Amid the COVID-19 pandemic, countries around the globe saw unprecedented causalities and increased mortality. While many nations have since recovered, new Northwestern University research shows that California has not rebounded to pre-pandemic life expectancy, based on early data obtained from the state.
American life expectancy has been falling behind that of other developed countries since 1990. It plummeted during the COVID-19 pandemic and increased in 2022-2023. Although estimates for 2024 have not been reported for the U.S., data through 2024 are available for California. This study examined how California life expectancy varied by year, income, race and ethnicity, and contributing causes of death.
The study - led by Hannes Schwandt, associate professor of human development and social policy at Northwestern's School of Education and Social Policy, associate director at Feinberg's Buehler Center and fellow at the Institute of Policy Research - was published last week in the journal JAMA Network Open. The researchers found that life expectancy overall in California has decreased sharply since 2019, with a deficit of .86 years remaining in 2024 relative to 2019.
"Usually, we expect a quick rebound after the temporal shocks of an event like a pandemic. Mortality is much lower in the years following, so life expectancy should be higher," Schwandt said. "The fact that four years after the pandemic we still see a deficit compared to 2019 is quite concerning."
In 2021, the life expectancy rate was the lowest of the five-year period that researchers analyzed. COVID accounted for 1.22 years (61.6%) of the deficit relative to 2019. The life expectancy increased slightly in the 2022-2023 year, but it still was a sharp decrease from what it was prepandemic.
Researchers collected death data for 2019-2024 from the California Comprehensive Death Files. The population counts for calculating mortality rates were obtained from the American Community Survey.
Life expectancy - the estimated lifespan of a human based on prevailing age-specific mortality rates - was calculated for the general population. To study health dipartites, researchers calculated life expectancy based on median income and four racial and ethnic groups: Hispanic, non-Hispanic Asian, non-Hispanic Black and non-Hispanic white.
Deficits relative to 2019 were higher in Hispanic and Black populations than Asian and white populations, 5.18, 4.04, 2.73, and 2.18 years in 2021, respectively. Although life expectancy in the Hispanic population recovered from losses in 2020-2021, the advantage over the white population remained lower in 2024 than in 2019 (1.17 vs. 1.98 years). The life expectancy gap between Black and white individuals remained higher in 2024 than 2019 (6.52 vs. 5.67 years).
Schwandt adds that when analyzing the lowest income populations versus highest, the data shows California is at prepandemic levels of inequality.
Researchers noted that drug overdoses were a major contribution to the life expectancy deficit, almost doubling from 2020 to 2023 across all racial groups, but with greater increases in Black populations, likely reflecting greater exposure to fentanyl.
"Overdose death had increased during the pandemic, and it was in part due to the fentanyl wave, which hit California hard," Schwandt said. "Overdose deaths declined both in the overall U.S. and in California, but California is still above the 2019 level."
Researchers said the increased rates in cardiovascular disease could contribute to the sluggish numbers.
"Increased mortality due to cardiovascular causes could be an explanation for the deficit," Schwandt said. "It could be linked to increasing obesity rates or potentially be linked to a phenomena like long COVID that we don't fully understand yet."
Schwandt is hoping to broaden the scope of the study once the U.S. numbers are available to researchers. "I'd like to analyze the data in rich and poor populations in other developed countries and compare them to the U.S. experience," he said. "How is the world recovering and is there anything we can learn from that?"
The study is titled "The Failure of Life Expectancy to Fully Rebound to Prepandemic Levels." In addition to Schwandt, co-authors of the study include Janet Currie of Princeton University; Till von Wachter and Jonathan Kowarski of University of California Los Angeles; and Steven H. Woolf of Virginia Commonwealth University School of Medicine.
