A Stark Look at Covid-19 and Racial Disparities
Life expectancy in the United States will almost certainly drop in 2020 due to Covid-19 deaths, extending a decline that frustrates economic demographers like David Bishai, MD, a professor at Johns Hopkins Bloomberg School of Public Health. After rising steadily for 50 years, U.S. life expectancy fell in 2015, 2016, and 2017. The drop wasn’t due to infectious disease or war or any biological limit to how long humans can live, but rather persistent systemic inequities and racial disparities in the health system, along with increases in deaths from opioids, alcohol, and suicide — the latter are what Bishai and other experts call “deaths of despair.”
The ultimate story of Covid-19, written through the lens of history with all the final death statistics, will undoubtedly mirror what we already know from hard data on U.S. life expectancy: On average, the haves outlive the have-nots in a country where the responsibility for health care is placed largely on the individual, and life expectancy varies dramatically based on disparities deeply rooted in geography, wealth, and race.
Globally, the United States ranks 50th in life expectancy, trailing such countries as Cuba, Chile, Slovenia, Portugal, France, and Italy. America is a full five years behind several of the leading nations.
And in America, there are notable gaps in longevity. On average, white men outlive black men by about 4.5 years, and white women outlive black women by about 2.7 years.
More glaring, life expectancy varies by a whopping 20.1 years in U.S. counties with the most favorable numbers — mostly on the coasts and scattered around a handful of other states, including Colorado — compared with counties at the bottom of the charts, which are mostly in the South or have large Native American populations. And things are not getting better for those at or near the bottom: Between 1980 and 2014, the worst counties made no progress, researchers concluded in the journal JAMA Internal Medicine.
That geographic disparity disproportionately affects minorities, the poor, people with underlying health conditions like heart disease and diabetes, and people who often have little choice about working from home or even staying home…