The United States, often regarded as a land of opportunity, faces a stark and growing divide in one of the most fundamental measures of well-being: life expectancy.
A new study published in The Lancet shows the gap in life expectancy across different population groups. While life expectancy is often seen as a marker of national progress, the U.S. is bucking global trends and falling further behind wealthy nations.
But what’s driving this widening gap—and what can be done to reverse it?
A Two-Decade Decline in Equity
Over the past two decades, the life expectancy gap in the U.S. has grown significantly. In 2000, the difference between groups with the highest and lowest life expectancies was 12.6 years. By 2021, this disparity had surged to over 20 years.
Researchers attribute this widening divide to persistent racial and geographic inequities, compounded by the devastating effects of the COVID-19 pandemic.
The study identified “Ten Americas,” distinct population groups defined by factors like race, ethnicity, income level, and geographic location. Asian Americans consistently had the highest life expectancy, averaging 84 years in 2021.
In contrast, Native American or Alaska Native populations in the West faced a staggeringly low average of just 63.6 years—a gap of more than two decades.
Non-Hispanic Black Americans also experienced a sharp decline during the pandemic, with their life expectancy dropping from 74.8 years in 2019 to 71 years in 2021.
COVID-19: A Catalyst for Inequity
The COVID-19 pandemic acted as an accelerant for existing disparities in health outcomes. Historically marginalized populations bore the brunt of the pandemic’s impact, experiencing higher mortality rates and devastating losses in life expectancy.
For example:
- American Indian or Alaska Native communities faced disproportionately high death rates due to limited access to healthcare and chronic underfunding of public health infrastructure.
- Non-Hispanic Black Americans saw significant declines in life expectancy due to higher rates of pre-existing conditions like hypertension and diabetes.
- Geographic disparities also played a role; rural and low-income areas were hit harder than urban centers with better healthcare access.
These trends highlight how systemic inequities amplify vulnerabilities during public health crises, such as unequal access to healthcare, education, and economic opportunities.
The Geography of Health Disparities
Where you live in America can determine how long you live. The study found that rural areas and regions with entrenched poverty—such as Appalachia and parts of the Deep South—had significantly lower life expectancies than wealthier metropolitan areas.
For White Americans living in low-income counties within these regions, life expectancy was markedly lower than that of their counterparts in more affluent areas.
This geographic divide is further compounded by racial segregation within cities.
Highly segregated urban areas showed some of the worst health outcomes for Black Americans due to concentrated poverty and limited access to quality healthcare services.
What Can Be Done?
Addressing this growing crisis requires urgent action from policymakers and communities alike.
Experts recommend:
- Investing in equitable healthcare: Expanding access to affordable healthcare services for underserved populations is critical.
- Tackling systemic barriers: Efforts must focus on dismantling structural racism and addressing economic inequalities that perpetuate health disparities.
- Strengthening public health infrastructure: Rural and low-income areas need targeted investments to improve healthcare delivery.
- Promoting education and economic opportunities: These are key drivers of long-term health improvements.
Without decisive action, these disparities will continue to grow, leaving millions behind in a nation that prides itself on equality.
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Nancy Maffia
Nancy received a bachelor’s in biology from Elmira College and a master’s degree in horticulture and communications from the University of Kentucky. Worked in plant taxonomy at the University of Florida and the L. H. Bailey Hortorium at Cornell University, and wrote and edited gardening books at Rodale Press in Emmaus, PA. Her interests are plant identification, gardening, hiking, and reading.
