US life expectancy improved in 2022, but child deaths rose, and drug overdoses were deadlier than ever

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Life expectancy in the United States started to rebound in 2022 as death rates from Covid-19 and other leading causes of death dropped, but deaths among children increased, and drug overdoses caused a record number of deaths.

In 2022, a 1.1-year increase brought overall life expectancy at birth to 77.5 years, according to final data published Thursday by the US Centers for Disease Control and Prevention. But that offsets less than half of the 2.4 years of life lost in the first two years of the Covid-19 pandemic, and life expectancy is still lower than it’s been in about 20 years.

The age-adjusted death rate for Covid-19 fell more than half between 2021 and 2022, and it was a key factor driving the overall death rate down 9%. Covid-19 dropped from the third leading cause of death to the fourth, but the virus still killed more than 186,000 people – about 6% of all deaths – in the US in 2022.

Heart disease remained the leading cause of death in the US, followed by cancer, the latest CDC data shows. Death rates ticked down about 4% and 3%, respectively. But together, heart disease and cancer still caused about 2 out of every 5 deaths nationwide.

“Life expectancy gives us a snapshot of the health of a population,” Dr. Steven Woolf, director emeritus of the Virginia Commonwealth University Center on Society and Health, said in an email. He was not involved in the new CDC report but has published research on life expectancy trends. “Vaccination of the population brought a welcome reduction in COVID-19 mortality, and medical care for chronic diseases has thankfully begun to return to normal and that is reflected in the rebound in life expectancy rates.”

But life expectancy in the US is lower than it is for peer countries and has been for decades, he said. Many wealthy countries made more “substantial” recoveries in life expectancy than the US did.

“Put simply, the fact that life expectancy in 2022 was lower than in 2019 means that Americans continue to die at higher rates than they did before the pandemic, despite the rebound,” Woolf said. “We are hardly out of the woods.”

A rising death rate among children, despite the overall decline, is a particularly worrying trend, experts say.

The death rate among children ages 1 to 4 jumped 12% between 2021 and 2022, while the death rate for children 5 to 14 increased 7% year-over-year, according to the latest CDC data. The infant mortality rate also increased, while the death rate for all other age groups decreased.

“This is a red flashing light about the poor health status of Americans and how it now puts our children at risk,” Woolf said. “This trend does not explain decreases in life expectancy for the total population, which is driven by deaths in adults, but it is alarming nonetheless because it means that our children, our most cherished population, are less likely to survive to adulthood.”

Last year, Woolf co-authored an editorial in the journal JAMA reflecting on the crisis of increasing mortality among children and adolescents in the US, a shift that started during the pandemic and threatens years of progress in reducing pediatric mortality rates. The work pointed to homicides, suicides, drug overdoses and car accidents as the principal causes.

“Importantly, these are the same causes of death that have been claiming the lives of young adults in their 20s. What this means is that the causes of death that have been claiming the lives of young adults have now reached down to younger age groups, claiming the lives of teenagers,” Woolf said.

Accidents, or unintentional injuries, were the third leading cause of death in the US in 2022. Drug overdoses account for a significant share of these deaths, and the devastating effects of the drug epidemic persisted into 2022, with drug overdoses killing more people than any other year on record.

Nearly 108,000 people died from a drug overdose in 2022, about 1,200 more than in 2021, according to another CDC report published Thursday.

There are a lot of factors contributing to the overdose epidemic in the US, making it harder to shift the trend from an increase in deaths to a decrease, said Susan Sherman, a Bloomberg Professor of American Health at the Johns Hopkins University Bloomberg School of Public Health.

“It’s a lot easier to go up than it is to come down without really implementing and scaling up services and understanding the drug markets and giving people the power to make informed decisions about using, or quitting using, and then having options afterwards,” Sherman said. She was not involved in the new studies but researches harm reduction interventions to inform drug policy and programming in order to reduce overdose deaths, violence and other harms.

The Covid-19 pandemic may have exacerbated some factors that were contributing to the US overdose epidemic, but it also created opportunities to better reach people with services and support, such as increased flexibility for remote prescribing of medications used to treat opioid use disorder. Some of those flexibilities have started to scale back in recent years.

“There are these evidence-based interventions that really need to be scaled up in a way to reduce the burden of harm in people’s lives,” Sherman said, but they’re not equally accessible to everyone. “We know that this whole continuum of care is something that needs to be accessible to people, but they don’t have the maximum benefit when they’re not scaled up.”

The data shows that the overdose death rate ticked down a bit for teens and adults younger than 35 in 2022, but unintentional injury was the leading cause of death for these age groups by a large margin in 2021.

As in 2021, the overdose death rate was highest among American Indian and Alaska Native people, jumping 15% in 2022, according to the latest CDC data. Overdose death rates also increased among Black, Hispanic and Asian people but decreased among White people.

While deaths from heroin and natural opioids such as morphine and oxycodone decreased, deaths from fentanyl and other synthetic opioids continued their steep upward trend. There were about 23 deaths from synthetic opioids other than methadone for every 100,000 people in 2022, more than double the rate from five years earlier and 4% higher than in 2021.

The rate of overdose deaths involving cocaine spiked in 2022, rising more than 12% in just one year. Deaths involving psychostimulants also increased in 2022, rising 4% year-over-year.

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