{"id":28756,"date":"2025-08-28T04:10:00","date_gmt":"2025-08-27T20:10:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28756"},"modified":"2025-08-28T06:12:52","modified_gmt":"2025-08-27T22:12:52","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e9%a2%84%e6%9c%9f%e5%af%bf%e5%91%bd%e6%9c%aa%e8%83%bd%e5%ae%8c%e5%85%a8%e6%81%a2%e5%a4%8d%e5%88%b0%e7%96%ab%e6%83%85%e5%89%8d%e6%b0%b4%e5%b9%b3","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28756","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u9884\u671f\u5bff\u547d\u672a\u80fd\u5b8c\u5168\u6062\u590d\u5230\u75ab\u60c5\u524d\u6c34\u5e73"},"content":{"rendered":"\n

Research Letter <\/p>\n\n\n\n

The Failure of Life Expectancy to Fully Rebound to Prepandemic Levels<\/h1>\n\n\n\n

Hannes\u00a0Schwandt,\u00a0Janet\u00a0Currie,\u00a0Till\u00a0von Wachter, et al<\/h3>\n\n\n\n

JAMA Published Online:\u00a0July\u00a09,\u00a02025<\/h3>\n\n\n\n

doi: 10.1001\/jama.2025.10439<\/h3>\n\n\n\n

US life expectancy plummeted during the COVID-19 pandemic and increased in 2022-2023.1<\/a><\/sup> Although estimates for 2024 have not been reported for the US, vital statistics 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.<\/a><\/p>\n\n\n\n

Methods<\/a><\/p>\n\n\n\n

Death data for 2019-2024 were obtained from the California Comprehensive Death Files, and population counts for calculating mortality rates were obtained from the American Community Survey.2<\/a> <\/sup>The California State Institutional Review Board waived requirements for informed consent because human participants were not involved. Life expectancy\u2014the estimated lifespan of a hypothetical cohort of newborns based on prevailing age-specific mortality rates\u2014was calculated for the general population. To study health disparities, life expectancy was also calculated for quartiles based on median income in residential census tracts and for 4 racial and ethnic groups (Hispanic, non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White [hereafter referred to as Hispanic<\/em>, Asian<\/em>, Black<\/em>, and White<\/em>, respectively]), as reported in fixed categories on death certificates. Contributions by cause of death were calculated using the Arriaga method. Supplement 1<\/a> details data sources, diagnostic codes, life expectancy calculations, and sensitivity analyses.<\/a><\/p>\n\n\n\n

Results<\/a><\/p>\n\n\n\n

Life expectancy in California increased slightly in the years preceding the pandemic, but decreased sharply after 2019, reaching its nadir in 2021 (Figure<\/a>). Life expectancy recovered thereafter, but a deficit of 0.86 years remained in 2024 relative to 2019. Although residents of the lowest-income census tract quartile (Q1) experienced larger losses than Q4 (eg, 4.25 vs 1.75 years in 2021), the life expectancy gap between Q1 and Q4 in 2024 was similar to 2019 (5.77 vs 5.63 years).<\/a><\/a><\/p>\n\n\n\n

Figure. \u00a0Life Expectancy in California by Income and Race and Ethnicity, 2015-2024<\/p>\n\n\n\n

\"Life<\/a><\/figure>\n\n\n\n

<\/a><\/p>\n\n\n\n

Deficits relative to 2019 were higher in Hispanic and Black populations than Asian and White populations (eg, 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, when it had fallen below that of the White population, the advantage over the White population remained lower in 2024 than in 2019 (1.17 vs 1.98 years) (Table<\/a>). The life expectancy gap between Black and White individuals remained higher in 2024 than 2019 (6.52 vs 5.67 years).<\/a><\/p>\n\n\n\n

Table. \u00a0Life Expectancy, Deficits Relative to 2019, and Contributing Causes of Death by Race and Ethnicity and Income, 2019-2024<\/p>\n\n\n\n

\"Life<\/a><\/figure>\n\n\n\n
<\/th>2019<\/th>2020<\/th>2021<\/th>2022<\/th>2023<\/th>2024<\/th><\/tr><\/thead>
US<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, ya<\/sup><\/td>78.8<\/td>77.0<\/td>76.4<\/td>77.5<\/td>78.4<\/td>NA<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22121.8<\/td>\u22122.4<\/td>\u22121.3<\/td>\u22120.4<\/td>NA<\/td><\/tr>
California<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, y<\/td>81.40<\/td>79.30<\/td>78.48<\/td>79.56<\/td>80.28<\/td>80.54<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22122.10<\/td>\u22122.92<\/td>\u22121.84<\/td>\u22121.12<\/td>\u22120.86<\/td><\/tr>
COVID-19<\/td>0.00<\/td>\u22121.22<\/td>\u22121.80<\/td>\u22120.66<\/td>\u22120.18<\/td>\u22120.11<\/td><\/tr>
Drug overdoses<\/td>0.00<\/td>\u22120.20<\/td>\u22120.36<\/td>\u22120.37<\/td>\u22120.40<\/td>\u22120.17<\/td><\/tr>
Cardiovascular disease<\/td>0.00<\/td>\u22120.23<\/td>\u22120.27<\/td>\u22120.27<\/td>\u22120.16<\/td>\u22120.14<\/td><\/tr>
Undetermined or missing<\/td>0.00<\/td>\u22120.08<\/td>\u22120.04<\/td>\u22120.01<\/td>\u22120.02<\/td>\u22120.07<\/td><\/tr>
Hispanic<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, y<\/td>82.55<\/td>78.39<\/td>77.37<\/td>80.11<\/td>81.15<\/td>81.11<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22124.16<\/td>\u22125.18<\/td>\u22122.45<\/td>\u22121.40<\/td>\u22121.44<\/td><\/tr>
COVID-19<\/td>0.00<\/td>\u22122.82<\/td>\u22123.65<\/td>\u22121.06<\/td>\u22120.21<\/td>\u22120.12<\/td><\/tr>
Drug overdoses<\/td>0.00<\/td>\u22120.19<\/td>\u22120.31<\/td>\u22120.38<\/td>\u22120.42<\/td>\u22120.22<\/td><\/tr>
Cardiovascular disease<\/td>0.00<\/td>\u22120.43<\/td>\u22120.42<\/td>\u22120.25<\/td>\u22120.09<\/td>\u22120.20<\/td><\/tr>
Undetermined or missing<\/td>0.00<\/td>\u22120.07<\/td>\u22120.04<\/td>\u22120.01<\/td>\u22120.02<\/td>\u22120.07<\/td><\/tr>
Non-Hispanic Asian<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, y<\/td>86.57<\/td>84.47<\/td>83.84<\/td>84.78<\/td>85.46<\/td>85.51<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22122.10<\/td>\u22122.73<\/td>\u22121.80<\/td>\u22121.11<\/td>\u22121.06<\/td><\/tr>
COVID-19<\/td>0.00<\/td>\u22121.25<\/td>\u22121.66<\/td>\u22120.68<\/td>\u22120.24<\/td>\u22120.13<\/td><\/tr>
Drug overdoses<\/td>0.00<\/td>\u22120.06<\/td>\u22120.06<\/td>\u22120.09<\/td>\u22120.08<\/td>\u22120.05<\/td><\/tr>
Cardiovascular disease<\/td>0.00<\/td>\u22120.39<\/td>\u22120.52<\/td>\u22120.47<\/td>\u22120.29<\/td>\u22120.25<\/td><\/tr>
Undetermined or missing<\/td>0.00<\/td>\u22120.02<\/td>\u22120.01<\/td>\u22120.01<\/td>\u22120.01<\/td>\u22120.03<\/td><\/tr>
Non-Hispanic Black<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, y<\/td>74.90<\/td>71.67<\/td>70.86<\/td>71.84<\/td>72.76<\/td>73.42<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22123.24<\/td>\u22124.04<\/td>\u22123.06<\/td>\u22122.14<\/td>\u22121.48<\/td><\/tr>
COVID-19<\/td>0.00<\/td>\u22121.18<\/td>\u22121.76<\/td>\u22120.73<\/td>\u22120.16<\/td>\u22120.10<\/td><\/tr>
Drug overdoses<\/td>0.00<\/td>\u22120.37<\/td>\u22120.69<\/td>\u22120.73<\/td>\u22120.99<\/td>\u22120.55<\/td><\/tr>
Cardiovascular disease<\/td>0.00<\/td>\u22120.29<\/td>\u22120.29<\/td>\u22120.40<\/td>\u22120.20<\/td>\u22120.19<\/td><\/tr>
Undetermined or missing<\/td>0.00<\/td>\u22120.19<\/td>\u22120.09<\/td>0.00<\/td>\u22120.03<\/td>\u22120.14<\/td><\/tr>
Non-Hispanic White<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, y<\/td>80.57<\/td>79.20<\/td>78.39<\/td>78.85<\/td>79.41<\/td>79.94<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22121.37<\/td>\u22122.18<\/td>\u22121.71<\/td>\u22121.16<\/td>\u22120.63<\/td><\/tr>
COVID-19<\/td>0.00<\/td>\u22120.60<\/td>\u22121.07<\/td>\u22120.54<\/td>\u22120.17<\/td>\u22120.11<\/td><\/tr>
Drug overdoses<\/td>0.00<\/td>\u22120.25<\/td>\u22120.46<\/td>\u22120.43<\/td>\u22120.42<\/td>\u22120.10<\/td><\/tr>
Cardiovascular disease<\/td>0.00<\/td>\u22120.18<\/td>\u22120.26<\/td>\u22120.30<\/td>\u22120.24<\/td>\u22120.14<\/td><\/tr>
Undetermined or missing<\/td>0.00<\/td>\u22120.09<\/td>\u22120.04<\/td>\u22120.01<\/td>\u22120.01<\/td>\u22120.08<\/td><\/tr>
Census tract quartile 1 (lowest income)<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, y<\/td>79.10<\/td>75.95<\/td>74.85<\/td>76.63<\/td>77.68<\/td>78.11<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22123.15<\/td>\u22124.25<\/td>\u22122.47<\/td>\u22121.42<\/td>\u22120.99<\/td><\/tr>
COVID-19<\/td>0.00<\/td>\u22121.89<\/td>\u22122.62<\/td>\u22120.85<\/td>\u22120.19<\/td>\u22120.11<\/td><\/tr>
Drug overdoses<\/td>0.00<\/td>\u22120.21<\/td>\u22120.43<\/td>\u22120.47<\/td>\u22120.52<\/td>\u22120.26<\/td><\/tr>
Cardiovascular disease<\/td>0.00<\/td>\u22120.32<\/td>\u22120.37<\/td>\u22120.33<\/td>\u22120.16<\/td>\u22120.13<\/td><\/tr>
Undetermined or missing<\/td>0.00<\/td>\u22120.12<\/td>\u22120.06<\/td>\u22120.01<\/td>\u22120.02<\/td>\u22120.08<\/td><\/tr>
Census tract quartile 4 (highest income)<\/td><\/td><\/td><\/td><\/td><\/td><\/td><\/tr>
Life expectancy, y<\/td>84.73<\/td>83.52<\/td>82.99<\/td>83.23<\/td>83.71<\/td>83.88<\/td><\/tr>
Deficit relative to 2019, y<\/td>0.00<\/td>\u22121.21<\/td>\u22121.75<\/td>\u22121.50<\/td>\u22121.02<\/td>\u22120.85<\/td><\/tr>
COVID-19<\/td>0.00<\/td>\u22120.56<\/td>\u22120.88<\/td>\u22120.45<\/td>\u22120.16<\/td>\u22120.10<\/td><\/tr>
Drug overdoses<\/td>0.00<\/td>\u22120.16<\/td>\u22120.20<\/td>\u22120.15<\/td>\u22120.13<\/td>0.00<\/td><\/tr>
Cardiovascular disease<\/td>0.00<\/td>\u22120.20<\/td>\u22120.29<\/td>\u22120.35<\/td>\u22120.27<\/td>\u22120.22<\/td><\/tr>
Undetermined or missing<\/td>0.00<\/td>\u22120.04<\/td>\u22120.02<\/td>\u22120.01<\/td>\u22120.01<\/td>\u22120.05<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

<\/a><\/p>\n\n\n\n

In 2021, COVID-19 accounted for 1.22 years (61.6%) of the deficit relative to 2019. Non\u2013COVID-19 causes became a larger contributor thereafter (Table<\/a>). Two causes of death\u2014drug overdoses and cardiovascular disease\u2014accounted for 20.4% of the deficit in 2020 and 49.9% in 2023. Drug overdoses made a larger contribution in Q1 than Q4 (36.6% vs 12.7% in 2023), whereas cardiovascular disease made a smaller contribution (11.5% vs 26.2%).<\/a><\/p>\n\n\n\n

The increasing role of drug overdoses during 2021-2023 affected all 4 racial and ethnic populations, but was greatest among the Black population. In 2023, overdoses accounted for 0.99 years of the deficit relative to 2019 in the Black population, compared with 0.42 years in the Hispanic and White populations and 0.08 years in the Asian population. Drug overdoses played a smaller role in 2024 than 2023 population wide (0.17 years vs 0.40 years) and in all racial and ethnic subgroups (Table<\/a>).<\/a><\/p>\n\n\n\n

Discussion<\/a><\/p>\n\n\n\n

This study found that California life expectancy remained lower in 2024 than in 2019, due primarily to non\u2013COVID-19 causes. COVID-19 accounted for 12.8% of the deficit in 2024. Although a prior analysis of California data reported that the life expectancy\u2013income gradient increased during 2020-2021,3<\/a><\/sup> by 2024 the gap between Q1 and Q4 returned to prepandemic levels. Life expectancy in the Black population was much lower than in other racial and ethnic populations, and Black and Hispanic populations experienced the largest deficits.<\/a><\/p>\n\n\n\n

The contribution of drug overdoses to the life expectancy deficit relative to 2019 almost doubled from 2020 to 2023, with greater increases in low-income census tracts and the Black population, likely reflecting greater exposure to fentanyl.4<\/a><\/sup> Overdoses contributed less in 2024, consistent with decreasing overdose mortality rates nationwide.5<\/a><\/sup> Cardiovascular diseases contributed substantially to deficits between 2020-2024 life expectancy and that of 2019, especially in high-income census tracts, consistent with California\u2019s increasing obesity rates.6<\/a><\/sup><\/a><\/p>\n\n\n\n

Study limitations include potential misclassification of causes of death, preliminary 2024 death and population counts, reliance on place (census tract\u2013based rather than individual-level income), and the inability to quantify the contribution of long COVID. Results for California may not be generalizable to other states.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research Letter  The Failure of Life Expectancy to […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28756"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28756"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28756\/revisions"}],"predecessor-version":[{"id":28757,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28756\/revisions\/28757"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}