Between 2018 and 2020 the average US citizen suffered a 1.87-year decrease in life expectancy, the first major fall since 1943. The damage was far from evenly distributed, with Hispanic Americans suffering more than twice the national average fall, the British Medical Journal reports. The years lost are much larger than for comparable countries and don't include the spike in deaths at the start of 2021.

In 2018, American life expectancy was three years shorter than other wealthy nations, a consequence of a health care system that excludes much of the population and many more deaths from guns. Aside from a few nations that managed to largely prevent COVID-19 from taking hold, the pandemic caused falls in life expectancy everywhere, which is pretty much what deadly infectious diseases do. However, the impact was anything but equal.

"When the pandemic came, my naïve assumption was that it would not have a big impact on the preexisting gap between the U.S. and peer countries," said Professor Steven Woolf of Virginia Commonwealth University in a statement. "It was a global pandemic, and I assumed that every country would take a hit. What I did not anticipate was how badly the U.S. would fare ... and the enormous death toll that the U.S. would experience."

Instead, Woolf and co-authors found 16 of the USA's “peer countries” lost less than three months life on average while Americans lost almost two years. For Black Americans, the figure was 3.25 years lost, far beyond that experienced by ethnic minorities in other wealthy countries. This took life expectancy for Black men to the lowest since 1998, reversing trends that have seen the racial gap closing for decades.

The effect was a consequence of not only official COVID-19 mortality but also the “excess deaths” that occurred at the same time among people not tested for the virus.

In the aftermath of the Great Recession, Americans suffered reduced life expectancy, something almost unprecedented in a period of peace with no major disease outbreak attributed to “deaths of despair”.

However, Woolf points out the pandemic has been on a very different scale. "To give some perspective, when the decline in life expectancy was happening a few years ago, it was a decrease of about 0.1 years each year that was making front-page news," he said. "That's the kind of increase or decrease that we're accustomed to each year." "1943 was the last time the US had such a large fall in life expectancy.”

Among the 16 comparable countries for which Woolf found data, six actually saw life expectancy go up in 2020 compared to previous years. This includes Denmark and Finland, which had few COVID-19 deaths compared to the rest of Europe, and New Zealand and Taiwan, which had almost none.

“Our Constitution delegates public health authority to states, so we had 50 response plans. Many lives were lost because so many decisions were driven by politics and ideology. COVID-19 exposed a lot of the systemic problems that have been fueling the long-term decline in the health of Americans,” Woolf said. "And when vaccination gets us past the pandemic, and COVID-19 is in the rear view mirror, those systemic issues will still be with us."