Income-based disparities in life expectancy persist in stark form. Californians living in the lowest-income census tracts (the bottom quartile) experienced a 0.99-year gap in 2024 compared to 2019, while those in the highest-income quartile had a slightly smaller 0.85-year gap. However, the overall life expectancy difference between these groups, 5.77 years, was nearly identical to the pre-pandemic gap of 5.63 years, suggesting that income-based health disparities persist even as pandemic impacts recede. The study highlights drug overdoses as a primary post-pandemic driver of reduced life expectancy. Black Californians and residents of low-income areas were especially affected. In 2023, drug overdoses contributed nearly a full year (0.99 years) to the life expectancy deficit for Black Californians and over half a year (0.52) for residents of low-income areas. That said, there are signs that state and national efforts to address the overdose crisis may be yielding early results. The number for Black Californians declined to 0.55 years in 2024 while it declined to 0.26 years for residents in low income areas; in the same time frame, the statewide number dropped from 0.4 years to 0.17 years. Currie attributed the initial surge in overdose deaths in part to the pandemic itself — there were disruptions in access to treatment, and many Californians suffered greater isolation. While she welcomed the recent progress, she cautioned that the share of deaths attributable to overdoses remains high and emphasized that this was 'one of the real bad consequences of the pandemic.' Meanwhile, cardiovascular disease is now the leading contributor to life expectancy loss among high-income Californians. In 2024, it accounted for 0.22 years of the gap for the wealthiest quartile, more than COVID-19 did at 0.10 years. The authors note this is consistent with statewide rising rates of obesity, which may be playing a role. Tyler Evans, chief medical officer and CEO of Wellness Equity Alliance as well as the author of the book 'Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19,' emphasized how the pandemic exacerbated long-standing health inequities. 'These chronic health inequities were further amplified as the result of the pandemic,' he said. While investments in social determinants of health initially helped mitigate some of the worst outcomes, he added, 'the funding dried up,' making recovery harder for communities already at greater risk of poor outcomes. Evans also pointed to a broader pattern of overlapping health crises that he described as a 'syndemic,' a convergence of epidemics like addiction, chronic disease and poor access to care that interact to worsen outcomes for historically marginalized populations. 'Until we invest in that sort of foundation long term, the numbers will continue to decline,' he said. 'California should be a leader in health improvement outcomes in the country, not a state that continues to have our survival decline.' Although the findings are limited to California and based on preliminary 2024 data, the study provides an early glimpse into post-pandemic mortality trends ahead of the Centers for Disease Control and Prevention's national life expectancy dataset, expected to be published later this year. California, home to one-eighth of the U.S. population, provides valuable insight into how racial, ethnic and socioeconomic disparities continue to shape public health. Ultimately, the study highlights how although the most visible impacts of COVID-19 may have faded, their ripple effects, compounded by ongoing structural inequities, continue to shape life and death in California. The pandemic may have accelerated long-standing public health challenges, and post-pandemic recovery, the study makes clear, has been uneven and incomplete. Currie warned that further cuts to Medicaid and public hospitals could make these gaps even worse. 'We know what to do. We just don't do it,' she said.
