Life Expectancy Trends: SDoH Impose Trauma amid the Pandemic

Drug overdose deaths were another influencer.

Amid last week’s hottest reports was new data from the National Center for Health Statistics. While it was expected that COVID-19 would dramatically impact life expectancy across populations, the data for those persons most vulnerable was alarming.

The first six months of 2020 revealed that life expectancy for the U.S. population had dropped by an average of one year.
 

• Life expectancy at birth was 77.8 years – a decline from 78.8 in 2019.
  • For males, life expectancy at birth was 75.1 – a decline of 1.2 years.
  • For females, life expectancy dropped to 80.5, a 0.9-year decrease.

What do these numbers have to do with the social determinants of health (SDoH)? Enough reports have spoken to the dramatic increase in COVID-related deaths across the most racially and ethnically diverse communities. Recent data aligns with these reports, and poses powerful considerations:

• Non-Hispanic Black males had life expectancy decrease by three years; this was a major shift from the prior years of increased lifespans for this demographic group.
• Hispanic males also had a large decrease in life expectancy, a decline of 2.4 years.
• Non-Hispanic Black females had life expectancy decline by 2.3 years; and
• Hispanic females saw a decline of 1.1 years.
• Life expectancy decline was less pronounced for non-Hispanic whites:
  • White males had a decline 0.8 years;
  • White females had a decline of 0.7 years.

The pandemic was not the only contributing factor to the shift. Massive numbers of people delayed medical treatment or opted to forego care for non-COVID-related illnesses due to fears of virus infection. Drug overdose deaths were another influencer. These deaths have cut a large slice out of all regions of the country, particularly racial and ethnic communities:

• A recent report from the Centers for Disease Control and Prevention (CDC) revealed over 81,000 deaths for drug overdose-related deaths between June 2019 and June 2020.
• This number reflected a 20 percent increase from the prior year, and the highest number of fatal overdoses ever recorded in the United States in a single year. Opioid deaths had fallen in 2018 for the first time in close to a decade, but increased use of fentanyl and other narcotics have led to rapidly rising rates.
• Emergency room overdose visits alone were up by 45 percent.

The population continues to suffer from unemployment, increased food insecurity, and lack of access to health and mental health services, along with pervasive pandemic-related anxiety over an unknown future. Generations to come will be forced to reconcile with the pandemic as yet another contributor of adverse childhood experiences (ACEs), trauma, and decreased life expectancy. More strategic action to fund, reimburse for, and address the SDoH is more than a priority, but a national imperative. 

Our Monitor Mondays Listeners Survey asked: how much life expectancy data of organizations’ target populations factored into operations (e.g., revenue management, workforce flow and staffing, funding streams)? And the results can be viewed here.

The outcome represents real pitfalls and promises for the industry to translate data into action, ensure financial sustainability for health organizations, address new dimensions of trauma, and positively impact life expectancy.

Programming Note: Listen to Ellen Fink-Samnick’s live reporting on the social determinants of health on Monitor Mondays, 10 a.m. Eastern.